For powerful sexual activities, people often use bunny rabbit or horse as a symbolic representation. These symbols have been used for a long time since bunny rabbit is a symbol for Playboy in sex, due to its brisk, funny, jumping activities and its indulgence in sex, and the horse is an indicator of power, for gaining vim and vigour. Some others may show a masculine body to denote power. In olden days, men had multiple wives and they were also able to satisfy all of them with their physique, healthy food and good, hard work. But this era of white collar jobs with hurried and tensed lifestyle which does not allow for it
Friday, June 27, 2008
Impotency and Treatment
For powerful sexual activities, people often use bunny rabbit or horse as a symbolic representation. These symbols have been used for a long time since bunny rabbit is a symbol for Playboy in sex, due to its brisk, funny, jumping activities and its indulgence in sex, and the horse is an indicator of power, for gaining vim and vigour. Some others may show a masculine body to denote power. In olden days, men had multiple wives and they were also able to satisfy all of them with their physique, healthy food and good, hard work. But this era of white collar jobs with hurried and tensed lifestyle which does not allow for it
Impotency
Impotency can pose in different forms depending on the types of origin
Difficulty in getting erection (varies from occasional or partial or complete, etc.)Difficulty in sustaining erection (varies from short span to zero time)
Difficulty in performing the sexual activity
Difficulty in ejaculation or early ejaculation
Sex without satisfaction in size, time and act.
Before discussing the cause of impotency and its treatments, everyone should know about the organs involved in sexual activity in the right way.
Testis - The two male gonads are small oval-shaped glands which hang in a scrotal sac of the inguinal region. They produce sperms. The testis originates in the abdomen and gets descended from the third month of uterine life to the scrotal sac. The ectopic or undescended testis may end in failure. The testis is mostly covered with convoluted seminiferous tubules. The secretions of seminal vesicles and bulbar glands add for the bulk or volume of semen. It is the responsible organ for manliness or maleness with its male hormones.
Sperm- is the spermatozoa of men. It is dispersed through semen. Semen is a mix of sperms and secretions which get ejaculated at the end of sexual act from the penis.
Prostate gland is located just below a male's bladder and surrounds the top portion of the urethra contributing to the sexual function with its secretions. It adds for the volume of the semen and it neutralises the acid suspension of the sperm and makes the sperm more capable of motion and increases the likelihood of fertilisation. Its secretion is continuous and more during the sexual act. The benign tumour of the prostate in old age will cause increased desire, priapism (persistent erection of the penis in night) and spermatorrhoea.Penis is a muscular & vascular organ which appears as a long slender shaft in a male. The penis is mainly composed of erectile tissues which are made of sponge-like work that can be filled with blood. The penis is capped with glans penis which is partially covered with prepuce. The glans penis has most sensitive receptors for stimulation of erection and ejaculation. The penis consists of two long columns of the corpus cavernosum and one column of corpus spongiosum. The corpus cavernosa has much arterial supply and blood vessels which usually get filled during erection and account for size enlargement. The centre of corpus spongiosum is pierced with urethra, the tube through which urine or semen get emerged. During sexual excitement, the penis gets engorged with blood and lubricating mucous gets poured into the urethra. Finally erected penis propels the semen deep into the vagina in a series of spurts followed by flaccidity of the penis.
The size and strength of the organ varies from person to person and races. Many males normally crave for long thick penis to satisfy their partner and go for unnecessary treatment. Even though science has proved that the size of the organ is not at all important in activity, as the vaginal canal of the female is sensitive for the initial 4-5cms only, males have a constant craving for it. But in extreme cases of small penis, surgery could help.
The tip or end of the penis has urethral opening. It is the common pathway or outlet for passing urine as well as semen, but never both at a time. If there is a leak of semen in urine, it is called spermatorrhoea which should be treated to avoid weakness.
Erection of penis Penis erection during sexual activity is important for penetrating the vagina. Also a firm erection is absolutely needed to lodge the semen deep in the vagina. The erection of the penis due to the filling up of the erectile tissue with blood makes it rigid and elevated. It depends upon the mental or physical make-up of the person. It gets varied depending upon the partner, places, stimulation and moods. The erected condition of the penis closes the opening of the bladder end and opens the opening of vas end. Normally, a male will have 2-3 erections in sleep (in REM type during dreams which occurs mostly in the early morning).
