Misdiagnosis of Underlying Causes of Impotence

About underlying conditions: With a diagnosis of Impotence, it is important to consider whether there is an underlying condition causing Impotence. These are other medical conditions that may possibly cause Impotence. For general information on this form of misdiagnosis, see Underlying Condition Misdiagnosis or Overview of Misdiagnosis

Underlying conditions list: The list of possible underlying conditions mentioned in various sources for Impotence includes:

Various hormonal or metabolic diseases can lead to impotence:
- Kidney disease
- Alcoholism
- Liver disease
- Hormonal abnormalities
- Testosterone deficiency
- Testicle disorder
- Pituitary disorder
Physical damage of various types can lead to impotence:
- Penile injury
- Pelvic injury
- Spinal cord injury
- Bladder injury (see Bladder symptoms)
- Prostate surgery
- Testicle injury
Blood or blood vessel disorders that may cause impotence include:
- Atherosclerosis
- Vascular disease
- Arteriosclerosis
- Aortoiliac lesion
- High blood pressure
Disorders affecting the nerves that may cause impotence include:
- Diabetes - impotence caused by diabetes is often curable by treating the diabetes.
- Neuropathy
- Diabetic neuropathy
- Autonomic neuropathy
- Alcoholic neuropathy
- Multiple sclerosis
- Spinal cord disorders
- Heavy smoking
- Penile nerve disorder
Brain disorders that may cause impotence include:
Psychological causes of psychogenic impotence include:
- Stress
- Fatigue
- Anxiety
- Guilt
- Depression
- Low self-esteem (see Self-esteem symptoms)
- Performance anxiety
- Fear of sexual failure
- Disinterest in sex
- Gradual degradation of sexuality in long relationships
- Fear of sexually transmitted diseases
- Fear of angina
- Fear of heart attack
- Boredom
- Sadness (see Depressive symptoms)
- Reduced libido
- Emotional disorder
- Deep-seated psychological disorder
Smoking - can contribute to or cause impotence in some cases
Certain medications

Impotence as a complication: Other conditions that might have Impotence as a complication might be potential underlying conditions. The list of conditions listing Impotence as a complication includes:

Impotence as a symptom: Conditions listing Impotence as a symptom may also be potential underlying conditions:

Underlying conditions discussion: Since an erection requires a sequence of events, impotence can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area of the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.

Damage to arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of impotence. Diseases--including diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular disease--account for about 70 percent of cases of impotence. Between 35 and 50 percent of men with diabetes experience impotence.

Surgery (for example, prostate surgery) can injure nerves and arteries near the penis, causing impotence. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to impotence by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.

Also, many common medicines produce impotence as a side effect. These include high blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug).

Experts believe that psychological factors cause 10 to 20 percent of cases of impotence. These factors include stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure. Such factors are broadly associated with more than 80 percent of cases of impotence, usually as secondary reactions to underlying physical causes.

Other possible causes of impotence are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as insufficient testosterone. ¹

Autonomic nerves go to the penis. Damage to these nerves can prevent a man's penis from getting firm when he wants to have sex. This condition is called impotence (IM-po-tents). Many men who have had diabetes for many years experience impotence. ²

Sexuality is often a delicate balance of emotional and physical issues. How we feel may affect what we are able to do. For example, men may fear impotence will become a more frequent problem as they age. But, if you are too worried about impotence, you can create enough stress to cause it. As a woman ages, she may become more anxious about her appearance. This emphasis on youthful physical beauty can interfere with a woman’s ability to enjoy sex. ³

Footnotes:
1. excerpt from Impotence: NIDDK
2. excerpt from Keep your nervous system healthy: NIDDK
3. excerpt from Sexuality Later in Life - Age Page - Health Information: NIA

Last revision: Nov 12, 2003

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