There are several types of erectile dysfunction or male impotence. The first is arteriogenic in which the arteries which supply blood to the penis do not have enough blood to cause an erection. This is a more common occurrence when there is narrowing of the arteries from a disease such as diabetes or in the elderly. Individuals who have high blood pressure or have had an injury in the genital region can also have a blockage in the artery that supplies the penis. An injury is more commonly found in young men. These can happen following a fracture of the pelvis or in cyclists who sustain friction in that region which can cause a thrombus to develop in the artery.
Impotence resulting from injuries are actually very common but often unsuspected. Patients who have sustained an orthopedic or urologic injury may find that after the fractures have healed they are impotent. Fortunately if they are evaluated by an andrologist who takes the complete history the causative agent may be discovered.
Another type of erectile dysfunction is venogenic where the veins of the penis while actually leak blood and prevent the development of an erection. Normally in the process of developing an erection the veins close down almost completely and no blood flows out of the penis. This raises the pressure and allows for the development of hardness. This type of impotence is common and can account for between 30 and 70% of men who suffer from this condition. Venogenic impotence can be differentiated between primary, or those men who have had the condition since birth, or secondary, those men who developed it suddenly after years of normal sexuality.
Neurogenic impotence results from poor nerve supply and conduction to the muscles and via supply. This breakdown can result in poor initiation and maintenance of an erection. These are the nerves that activate the arteries and veins and alter the blood flow in the penis during erection.
Neurogenic impotence can originate from injuries to the back or spinal cord or injury to other nerves supplying the penis after a pelvic or perineal injury. There are also a wide variety of operations done in the pelvic region which can affect the nerves that supply the penis. Other medical disorders which affect the nervous system such as multiple sclerosis, myelitis or tumors can also affect the nerve supply.
While individuals who suffer from diabetes may experience arteriogenic impotence they can also suffer from neurogenic impotence. Unfortunately, the damage to the nerve supply cannot be reversed, but, there are treatments for individuals with diabetes which can restore them to a normal sex life. At this time there are a few physicians who address these issues with their diabetic patients on a proactive level even though as many as 50% of all male diabetics are impotent.
Hormonal impotence happens when there is an imbalance of sex hormones being secreted by the body and carried in the blood stream. More often, this lack of sex hormone affects the male libido rather than the quality of the erection. And as discussed above, there are a number of individuals who have more than one factor which affect this condition such as the diabetic who suffers from both arteriogenic and neurogenic impotence.
Psychogenic impotence is a condition in which there is no organic factor found in the diagnosis of erectile dysfunction and the problem lies purely in the mind. However, before jumping to a diagnosis of psychogenic impotence, individuals should be thoroughly checked out and evaluated for physical causes which would include medical conditions that have not yet been diagnosed. There have been times when the initial symptom of a thyroid or pituitary condition has been found because of the complaints of male impotence.
RESOURCES
University of Maryland Medical Center: Impotence
Johns Hopkins Medicine: Impotence/Erectile Dysfunction
Patient Medical: Definitiono of Erectile dysfunction
Cleveland Clinic: OVerview of Sexual Dysfunction
National Cancer Institute: Prevelance and Types of Sexual Dysfunction in People with Cancer
Journal of American medical Association: Male Sexual Dysfunction
Primary Care: Male Sexual Dysfunction