"What Men Don't Know About Impotence!"

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Normal penis erectile function

Causes of male impotence

Treatment of male impotence

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What is Male Impotence?

Impotence doctor Male Impotence is defined as the inability to achieve or maintain an erection sufficient for mutually satisfying intercourse.  Impotence impacts more than a man's sexual activity.  The emotions and uncertainties that coincide with male impotence often have a significant effect on a man's self-esteem, as well as, his relationship with his partner.  Although the incidence of male impotence increases with age, it is not an inevitable result of aging.  Impotence is a secondary condition linked to many medical conditions.

The first step in treating impotence is that the individual understands the psychology, physiology and anatomy responsible for the ability to achieve and maintain an erection.  If we can comprehend these events than we can better understand the factors that are responsible for impotence and address the questions concerning impotence treatment.

What is normal penis erectile function?

For something that appears so natural, an erection is a rather complicated process involving the coordination of the psychological, neurological and cardiovascular systems.  The penis becomes erect following a series of events.  First, the nerves are stimulated, a sensation known as arousal.  No matter what the nature of the stimulus, visual, mental or physical the brain coordinates the following series of events:

Nerve impulses transverse the length of the spinal cord to the pudendal nerve and on to the penis.  Smooth muscle within the walls of the penile arteries respond by relaxing.

Subsequently, the penile arteries dilate allowing up to eight times more blood to flow into the corpora cavernosum, (two parallel cylinders that transverse the length of the penis).

The cavernosum become engorged with blood expanding and lengthening the penis.

The expanding tissue then exerts a positive pressure compressing the veins that normally empty the blood from the penis, maintaining the blood in the penile tissue.

When ejaculation occurs or when arousal is discontinued the penis returns to its non-erect state.


What are the causes of male impotence?

Historically, when an ompotent individual consulted his physician concerning impotence he was usually informed there were no known physiological answers concerning male impotence.  Today, a generation of impotence research has resulted in significant advances in both the diagnosis and treatment of impotence. Physicians now understand that approximately eighty-five percent of male impotence is attributable to physical/organic conditions while only fifteen percent is due to psychological or mixed origin (both psychological and organic).  Some important causes of physiological impotence are as follows:

Vascular Disease is the leading cause of male impotence. Vascular disorders including arteriosclerosis (hardening of the arteries), hypertension, hypercholestremia and other conditions which interfere with the blood flow to the penis.  Additionally, "venous leakage" also contributes to poor erections.  This impotence condition occurs when the penile veins are unable to constrict efficiently during an erection.  When these veins "leak" blood escapes to the periphery resulting in a poor erection

Diabetes is another common cause of impotence. Approximately fifty percent of men with diabetes (insulin dependent) experience some degree of impotence after the age of fifty-five.  Diabetes results in poor circulation and/or peripheral neuropathy.  When the nerves are involved sexual stimuli are not transmitted appropriately to or from the brain and impotence develops.

Prescription medications often cause impotence as a side effect.  Some two hundred known medications fall into this category including:

  • Antihypertensives medications significantly:
    1. beta-blockers e.g. Atenolol, Propanolol and Tenorium.
    2. Diuretics medications e.g. HydroDiuril and Lasix.
    3. Ace Inhibitors/Calcium Channel Blockers medications e.g. Vasotec, Lotension, Cardizem, Norvasc periodically cause impotence, however, they are generally represent an excellent alternative medication for individuals with drug induced impotence.
  • Antidepressant/Antipsychotic medications of almost any label can also result in impotence e.g. Prozac, Elavil, Zoloft, Thorazine, Haldol. Note: Many other medications in a variety of classes can periodically cause impotence.  If you are taking a prescription medication or over-the-counter medication, regularly, please consult with your physician.  However, never alter a dosage or discontinue a medication without the advice of your physician.
  • LH-RH Analogs/Antiandrogen medications e.g. Lupron Depot®, Eulexin, Nilandron®, Casodex®, etc.  These medications are used in the treatment of prostate cancer.  They function by decreasing the production of testosterone in the testes and adrennal glands.  The decrease in testosterone often results in impotence.
  • Chemotherapy/Radiation therapy are also significant contributors to impotence.  These drugs/treatments are used in the treatment of cancer.

Substance Abuse can also negatively effect male potency.  The chronic use of cocaine, marijuana, alcohol, steroids etc. often results in male impotence, as well as a decrease in desire.  Excessive tobacco use can also attribute to impotence by accentuating the effects of other risk factor such as vascular disease or hypertension.

Radical Pelvic Surgery also result in male impotence. Surgical procedures involving the prostate gland, bladder or colon may interfere with the nerves involved in the erectile response.  Radiation therapy for cancer may also effect the erectile process.

Neurological diseases such as multiple sclerosis, Parkinson's disease, spinal cord injuries, long term effects of diabetes can also result in the disruption of the normal sequence of events necessary for an erection to occur. 

Deficiencies in the Endocrine System are another source of impotence. Low levels of testosterone or thyroid hormone can interfere with the stimulation process necessary in the erection sequence.  Excessive production of prolactin by the pituitary gland may contribute to decreased levels of testosterone resulting in a lack of desire.  Diabetes once again enters the scenario as it is classified as an endocrine disorder.