Mechanism of getting erection - Penile erection is mostly controlled by the autonomic nervous system, i.e. sympathetic and parasympathetic nerves. The stimulation can be from psychogenic or genital touch. On getting stimulation, from brain or genitals,
§ Penis blood supply is increased in many ways
§ Venous return of the penis is blocked for holding all incoming blood in the penis itself
§ The blood filled penis gets elevated and becomes firm
If anything goes wrong, the penis will be flaccid and not enable sexual activity.
Ejaculation - is the sudden forcible expulsion or throw or spurt of semen into the vaginal canal from the penis to reach the uterus. The erected penis will throw semen deep into the vagina. Or, otherwise, it oozes out. It is a reflex phenomenon which intensely makes it a pleasurable sensation for men. The stimulation of ejaculation arises from the glans penis which finally pours the sperm into the vagina with the contraction of the smooth muscles of various glands and ducts. Early ejaculation may occur prior to penetration, or before getting orgasm.
Nowadays, you can see advertisements from money-minting people who promise extra long time for ejaculation. Sometimes, this extra long time may cause failure in getting ejaculation and satisfaction.
Libido - is the psychological feeling for moods of sex. It drives and keeps us in sex.
Orgasm - is the height or apex in the sexual excitement. The violent muscular contractions and movement of the body including the changes in heart beat, respiration and blood pressure with excitement accounts for the orgasm which is followed by a pleasant fatigue.
Female reproductive organs
Vagina is the sheath-like structure forming vaginal canal of nearly three inches from vulva to cervix. It accepts penis during sexual activity. Inflammation may cause pain, loss of libido and white discharges. Itching and urinary tract infection can also spread infection inside the vagina and reflect in sex. Dryness of vagina will cause difficulty in sexual activity and painful sex.
Uterus is the hollow muscular pouch or organ which usually gets prepared during every period for providing lodging facility for the fertilised ovum (if any). It takes care for the accommodation, nourishment and development of the fertilised ovum. If fertilisation of egg doesn't occur, then it sheds its layers as menstrual bleeding.
Ovaries - are a pair of almond-sized organs which is kept loosely by the side of the uterus by a fold of peritoneum. They manufacture eggs for fertilisation and it is the organ responsible for the sexual moods and femininity of the female.
Fallopian tube - is a tube which leads the ovum from the ovaries to the uterus. Usually fertilization occurs in the middle of the fallopian tube. In case of blocked tubes, the egg or sperm will not be able to reach each other, for fertilisation which may result in infertility.
Ova or ovum - the egg of the female, which after getting fertilised have the ability to become an offspring.In the female reproductive organs, except the vagina, nothing else is involved in the sexual activity. Ovaries may account for moods.
Check how Potent you are
Please read the following questions, and answer true or false. Total the number of true, and false answers at the end of the questionnaire, and see how well you did.
- Erectile dysfunction is often called the most common untreated medical disorder in the world.
- Erectile Dysfunction may be caused by medications for high blood pressure, cigarette or recreational drug use, partner conflicts, or depression, to name a few.
- Erectile dysfunction effects nearly 20 million men in the United States.
- Erectile dysfunction is a difficult subject for many people to discuss. It is often accompanied by embarrassment, guilt, and lack of self-esteem.
- Erectile dysfunction can be successfully treated over 95% of the time.
- Erectile dysfunction is not merely a consequence of growing older, although it is often due to the consequences of medical conditions.
For scoring purposes, give yourself two points for each right answer. The answer to questions 1-6 are "True."
- If your score is 8 or above, you have a pretty good understanding of Erectile Dysfunction. Read on…
- I am confident that I can get and maintain an erection hard enough for penetration (entering your partner).
- During sexual intercourse, I always maintain an erection to satisfactory completion.
In general, I rarely worry about successful sexual performance. - When I attempt sexual intercourse, it is almost always a satisfactory experience for me.
- I would rate my overall level of desire for sex, as moderate to high.
- I would rate my overall sex life as moderate to very satisfying.
If you answered "False" to two or more questions between 7-12, you may want to talk to your urologist about ED.
Impotence: Causes and Solutions
Impotence, the persistent inability to achieve and maintain an erection for intercourse, affects as many as 18 million men in the United States between the ages of 40 and 70. Until recently, doctors thought impotence was mainly rooted in psychological causes. Now it is believed that 50 to 70 percent of all cases are caused by physical problems. Erection difficulties tend to increase with age, but that is not the only or even the most important factor. Your general physical and psychological health, as well as lifestyle habits and certain medications, can all cause impotence, but you don't have to live with this problem. In most cases, impotence can be successfully treated.
