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WHAT IS IMPOTENCE? viagra viagra viagra
The penis is composed of three different regions: a pair of parallel spongy columns called the corpus cavernosum and the central corpus spongiosum, which contains the urethra (the tube that carries urine from the body). All three regions are made up of erectile tissue. Erectile tissue is rich in tiny pool-shaped blood vessels called cavernous sinuses, which are surrounded by smooth muscles and supported by elastic fibrous tissue composed of a protein called collagen. In the flaccid, or unerect, normal penis, the small arteries leading to the cavernous sinuses contract, reducing the inflow of blood. The smooth muscles regulating the many tiny blood vessels within the penis also contract. When a man becomes aroused, his central nervous system stimulates the release of a number of chemicals, including acetylcholine and nitric oxide, that relax the smooth muscles in the penis, allowing blood to flow into the tiny pool-like sinuses and flood the penis. The spongy chambers almost double in diameter due to the increase in blood flow. The veins surrounding the corpus cavernosum and corpus spongiosum are squeezed almost completely shut by the pressure of the erectile tissue; they are unable to drain blood out of the penis, causing it to become rigid.
Oxygen-rich blood is critical for erectile health. Oxygen itself affects two substances that are important in achieving erection: it suppresses transforming growth factor beta 1 (TGF-B1) and enhances prostaglandin E1. The smooth muscles produce TGF-B1, which is a component of the immune system, and one of its roles is to produce collagen. Collagen contributes not only to structural tissue in the body but is also the material that comprises scar tissue. Prostaglandin E1 is produced during erection by the muscle cells in the penis; it activates an enzyme that results in calcium release by the smooth muscle cells, which, in turn, relaxes them and allows blood flow. Prostaglandin E1 also suppresses collagen production. Oxygen levels vary widely from reduced levels in the flaccid state to very high in the erect state. During sleep, for instance, oxygen levels are high and a man can normally have three to five erections per night, each one lasting from 20 to 40 minutes.
Normal levels of hormones, especially testosterone, are essential for erectile function, though it is not clear what their role is in potency.
Impotence (Erectile Dysfunction)
Impotence or erectile dysfunction is the inability to achieve or maintain an erection sufficiently rigid for intercourse, ejaculation, or both. It does not affect sexual drive or the ability to have an orgasm. Rarely does erectile dysfunction signify a chronic problem. When a consistent pattern of sexual dysfunction extends over a prolonged period of time, however, a physical or serious emotional disorder may be indicated. Impotence is not new in the medical texts or in human experience. It is not easily or openly discussed, however. Our cultural expectations of male sexuality have forced many men to refrain from seeking help for a disorder that can, in most cases, benefit from medical treatment. Perhaps a good first step is to think of the problem as erectile dysfunction instead of impotence, a term which comes from the Latin meaning "loss of power." Certainly this physical event, usually temporary and normal, should not be described exclusively with a word falsely suggesting a sweeping diminution in a man's overall capabilities.
What are the Symptoms of Impotence?
The characteristic symptom of impotence is a change in the quality of the erection, either in rigidity, in the ability to sustain the erection, or both. One indicator of physical impotence, as opposed to psychological, is the inability to experience or maintain an erection upon waking up in the morning. Psychological impotence tends to be abrupt and related to a recent situation; physical impotence occurs gradually but continuously over a period of time. Also, with psychological impotence, a man may be able to have an erection in some circumstances, but not in others. Impotence persisting over a three-month period and not due to an apparent stressful event, drugs, alcohol, or medical conditions signals the need for medical attention by a urologist specializing in impotence (as one in three urologists do).
How Serious Is Impotence?
Impotence is not life threatening, of course. It can be symptomatic, however, of other serious problems, such as atherosclerosis, diabetes, and hypertension. Impotence can also be indicative of an injury, age-related changes in tissue, or the possible long-term effects of risky behaviors such as smoking, heavy drinking, or an unhealthy diet.
Psychological factors related to impotence can be significant. Erectile dysfunction can have a devastating effect on a relationship and can cause extreme depression, which may become chronic if the erectile dysfunction is not treated.