Inability of the male to perform the sexual act. It may be partial or complete, temporary or permanent. Psychological factors are the most common cause and these include anxiety, ignorance, fear, guilt, weakness of sexual desire or abnormality of such desire. Counselling or sex therapy, preferably with the partner, has a 50-per-cent chance of helping to cure long-term impotence of psychological origin. Among organic causes are lesions (see LESION) of the external genitalia; disturbances of the ENDOCRINE GLANDS, such as diminished activity of the gonads, thyroid gland or pituitary gland; diseases of the central NERVOUS SYSTEM; any severe disturbance of health, such as DIABETES MELLITUS; and addiction to alcohol.
An oral drug for treating erectile function is sildena?l citrate (Viagra®), the ?rst in a new class of drugs called phosphodiesterase type 5 inhibitors, also including tadala?l (Cialis®) and vardena?l (Levitra®). They work by improving blood ?ow to the penis. They can be taken an hour before intercourse (up to 12 hours before, in the case of tadala?l). These drugs are not aphrodisiacs, and side-effects include headache, facial ?ushing and indigestion. There are some suggestions that they may affect retinal function.
Intracavernosal injection or urethral application of alprostadil, a drug which increases local blood supply to the penis, has been used for some years under medical supervision, but success has been variable and oral sildena?l seems to be a more convenient and e?ective treatment for a man with this disorder.... impotence
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