Psychological impotence is usually diagnosed when no physical causes can be defined.  Pure psychological impotence usually occurs suddenly without warning as opposed to physical impotence that may gradually develop over years.  Some common causes of psychological impotence are as follows:

  • Performance anxiety is one of the most common causes of psychological impotence.  When a man feels pressured to achieve or maintain an erection, he will commonly become anxious and nervous when in a sexually demanding situation.  Stress increases the body's production of catecholamines such as adrenaline and nor- adrenaline, which act as erection inhibitors.  The release of these inhibitors further contributes to failure resulting in more anxiety.  Therefore, the cycle begins, increased stress resulting in increased catecholomines that further inhibits the erectile process.
  • Depression is another cause of psychogenic impotence.  Unfortunately, many of the popular antidepressant medications (for a list see prescription medications in the next section) have side effects which include erectile failure.

Anatomical Deviation of the Penis, Peyronies Disease, may also cause impotence.  This condition usually develops from an inflammatory process and results in fibrous scaring of the penis.  (The cause of this process is not yet understood)  However, when an erection does occur, there is a bending of the penis secondary to the scar tissue.  This curvature may interfere with erectile capacity and/or ejaculation.

What are the Impotence treatment options?

Until recently, male impotence individuals who sought medical treatment for impotence were told "It's all in your head".  Physicians labeled these impotence individuals with a psychological disorder and they were referred to impotence counseling.  Today, there are many impotence treatment options available, the impotence treatment option you choose should be specific and responsive to your needs and expectations as well as your partners.  The following is a summary of the more popular impotence treatment options available today:

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Oral Medications one in particular Viagra® (Sildenafil Citrate) has change the course of male impotence treatment for impotence. Never has so much Viagra users enthusiasm surrounded a impotence prescription medication.  In the first six months alone, Pfizer's sales of the blue diamond shaped impotence tablet topped 50 million. Viagra® impotence treatment is dispensed as a pill and ingested orally.  Approximately 30-60 minutes later the impotence drug is absorbed into the bloodstream. Viagra® impotence treatment then functions as an inhibitor to an enzyme found mainly in the penis.  By inhibiting this impotence enzyme a series of natural occurring events, take place resulting in increased blood flow to the penis thus generating a fuller erection.  Since the male impotence medication increases the levels of a naturally occurring, process spontaneous erections do not occur.  Viagra® impotence treatment is essentially changing the way we treat impotence. The male impotence medication is manufactured by Pfizer pharmaceuticals.

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Penile Injection Male Impotence Therapy uses a hypodermic needle to inject impotence medication (mixture of papaverine, phentolamine and prostoglandin) into the side of the penis.

Urethral Impotence Inserts consists of a disposable applicator, small enough to fit into the urethra.  The impotence treatment applicator is inserted into the urethra approximately one inch and the impotence medication (prostaglandin E-1) is released.  As a result, an erection occurs lasting 30-60 minutes. 

Vacuum Impotence Treatment Therapy works by placing a cylinder with an attached pump over the penis.  The impotence treatment pump creates a vacuum in the cylinder, which pulls blood into the penis to create an erection.  The cylinder is then removed while simultaneously a constriction band is placed at the base of the penis.

Hormonal Impotence Treatment Therapy is used to treat the small percentage of individuals who have abnormally low levels of testosterone.

Vascular Impotence Treatment Surgery may involve both the arterial and venous systems.

Penile Impotence Treatment Implants requires surgical insertion of a prosthetic device.  Three impotence treatment forms of penile prosthesis are currently available flexible, malleable and inflatable.

Herbal Impotence Remedy Approaches are not currently regulated by the FDA so it is difficult to ascertain whether their impotence remedy hype is warranted.  Furthermore, these products tend to suggest an aphrodisiac effect (help with the loss of sexual desire) rather than improvement with male impotence.

Psychotherapy and/or Behavioral Impotence Therapy have been found to be beneficial in treating impotence.  Although the majority of causes of impotence are physical, there are quite frequently underlying psychosocial factors involved as well.  Impotence Psychotherapy and/or behavioral impotence therapy may be helpful in individuals whom no organic cause for impotence has been detected.  Therapy often focuses on complications surrounding performance anxiety, dysfunctional relationships, loss of a partner, psychotic disorders, substance abuse, etc.

Male Impotence Partners can provide support for individuals with impotence.  The condition affects the relationships of more than 50 million Americans. If you are a impotence partner, you can make a difference through support and impotence education.  For a list of Impotence Support call 1-800-669-1603.

To send away for Free impotence related brochures from Pfizer on men's sexual health problems, call Free 1-877-334-6361.

Note: All of the above mentioned treatments only treat impotence, they do not treat the underlying impotence illnesses or disorders responsible for the impotence.  The prolonged use of some these impotence treatments in individuals who have conditions such as those listed under causes of impotence is inappropriate.  Please be responsible with your health.  Schedule regular appointments with your family physician and/or your urologist so they may address and treat the underlying conditions responsible for your impotence.

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