What is it about ?
We talk about impotence when attempts at sexual intercourse frequently fail because we cannot achieve or maintain an erection. Impotence and infertility are two different things. Infertility is the inability to conceive a child in a natural way, when intercourse is quite normal.
What is their frequency?
About half of men between the ages of 40 and 70 say they sometimes have erection problems. This does not mean that half of men become impotent with age. These are often transient inconveniences: sometimes, absence of an erection, the erection is not hard enough to succeed in having a report, the erection cannot last long enough … Often, this is due to a decline self-confidence or marital / relationship problems. Illness as a cause of impotence is much less common.
How to recognize them?
You can’t get an erection and keep it. If this is the case in three quarters of attempts at sexual intercourse, we speak of severe impotence. This is then a permanent problem. When problems occur occasionally, there is usually no underlying disease.
The answer to a number of questions can already provide a lot of clarification: do you still have these problems? Do you still have morning erections? Do you only have problems with your regular partner? Did the problem start suddenly or has it not been so good for a long time? Do you drink alcohol, take drugs, or take any medications that may have an influence? Are you having problems in your relationship?
If your problems are limited to one partner, if you still have erections in the morning, and you still manage to masturbate normally, there is likely no underlying disease. If impotence started gradually and increases over the years, there is usually an underlying problem.
How is the diagnosis made?
First of all, the doctor will check whether any existing illnesses and medications used may have an influence on the problem. Diabetes, hypertension, cardiovascular disease and the drugs with which they are treated may explain the situation. Well-known examples are beta blockers, diuretics, painkillers (benzodiazepines) and antidepressants. We will try to treat these diseases as well as possible or to adjust the treatment. The doctor will also ask you questions about your habits (smoking, alcohol consumption, diet, etc.).
If these adjustments do not change the situation, the doctor will schedule further tests or refer you to a specialist. It will be possible to check whether you have abnormalities in the blood vessels (arteriosclerosis), in the functioning of the glands (a deficiency of the male hormone testosterone or a disorder in the functioning of the thyroid gland), the nervous system or still prostate. It will also be checked for psychological causes such as depression, stress and marital / relationship problems.
What can you do ?
It is usually helpful to let the time pass for a bit. In most cases, everything comes back to normal spontaneously. Some men want to have sex at all costs and they are obsessed with failure. This only makes the situation worse.
If you are unsure whether you have nighttime or morning erections, you can put paper tape around the penis before you go to bed. If the paper is torn in the morning, you have most likely had an erection.
If there is a couple problem at the base of the situation, ask the doctor to refer you to a psychologist.
Definitely do not buy drugs on the Internet. The quality of these products is not guaranteed and tests have shown that the dose in the pills ranges from 0 to 200% of the normal dose!
What can your doctor do?
First, the doctor will do a blood test and check the prostate. If it finds that the testosterone is too low, it can be given in the form of tablets or on the skin with a gel. If there are no results after a few weeks, he will send you for more specialized examinations.
In the presence of normal testosterone, it is possible to try a drug that increases the blood supply to the penis. These are called phosphodiesterase type 5 inhibitors. All of these products work the same, but the duration of action varies. However, these products can have serious side effects. Patients with heart disease should not take them because these drugs can cause a heart attack. They also lower blood pressure. They should not be taken at the same time as nitrates, drugs prescribed for angina pectoris, in tablet or patch form. Some men use these products to be able to have sex several times in a row. It is not recommended.
There are also products that can be injected directly into the penis (prostaglandins) that give an erection after 10 to 30 minutes. This procedure should first be tested in the hospital. This is where the correct technique is taught to the user. An alternative is to insert this medication into the urethra. In rare cases, the erection can last more than 6 hours and become very painful. You have to administer some kind of antidote or remove blood from the penis with a syringe.
One ultimate solution is to surgically place artificial cavernous bodies in the penis. These produce an artificial erection that allows you to have sex.
Want to know more?
- Beta-blockers – CBIP – Belgian Center for Pharmacotherapeutic Information
- Diuretics – CBIP – Belgian Center for Pharmacotherapeutic Information
- Benzodiazepines – CBIP – Belgian Center for Pharmacotherapeutic Information
- Antidepressants – CBIP – Belgian Center for Pharmacotherapeutic Information
- Phosphodiesterase type 5 inhibitors – CBIP – Belgian Center for Pharmacotherapeutic Information
- Nitro derivatives – CBIP – Belgian Center for Pharmacotherapeutic Information
- Prostaglandin in erectile dysfunction – CBIP – Belgian Center for Pharmacotherapeutic Information
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
- Alcohol aid – Le Pélican & Le center ALFA
- Find a psychologist – Commission des psychologues
- Mental Health Services – The Social Guide
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