Understanding Impotence

Impotence is a term that has mostly fallen out of use, in favor of the more descriptive and clinical term erectile dysfunction, although it is still used at times in both in popular culture and by some physicians when talking about sexual dysfunction in males (for example, there is still a medical journal called The International Journal of Impotence Research).

What Is Impotence?

The way it's used today, impotence refers in general to a man's inability to perform sexually, and specifically to his inability to get an erection. Of course, impotence has many other meanings, including powerless, helplessness, weakness, etc... The inaccurate idea that if a man can't get an erection, he has no sexual power, is what makes impotence such a dangerous but also popular term. It's a word that strikes fear in the hearts of those who are worried it might happen to them, and causes pain when it's directed at someone as an insult.

Impotence isn't an accurate term because the truth is that men have sex all the time with and without erections, and a man's sexuality or power isn't related to just one part of his body. When we confuse ability to get erections with ability to give and receive sexual pleasure, we make worse a complicated and common sexual complaint -- an inability to get an erection that is satisfactory for sexual pleasure.

In order to understand why erections don't work, you need to understand the basics of how erections work. Getting an erection involves multiple parts of your body, including your brain, nerves, hormones, muscles, and heart. Anything that interrupts this any of these systems may result in what gets called impotence.

Causes of Impotence

Because erections involve multiple systems, there are often multiple causes of impotence, even for one man. Causes of impotence are often broken down into different categories. These include:

Physical Causes:

• Diabetes
• High blood pressure
• Multiple sclerosis
• Parkinson's disease
• Heart disease
• Conditions that affect thyroid function and/or interrupt hormones in the body
• Spinal cord injuries
• Injuries to the groin (recent research also points to consistent but mild trauma related to cycling)
• Colon surgery
• Hemodialysis
• Prostatectomy
• Other treatments for prostate, penile, and rectal cancers, including some chemotherapy and hormone treatments
• Medications for high blood pressure, heart disease, and some antidepressants
• Alcohol
• Marijuana
• Cocaine
• Tobacco

Psychological Causes:

• Depression
• Stress
• Sexual performance anxiety
• Relationship problems (which may or may not be related to sex)

Treatments for Impotence

Once you've determined the cause or causes, there are various treatment options, including:

• Medications to treat impotence
• Products
• Penile rehabilitation
• Surgery
• Sex therapy
• Natural remedies

What Should I Do If I Think I'm Impotent?

If you are experiencing difficulty with erections, the first step should be to speak with a doctor. Erectile difficulties may be an early warning sign of other potentially serious health problems -- your body's way of telling you that something else is going on. It's important to understand what might be causing the changes in your erections.

In addition to seeing a physician, you may want to consider speaking with a therapist or counselor, and perhaps a sex therapist. Sex therapists specialize in the diagnosis and treatment of sexual dysfunctions. If you see a sex therapist, you'll also need to get a medical exam, but a therapist will likely have more information than your regular doctor about the details of sexual dysfunction.

One of the most difficult aspects of erectile difficulties is the way that our thoughts and feelings can perpetuate our difficulties. We all have the right to use language we want to describe ourselves. But you may want to consider how describing this problem as impotence, or calling yourself impotent, is actually working against your goal of feeling positive about yourself and your ability to both give and receive sexual pleasure.

What Should We Call Impotence?

The term impotence is already in the process of disappearing from medical literature (although it's a slow process). Impotence is a problem in part because of the way it makes men feel, and also the message it explicitly sends about sexual power being only about erections. Impotence is also a problem because it isn't precise. This might be fine for literature, but if you're trying to isolate and solve a health problem, the more precise you can be, the better. So impotence should be called whatever it actually is. If it's erectile dysfunction, call it that. If it's premature ejaculation, call it that. If it's a bad relationship, or a bad year, call it that.