How Does an Erection Occur?
In order to get an erection, several parts of the body must work together. The brain sends a message of sexual arousal through the nervous system to the penis. This message causes the muscles along the penis to relax. At the same time, the artery to the penis dilates to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. A breakdown in any of these systems makes getting or keeping an erection difficult.
Virtually all men occasionally fail to get an erection. That's normal. But if a man has trouble getting or maintaining an erection about 25 percent of the time, he should see an urologist. These physicians specialize in disorders of the kidneys, bladder, prostate, penis and urethra.
Usually, after asking questions about when and how the impotence developed, the urologist will give the patient a complete physical exam to determine if his hormone levels are normal and if the blood vessels, nerves and tissues of his penis are working properly. If this initial work-up doesn't pinpoint the cause of the problem, a nocturnal penile tumescence test can be done.
Men with no physical abnormalities almost invariably have nightly erections during sleep. The patient may spend a few nights in a sleep laboratory where a gauge that measures the frequency and duration of nocturnal erections is attached to the base of the penis. A home version of this, the snap-gauge test, can also be used. Before going to sleep, the patient attaches the gauge to the base of his penis. During the night, the gauge will break at different degrees of penile rigidity and show whether a partial or full erection has taken place during sleep. If nocturnal erections do not occur, the impotence is most likely physical. Additional testing is then required to identify the precise cause of the problem.
To Help Prevent Impotence
Exercise regularly
Limit the amount of fat and cholesterol in your diet
Drink only in moderation
Don't smoke
What Are the Physical Causes of Impotence?
Physical impotence occurs when there is a problem with any of the systems needed to get or maintain an erection. The good news is that potency can usually be restored when a man is treated for underlying medical conditions, when medications are adjusted or when lifestyle habits are changed.
Here are some of the top causes of impotence:
Vascular Disease. Hardening of the arteries can affect the artery leading to the penis so that it cannot dilate enough to deliver all the blood necessary for an erection. Impotence can also occur if the nerves that control blood flow to the penis are damaged.
Diabetes. One out of every four impotent men has diabetes, which can cause nerve deterioration (diabetic neuropathy). Impotence may result if nerves or blood vessels that control the flow of blood to the penis are affected. In some cases, keeping the diet and blood sugar under control can decrease impotence. But permanent nerve damage can result in a chronic problem.
Disease of the Nervous System. Some conditions, such as multiple sclerosis, Parkinson's disease and spinal cord injuries, can affect or cause impotence.
Cancer Surgery. Surgery to remove cancer from the prostate, bladder, colon or rectal area can cause impotence if the nerves and blood vessels that control erections are damaged in the process of removing cancerous tissue.
Medications. Some prescription medications for high blood pressure, depression, spinal cord injury, diabetes and other conditions can cause temporary impotence by interfering with the nerve impulses or blood flow to the penis. Doctors may be able to adjust the dosage of a drug or change the medication to reverse or minimize the problem.
Smoking. A recent study at the New England Research Institute in Watertown, Massachusetts, found that impotence was equally common among smokers and non-smokers in general. However, among men with certain health problems, those who smoked were much more likely to have potency problems. For example, 56 percent of smokers with heart disease were completely impotent compared with only 21 percent of non-smokers with the disease.
Alcoholism. Excessive alcohol consumption disrupts hormone levels and can lead to nerve damage. This type of impotence may be reversible or permanent depending on the severity of the nerve damage. Some clinical studies suggest about 25 percent of all alcoholics become impotent -- even after they stop drinking.
Hormone Imbalance. Abnormal testosterone levels are rare, but they can cause impotence. In addition, other illnesses, such as kidney failure and liver disease, can disrupt the balance of hormones.
What Are the Psychological Causes of Impotence?
A man who is depressed, under stress, or worried about his "performance" during sex may not be able to have an erection. Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Some impotence problems can be solved when a man understands the normal changes of aging and how to adapt to them. For example, as men get older they generally need more direct stimulation to achieve an erection. They may also have less firm erections, take longer to ejaculate and need more time between erections.
Relationship woes can interfere with potency and so can job stress, depression or financial worries. Impotence may also be the result of deep-seated emotional trauma, such as having been sexually abused as a child. Qualified psychotherapists can diagnose such problems and help men understand and overcome them.
