home > what's wrong > impotence

OVERVIEW

EVALUATION

Impotence, the inability to obtain or sustain an erection is almost an inevitable for all men. I see thousands of men with these problems, and probably 75% of men start having problems between the ages of 45 and 55. A full range of information can be obtained in the book, Overcoming Impotence Forever.

TREATMENT

Causes of impotence include normal aging, diabetes, vascular disease, the effects of surgery or medication and Peyronie’s disease to name some of the more common. The bottom line of normal erections is normal circulation within the penis. As one may succumb to some of the conditions listed above, the circulation of the penis may not be adequate to maintain a quality erection. This can be devastating to men and often to their partners and relationships as well. Impotence can affect many aspects of a man’s life, and unfortunately, for many of the millions of men suffering from impotence they believe they are the only one suffering. In fact this condition affects at least 40% of men over the age of 40 years, and the incidence increases as the population increases.
Most men suffering from impotence can be helped. In fact, it is fair to say that probably 99% of men can be helped. Medications, surgery, vacuum devices all can be used. Medications can include yohimbine and other natural preparations to improve blood flow. In addition, vacuum constriction devices are of help to some men. Dr. Mobley is partial to the devices produced by Mentor.

The drug prostaglandin helps many men, and comes in two administration forms; one is an injection technique, and the other is the placement of a pellet of medication into the urinary canal (the urethra). Peyronie’s disease is a condition in which scar tissue forms in the penis. The cause is unknown. Treatments include medications and surgery. Some men with Peyronie’s disease do not require any form of treatment. The only men who need treatment are those that have marked curvature of the penis, pain, or impotence. One of the newer forms of treatment for Peyronie’s disease is an old drug, colchicine, that has been used for years in the treatment of gout. To find out more about the treatment of impotence, TAKE THE TOUR ,which will guide you through all of your options, by clicking the link at the top of this page.

FAQ'S

What exactly is meant by the word impotence? Impotence is the inability to obtain or keep an erection for satisfactory sexual relations.

I have heard this is all in your head......is this true? Some cases of impotence are due to stress, anxiety, "fear of failure" etc., but most of the time the problem is physical.

Is impotence uncommon? Impotence is a normal fact of life. It is going to eventually affect nearly all men. It happens at different ages, but it is very common in almost any age group.

Since I know that I'm not alone, my next question is "can I be helped?" Impotency is very common, and the good news is that almost all men can be helped. Too many men suffer silently for years....or forever, when help is usually available.

How can you find out what is wrong with me? A medical history and examination are first. Usually we try to determine if the problems are physical or psychological, and this can be done in several ways.

What about hormones? We usually like to know if the hormones, are normal or not, and this can be determined with blood tests.

If my hormones are normal, does this mean the problems I'm having are psychological? No, there is more to it than that. To determine if the problem physical or psychological we need to determine the nature of your natural erections.

How is this done? Usually we can either get some determination of blood flow in the penis or can measure erections that occur during sleep.

I used to have erections in the morning when I had a full bladder, but I don't anymore. What does this mean? This could be a hint that the problems are physical, however it may simply be an indicator of your depth of sleep at that time of the morning.

Could you explain that a little more...? We know that men physically capable of normal erections have these erections during REM sleep, the deepest part of sleep. Knowing this, we can evaluate sleep erections to distinguish physical from psychological impotence.

What if I have perfectly normal sleep erections, but can't perform when I am awake, and want to.........what can be done? In this situation the problem is usually due to anxiety, and often if the couple will meet with a therapist for a few visits you can learn to minimize your anxiety, and thus improve performance.

What if the problems I'm having with poor erections are indeed physical, what can be done to help me? Before I answer that, let me make a point, since you used the term "poor erections." Keep in mind that losing erections is very natural..... it will happen to all men eventually, and the first step in this process is usually the inability to maintain erection, then difficulty getting erections, and finally, no erections at all.

Well, I'm at the point where my erections are of poor quality, and they don't last. What can be done? Treatments options include surgery medications and vacuum devices.

What about hormones? Some of my friends are taking hormone shots? There are two principal hormones involved in potency, and if you have abnormal levels, hormone treatments may be helpful. DHEA is a hormone that is sometimes taken and does not require a prescription.

I've heard about injections into the penis. Sounds terrible, but I'd like to know what it's about. First I will take a moment to explain the medication injected. Although over a number of years we have used several medications, most commonly we use a medication called prostaglandin to improve circulation in the penis.

Does it always work? No, it doesn't work in all people, nor does it work all the time in those who are helped. Prostaglandin is now available in two forms; one is the injection of medication into the side of the penis, the other is the insertion of a pellet into the urethra (the urinary canal). These treatments work in some men some of the time, but tend to lose effectiveness over time.

Is surgery the best treatment? Surgery is the most reliable treatment, usually the most natural, and has a very high satisfaction rate.

Tell me about he surgery. Penile implant surgery has been done extensively for over 25 years. There are several different types of implants; inflatable, which are the most natural, and malleable, or bendable implants.

How is the surgery done? A small incision is made to implant the prosthesis, and all components are usually put in through this small incision. This is usually done as an out-patient procedure, and the man usually needs 5-7 days at home afterwards.

Is it natural? Very natural. Most men have no sense of there being something in the body once they are healed. And keep in mind, it is completely internal, there is nothing outside the body-a question I am often asked.

Does insurance cover the surgery? Almost always, and at present, it is covered by Medicare as well.

Is there anything else? Vacuum devices have been in use for a number of years, and they work fairly well for some men, and they work fairly well for some men, and are quite safe. We have brochures and videos you can review. In addition there is a good deal of research being done in this field, so there may be developments that we don't yet know about. Keep in mind, you have made the first step, and almost all men can be helped. Also, for your benefit, we have an instructive video library at your disposal.