Source: About.com

Changes in Men's Sex Life Due to Aging

Sex and Aging for Men: Main Changes

Primarily due to a drop in testosterone, men will experience changes in their sexual function as they age. These changes include (see sex tips for the older man for tips on dealing with these changes):

• Fewer sperm are produced
• Erections take longer to occur
• Erections may not be as hard
• The ‘recovery time’ (time between erections) increases to 12 to 24 hours
• The force of ejaculation decreases
• Sexual desire decreases are due to emotional reasons or health problems

Decreased Testosterone

As a man ages, his testosterone levels decrease. Typically this decrease in testosterone stabilizes around age 60. Testosterone decrease is the primary reason for many of the conditions listed above. Testosterone replacement therapy is becoming popular for addressing concerns of aging men. This type of hormone treatment is controversial and should be approached with caution. Increasing muscle mass through exercise and proper nutrition can help maintain a healthy testosterone level.

Cardiovascular Disease, High Blood Pressure and Male Sexual Health

These health conditions alter how the blood flows in the body. When the arteries become narrower and harder, blood does not flow as freely. This can be troublesome for men trying to achieve an erection, as erections depend on the ability of blood to fill the penis. Controlling high blood pressure and other cardiovascular diseases through lifestyle change and medication can improve sexual performance.

Diabetes and Male Sexual Health

Many men with diabetes have normal sexual lives. However, diabetes can cause impotence, the inability to have sex. Men with diabetes are approximately three times more likely to experience erectile dysfunction than men without diabetes. They also experience this condition approximately 15 years earlier than men without diabetes. If you have diabetes and are having trouble maintaining an erection, talk to your doctor. Many medications can help.

Pain and Male Sexual Health

Many health conditions such as arthritis, back pain and shingles can interfere with sex by causing pain that may make sex uncomfortable. These conditions also can alter your mood, sleep habits and attitudes. Experimenting with different sexual positions and techniques can help. You can also talk with your doctor about managing pain.

Incontinence and Male Sexual Health

Incontinence is the loss of bladder control which can cause urine leakage. This condition becomes more common as people age. Often leakage occurs during exercise, laughing or coughing. During sex, extra pressure is placed on your bladder. Men with an incontinence condition may be afraid to have sex. By controlling incontinence through medical or behavioral approaches, the chance of leakage during sex can be greatly reduced.

Medications and Male Sexual Health

Some of the medications prescribed to treat common age-related health conditions can interfere with sex. Some blood pressure medicines, antidepressants and diabetes drugs can make it more difficult for men to maintain an erection. These medications can also reduce sexual desire. You may be able to use alternative medications if you experience these side effects. Talk to your doctor.

Prostatectomy: Prostate Surgery

A prostatectomy is a surgical procedure that removes some or all of a man’s prostate. This is often done to treat prostate cancer or an enlarged prostate. A consequence of this surgery can be incontinence or impotence. Before undergoing a prostatectomy, be sure to talk to your doctor about any concerns you have about your sex life.

The Bottom Line

If you are not satisfied with your sexual ability, talk to doctor. Changes in your medication, managing your health conditions and treatment of sexual problems may help.

_Source:

National Institute on Aging. Bound For Your Good Health: Sexuality in Later Life. NIH Publication Number 05-7185.

How To Talk to Your Partner About Your Sexual Issues or Concerns

Whether we are in a brand new relationship or have been married for forty years, when it comes to talking with our partners about sex, panic can often set in.

When we imagine the potential for rejection and drama, taking a risk like that with someone we love can often feel too great. This is probably the reason so few of us do try to share the really difficult stuff of our sexual lives. Here are ideas on raising those hard-to-raise issues.

Difficulty: Hard

Time Required: Allow as much time as possible.

Here's How:

1. Clarify the Issue for Yourself
   Sex is complicated, your feelings may have as much to do with your own baggage and history as with your partner. If something is on your mind, sit with it for a while and clarify what doesn’t feel right. Some people find that writing a helpful way to do this; others will talk with close friends. The point of this is not to start complaining to others or placing blame. The exercise is all about you and how you feel.