What are the Treatment Options?
When treatment of underlying physical or psychological problems fails to restore potency, a man and his sexual partner can consider one of the following solutions:
Viagra. The most recent treatment for impotence approved by the FDA, this prescription drug is expected to benefit 70% of men with erectile dysfunction and has revolutionized the way impotence is treated. All a man needs to do is pop a Viagra pill an hour before sexual activity and the medication works on normal body chemistry to allow blood to rush into the penis when a man is sexually stimulated (men should take no more than one pill a day). Despite all the hype about Viagra, men should exercise caution in deciding whether this drug is right for them.
Vacuum Device. With this treatment, a man slips a hollow, plastic cylinder over his flaccid penis. He then attaches a hand pump to draw air out of the cylinder, creating a vacuum that draws blood into the penis. Once the penis is erect, the man slips an elastic ring over the cylinder onto the base of his penis and removes the cylinder. The ring will keep blood from flowing out, allowing intercourse.
Note: This device should only be used when seeing a doctor regularly since mishandling can damage the penis.
Self-Injection. One or more drugs (papaverine, phentolamine and prostaglandin-E1) can be injected into the penis to increase blood flow. The injection is nearly painless and produces a more natural erection than a vacuum device or implant. However, until the proper dose is worked out, a man might have a prolonged and painful erection. In rare instances, an erection that does not go down after ejaculation may require surgery.
Penile Implants. Surgical implants can be used as alternatives if the above treatments are unsatisfactory. Experts at the Mayo Clinic say there is a 10 to 15 percent chance that an implant will malfunction within five years, but the problem almost always can be corrected. Over 90 percent of patients are satisfied with these devices.
The two major types are:
Malleable Rods. Two long rods (also referred to as semi-rigid prostheses) are inserted into the outer channels of the penis through a small incision in the lower abdomen or scrotum. Each rod is one solid piece and so remains erect at all times. However, they can be bent close to the body for concealment. Because there are no moveable or inflatable parts, malfunctions are rare.
Inflatable Cylinders. These devices consist of one or two inflatable cylinders, a finger-activated pump and an internal reservoir that stores liquid used to inflate the tubes. All components -- the cylinders, pump and reservoir -- are implanted within the penis, scrotum and lower abdomen respectively. When the pump in the scrotum is manually squeezed several times, the fluid from the reservoir is released into the cylinders. They expand and create an erection, which is maintained until the release valve on the pump is squeezed to return the fluid to the reservoir.
Case Study
- A study done at the Boston University School of Medicine linked overall health to impotence. Researchers studied the medical histories of 1300 men aged 40 to 70. They found some impotence in a total of 52%. Men who were being treated for heart disease, high blood pressure, or diabetes were one and a half to four times more likely than the overall group to be completely impotent later in life. The situation was even worse for men who had heart disease or hypertension and who smoked.
- Alcohol intake decreases the body’s ability to produce testosterone. Research at Chicago Medical School revealed that drinking alcohol may cause the mormonal equivalent of menopause in men. Alcohol not only affects sexual function, but also helps set the stage for a heart attack and other dangerous conditions.
- Arteriosclerosis, which restricts blood supply to the penis and to the nerves that govern sexual arousal, may result in a "failure to perform." If impotence is related to clogged blood vessels, a diet low in fats can actually help reverse the problem.
- A study done at Boston University showed that men who smoked one pack of cigarettes a day for five years were 15 percent more likely to develop clogging in the arteries that serve the penis, a situation that can cause impotence. In addition, heavy smoking decreases sexual capability by damaging the tiny blood vessels in the penis. The use of marijuana and cocaine also can result in impotence.
- Duplex untrasonography, a noninvasive method of measuring penile blood flow, is a reliable method of determining whether arterial occlusion plays a role in impotence. If you doctor believes atherosclerosis to be the underlying problem, he or she may advise vascular surgey to improve blood flow to the penis.
- According to figures from impotence organizations, only about 5 percent of the estimated 30 million men affected are aware of therapy options.
- Urologists differ in the types of treatment they recommend for impotence, but many opt first for nonsurgical treatment.
