Sexual arousal disorder in men (impotence), the causes of impotence (Erectile dysfunction)

Sexual arousal disorder in men (impotence) - failure to erect or to maintain it at a level sufficient to perform normal coitus. Dysfunction may be primary and secondary. Primary dysfunction occurs very rarely and in cases not associated with organic lesions, it usually indicates the presence of serious psychopathological disorders. In secondary dysfunction impotence hampered the completion of more than 25% successfully initiated sexual acts.
Etiology

Primary impotence is almost always intrapsi-psychotic reasons. In rare cases, lead role in the genesis of primary impotence belongs biogenic factors, usually associated with low testosterone levels and thus a violation in the hypothalamus-pituitary-gonad; casuistic cause may be vascular pathology. By intrapsychic causes of impotence are the primary pathological fear of the vagina, the experience of sexual guilt, fear of intimacy, depression.

Over 50% of cases of secondary impotence, also called mental factors. These factors, referred to as "direct" causes (see above), may be included after a transient episode of impotence of any etiology.

Impotence may be situational, ie, conditioned place, time, specific partner, fear of failure, undermine self-esteem.

Impotence can also cause systemic factors. These include: systemic diseases (most often - diabetes mellitus, and syphilis, alcoholism, dependence on psychoactive substances, hypopituitarism, hypothyroidism), local disorders (eg, congenital disorders and inflammatory diseases of genital organs), cardiovascular disorders, such as aneurysm aorta and atherosclerosis (eg, Leriche), nerve disease (multiple sclerosis, spinal cord injuries, mikroadenoma with hyperprolactinemic pituitary, heart spasms), intake of certain drugs such as hypertensives, sedatives, tranquilizers, and amphetamines; surgical procedures, such a sympathectomy. Effects of prostatectomy and castration are highly variable. Transurethral prostatectomy is usually not accompanied by the development of impotence, but after perineal prostatectomy impotence occurs almost always. However, such a common consequence of prostatectomy, as retrograde ejaculation, does not depend on the method of surgical intervention.

Impotence is not an inevitable attribute of aging and may be absent at the eighth and ninth decades of life. And if the age of the frequency and severity of ejaculation, and hence the degree of sexual tension and the need to ejaculate decreased, the capacity for erection often persists.