2. Try to Write it Down
   Don’t worry about floral language or grammar. Writing down what you want to talk about is a great step to clarify your issues for yourself and practice the way you might communicate it to your partner. Some people actually write their partner a letter, and end up giving it to them at a later point. Letter writing can be a powerful way to communicate your thoughts and feelings, and if done along with talking it can increase intimacy in a relationship in surprising ways.



3. Practice the Talk
   This doesn't work for everyone, but if you’re nervous about talking it can help to do some practice talking. If you have a good friend you can do this with, great. If not, going through it on your own can help. Before every major “talk” I’ve ever had to do, I sit down in front of my computer screen and practice. If my monitor could talk, it would probably tell me to get a life, but it’s a great tool for me (and I’m pretty sure my monitor is too old a model to be talking).



4. Consider Your Timing
   One of the most important considerations is when to talk. This will depend a lot on what you are talking about. If you want to raise the idea of trying something new in bed, then raising it just before you’re about to be intimate with your partner is probably not a good time. Ditto for raising your dissatisfaction with the frequency of your sex life minutes before your kids are due home (or your in-laws are coming over).



5. Choose Your Location
   As with timing, location can make a difference. Bringing up sexual dissatisfactions in bed can be a bad move as it may create an association of negativity in your bed. Both you and your partner may also feel more vulnerable in bed than you would having the conversation fully clothed, out for a late-night walk.



6. Allow Time for Processing
   Remember that your partner may be surprised by what you are saying. Give both of you the time and space to respond honestly without having to feel rushed or pressured. You may not be able to completely resolve the issue, or even talk about all the aspects of the issue in one sitting. Think about sexual communication as an ongoing process, not a one-shot deal.



7. Be Generous
   No matter how hard it is for you to bring up your sexual concerns, if you are the only one raising them, consider that it may be even harder for your partner. If you can, try to be generous with your partner and try not to place the blame too heavily on either of you. There are two of you in the relationship, and ultimately both of you need to take responsibility for what is happening.



8. Check In Afterwards
   Sometimes we can make ourselves so anxious about bringing something up with a partner, and then it goes not quite as bad as we thought, and we’re relieved, so we want to just move on. Give yourself permission to bring the topic up again. Don’t do it in a nagging way, but make it clear that your partner that you care about how they feel and you want to check in with them about how the conversation went.

Tips:

1. Keep in mind that every situation is different. These are general tips and your situation may call for many additional considerations.



2. Remember that your imagination can be your worst enemy when it comes to taking risks like this. The reality is that the response is almost never as bad as you think it will be, and talking openly about your sexual feelings, desires, likes and dislikes, can not only improve your sex life with your partner, it can improve other aspects of the relationship.

Source: About.com

Reasons why men feel pain during sex

Pain During Intercourse

Experiencing pain during intercourse affects sexual performance as well as pleasure. It can even have lasting psychological effects such as fear of penetration leading to impotence. Not surprisingly, equating pain with intercourse can put a strain on relationships, so in this article I look at some of the physical causes of pain during intercourse.

Infection
Pain can arise because of infections such as herpes or sexually transmitted diseases such as untreated gonorrhea.

Foreskin Problems
An overtight foreskin (phimosis) or damage to the foreskin resulting from tearing, friction or inflammation can all lead to pain.

Deformities of the Penis
Conditions such as hypospadias or scar tissue from previous traumas or infections.

Priapism
This is a condition where a non-sexual and often painful and sustained erection occurs.

Allergy
Allergy to the penis by vaginal fluids or contraception chemicals.

Hypersensitivity of the penis
This can occur post orgasm and ejaculation. Growths (benign or cancerous), urinary tract stones or penile deformities.

Action
Pain during intercourse is not normal and should be checked out by a medical practitioner. Do not continue attempting intercourse until you have recieved treatment. This is especially important if the cause of pain is due to infection.

Source: About.com