- Injections of the drugs papaverine (Pavabid) and phentolamine (Regitine) or prostaglandin E1 (PGE1) into the base of the penis before intercourse have been shown to be roughly 80% effective in producing "satisfactory erection" in impotent men who have tried it. The drug alprostadil also is available in an injection kit (Caverject). These drugs work by relaxing smooth muscle, causing the blood vessels in the penis to dilate, promoting an erection that can last an hour or more. An estimated 300,000 men in the U.S. use this technique each year. Possible side effects include priaprism (prolonged, painful erections). Also, although the injections are done with a tiny needle, and are supposed to be painless when done properly (proper technique is crucial), this prospect is unappealing to many men. A less invasive technique, which involves instilling alprostadil into the urethra with a tiny plunger, is under development and is expected to become available in the near future.
- Yohimbine (sold under the brand names Dayto, Yocon, and Yohimex) is a prescription drug that has been approved by the FDA for treatment of impotence. Its effectiveness is questionable, however. Many experts consider it to be, in essence, a placebo. Yohimbine has an effect on the body similar to that of adrenaline; it speeds up the heartbeat and elevates blood pressure. Beware of yohimbine if you have high blood pressure.
- Three drugs may offer hope. Viagra has achieved very good results in men with psychogenic impotence and also in men with organic impotence. The intensity of the erection is enhanced as well as overall performance and there may be major side effects, and a risk of death for some patients. A doctor will be able to determine if Viagra is right for you. (For books on the subject, check "Books" "Issues" "Health-General".) Vasomax has been used for years as an injectable medication and is now being tested in pill form. It is another medication which works to dilate penile blood flow in men with mild vascular problems. Apo-Morphine is being evaluated for treatment of only psychogenic impotence.
Medical Urethral System for Erection (MUSE) is a cream which is absorbed through the urethra and dilates the cavernosal spongy tissue of the erectile chambers. It has about a 66% success rate and anxiously awaits approval to replace injectable forms of therapy. - Injection Therapies - Papaverine was the first effective medical treatment for ED. To date, there are two currently approved by the FDA. Caverject and Edex which are effective in about 85% of patients. Occasionally, Papaverine by itself or with Regitine and Prostaglandin E will be used, which is much better than any on eof them used alone. Some men will have erections lasting a few minutes to 45 minutes. Dosage determines this. Used immediately after radical prostatectomy or radiation therapy may prevent atrophy of the smooth muscle necessary for erection which is associated with non-use of the penis.
- If impotence is linked to high levels of the hormone prolactin, bromocriptine (Parlodel) may be prescribed to correct the problem.
- A number of vacuum devised are used to promote erection. With these devices, a cylinder is placed over the penis and a hand pump is used to create a vacuum in the cylinder. This in turn causes blood to flow into the penis, creating an erection. The user then puts a constriction band around the base of the penis, causing the erection to last up to thirty minutes. These devices are available by prescription only. Some 100,000 men in the U.S. choose this treatment each year. While this eliminates the need for medication, it does require some preparation time which decreases spontaneity. However, they work for many men and are covered by Medicare and many insurance companies. Problems abound with this technique, however.
- Since the early 1970s, more than 250,000 American men have turned to inflatable penile implants to mechanically create erections. Penile implants are surgically installed devices that are made of silicone or polyurethane. One type is made of two semi-rigid but bendable rods; another type consists of a pump, a fluid-filled reservoir, and two cylinders into which the fluid is pumped to create an erection. Penile implants are now coming under FDA scrutiny. Since 1984, the FDA’s Center for Devices and Radiological Health has logged more than 6,500 reports of problems with inflatable devices - a large number for a medical device, according to the FDA. With the development of more effective agents, implants are now considered to be a last resort, to be tried only when all other methods have failed. Penile Prosthesis, rigid, semi-rigid or inflatable implants, can very a scary thing for many men. Getting your questions answered is most important because it is a serious decision. They are only necessary in about 10% of patients. For men who have become impotent following radical surgery, radiation or cryosurgery, or have arthritis and decreased manual dexterity, this procedure may be the last hope. The success rate is very high and they remain effective at a 90-95% rate 5 years after implantation.
- Dr. Robert Frankt of Budapest University in Hungary found a great increase in sexual vitality and energy in men using a combination of two herbs, green oats (Avena sativa) and stinging nettle. "Feeling one’s oats" is an expression that originated centuries ago, and probably with good reason: a study by the Institute for Advanced Study of Human Sexuality found that men who suffered from reduced sexual desire and diminished performance were helped by green oats. Nettle if full of vital minerals and is good also for hypoglycemia, allergies, depressions, prostate and urinary tract disorders, and a host of other problems.