Impotence (Erectile Dysfunction)

What Is Impotence?

Impotence or erectile dysfunction, occurs in men who are unable to achieve or sustain an erection. Men may be able to develop an orgasm, but their sexual drive may be unaffected.

Normally, a man's penis is flaccid, or "limp". With increased arousal, and increased blood flow to the penis, the man's sexual organ should be erect. Upon orgasm, or completion of arousal, the penis becomes limp again.

What Causes Impotence?

There are many causes of impotence, including:

• Age - many men, with increased age, will develop an inability to achieve or sustain an erection.
• Vascular problems - because an erection is due to blood flow to the penis, men who have problems with blood flow (circulation), or their vascular system, may experience impotence.
• Other health conditions - Men with diabetes may experience a decreased sensation.
• Smoking and alcohol use - in general, may lead to impotence in all populations, regardless of whether or not your are receiving chemotherapy
• Protective barriers - some people who use condoms, or other protective barriers, may experience a decreased sensation during sexual activity
• Medications - such as antidepressants, heart medications, and narcotics may decrease your ability to have an erection.

Impotence - Chemotherapy and Cancer Related Issues:

• Prostate cancer, or prostate surgery - whether in its' early stages, or advanced, men may experience erectile dysfunction due to nerve damage from the tumor, or surgery to remove the tumor.
• Testicular cancer - hormonal therapy that may be used to treat your cancer, or following surgery, you may have difficulty with your sexual organs.
• Radiation therapy - Radiation to the pelvic region may cause damage to your nerves.
• Anxiety and depression - it is normal to experience anxiety or depression, due to situational factors. Since a large component of sexual health is mental, anxiety and depression may negatively affect your self-esteem, and prevent you from being able to attain an erection.
• Chemotherapy will often slow down the amount of testosterone produced. Many chemotherapy and cancer treatment options include androgen or testosterone deprivation therapy.
• Some medications used to control nausea may affect a man's hormone balance. Hypogonadism is a term used to describe what men are experiencing if they are deficient in certain male hormones, especially testosterone.
• The physical side effects of chemotherapy are usually temporary and resolve within one to two weeks after stopping the chemotherapy. However, chemotherapy agents, such as Ciplatin or Vincristine, may interfere with the nerves that control erection leading to possible impotence. Make sure you discuss potential side effects of cancer chemotherapy with your doctor or healthcare provider.

What To Do For Impotence (Erectile Dysfunction):

• Inform your physician or healthcare provider. They may be able to prescribe, adjust, or change your medications to help your situation. Avoiding medications that negatively affect your chance of attaining an erection, such as heart medications, and certain anti-depressants, is the first step.
• Drugs such as Sildafenil (Viagara^®) provide another resource for men with erectile dysfunction. It is safe for many people who have received treatment for their cancer. Sildafenil blocks an enzyme, which allows your penis to sustain an erection for long periods of time.
• Vacuum devices, and penile implants may provide other options, if you are not responding to medication changes.
• There are many ways to experience intimacy, and not all of them include performing sexual intercourse. Spend time with your intimate partner touching and caressing.  There is no reason not to be physically close in other ways even though intercourse may not be an option at this time.
• Maintain good general health, through diet and exercise, avoiding alcohol, and other things that can lead to erectile dysfunction.
• Use water based vaginal lubricants such as K-Y jelly, Lubrin, Surgilube or Astroglide, prior to penetration, for vaginal dryness.  These are located in the feminine hygiene section or birth control section of your pharmacy or drug store.
• Hormone replacement therapy, if you did not receive treatment for a hormone - related tumor (such as with prostate or testicular cancer), may be an option for some. Androgen patches and testosterone replacement may be used under the supervision of an endocrinologist (someone who specializes in hormones).
• If you are experiencing erectile dysfunction from impaired blood circulation, Kegel exercises may help. These exercises focus on strengthening muscles that are usually used for intercourse.
  • Simply contract the muscle that controls urination (but not during urination), and attempt to hold each contraction for at least 10 seconds, and then release. Do these exercises at least 3 to 5 times a day, with 5 or 10 contractions at each time.

Common Problems With Sexuality: Impotence, Gynecomastia, Loss of Libido, Vaginal Dryness, Vaginal Infection, and Genital Pain

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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