impotence (im`pətəns), inhibited sexual excitement in a man during sexual activity that, despite an unaffected desire for sex, results in inability to attain or maintain a penile erection. Known medically as male erectile dysfunction, it affects younger and older men alike. Impotence can result from psychological factors (performance anxiety or fear of abandonment or unwanted pregnancy), sociocultural factors (negative sexual attitudes or religious beliefs), or physical causes. Impotence is distinguished from sterility (inability to produce sperm adequate for reproduction; see infertility infertility, inability to conceive or carry a child to delivery. The term is usually limited to situations where the couple has had intercourse regularly for one year without using birth control .
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Physical causes include low testosterone testosterone (tĕstŏs`tərōn), principal androgen, or male sex hormone .
..... Click the link for more information. levels, diabetes diabetes or diabetes mellitus (məlī`təs)
..... Click the link for more information. , arteriosclerosis arteriosclerosis (ärtĭr'ēōsklərō`sis)
..... Click the link for more information. , prostate cancer surgery, and neurological diseases such as multiple sclerosis multiple sclerosis (MS), chronic, slowly progressive autoimmune disease in which the body's immune system attacks the protective myelin sheaths that surround the nerve cells of the brain and spinal cord (a process called demyelination), resulting in damaged areas
..... Click the link for more information. and Parkinson's disease. Many drugs, illicit (e.g., marijuana marijuana or marihuana, drug obtained from the flowering tops, stems, and leaves of the hemp plant, Cannabis sativa (see hemp ) or C. indica; the latter species can withstand colder climates.
..... Click the link for more information. , heroin heroin (hĕ`rəwən), opiate drug synthesized from morphine (see narcotic ).
..... Click the link for more information. , and cocaine cocaine (kōkān`, kō`kān), alkaloid drug derived from the leaves of the coca shrub.
..... Click the link for more information. ) and prescription (e.g., ulcer ulcer, open sore or circumscribed erosion, usually slow to heal, on the skin or mucous membranes. It may develop as a result of injury; because of a circulatory disturbance, e.g.
..... Click the link for more information. medicines such as cimetidine (Tagamet) and hypertension hypertension or high blood pressure, elevated blood pressure resulting from an increase in the amount of blood pumped by the heart or from increased resistance to the flow of blood through the small arterial blood vessels (arterioles).
..... Click the link for more information. medicines such as beta-blockers beta-blocker or beta-adrenergic blocking agent (bā`tə ăd'rənûr`jĭk)
..... Click the link for more information. and diuretics diuretic (dī'yərĕt`ĭk), drug used to increase urine formation and output.
..... Click the link for more information. ), have been associated with impotence in some men. Smoking smoking, inhalation and exhalation of the fumes of burning tobacco in cigars and cigarettes and pipes. Some persons draw the smoke into their lungs; others do not. Smoking was probably first practiced by the indigenous peoples of the Western Hemisphere.
..... Click the link for more information. and alcoholism alcoholism, disease characterized by impaired control over the consumption of alcoholic beverages. Alcoholism is a serious problem worldwide; in the United States the wide availability of alcoholic beverages makes alcohol the most accessible drug, and alcoholism is
..... Click the link for more information. also can inhibit sexual excitement. Often, more than one factor is involved. In general, anything that can affect the flow of blood to the penis can cause impotence.

Treatment depends on the underlying cause, and may involve education and counseling of the man and his partner. Treatments include self-injection of a vasodilating drug before intercourse, and implantation of rod-shaped devices into the penis that are inflated via an attached fluid reservoir. In 1998 the first pill for the treatment of impotence, a prescription drug called Viagra (sildenafil citrate), was approved for sale in the United States. It acts by blocking an enzyme called phosphodiesterase 5 (PDE5), which can end an erection prematurely.

See also sex therapy sex therapy, treatment of sexual disorders and dysfunction, including impotence , orgasmic dysfunction, vaginismus (spasm of the muscles of the vagina), premature ejaculation, and lack of sexual responsiveness, not caused by a physical problem.
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impotence

Inability to achieve or maintain erection of the penis; hence, inability to participate fully in sexual intercourse. Erectile impotence (failure to achieve erection) may have either physical causes (e.g., alcoholism, endocrine disease) or psychological ones (e.g., anxiety, hostility toward the partner). Ejaculatory impotence (inability to reach orgasm, sometimes with an erection maintained for a long time) nearly always has an emotional cause. See also Viagra.

impotence [′im·pəd·əns]

(medicine)

Inability in the male to perform the sexual act.

Lack of sexual vigor.

Impotence

Chatterly, Sir Clifford

paraplegic from the war, unable to satisfy his wife sexually. [Br. Lit.: D. H. Lawrence Lady Chatterly’s Lover in Benét, 559]

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impotence

impotence