Impotence: new breakthroughs.

• Author: Schilling, Edward L., III

WOMAN called the Impotence Institute of America's Help-Line and asked if she could be provided with information about female impotence. The caller and her husband were having trouble conceiving a child and were wondering if it had to do with her being impotent. This is not an unusual case. Every week, the Institute receives calls from both men and women expressing similar confusion about what impotence truly is.

Simply stated, impotence is the inability for a man to get or maintain an erection firm enough for sexual intercourse. It is not infertility or incontinence. How prevalent is impotence and why does it remain one of the most underreported ailments facing men today? First, it is necessary to understand the scope of the problem.

The Massachusetts Male Aging Study found that the number of American men suffering from varying degrees of impotence exceeds 30,000,000. If each has a partner, that figure jumps to 60,000,000 people affected by the condition.

Until the last 10 years, impotence was believed to be caused primarily by psychological problems. Men were told that it is all in your head." It now is understood that more than 85% of all cases have a physical cause. This is why is it critical for a man who believes he is impotent to have a complete physical examination. It is important not only to treat the impotence, but to determine the related medical conditions or disease causing it.

A chief culprit is diabetes. The disease damages the nerves that control blood vessels throughout the body, particularly those of the penis. By age 45, more than 30% of diabetic men are impotent; by 60, the number has grown to 55%. Some studies suggest the occurrence of impotence in diabetic men to be as high as 75%. Myron I. Murdock, National Medical Advisor to the Impotence Institute of America, points out that, "If a man is diabetic, and lives long enough, he will become impotent." Even with the improved methods of diabetic management, damage to the nerves controlling the blood vessels and arteries of the penis is inevitable.

An erection requires a sevenfold increase in the blood flow to the penis. Anything that either impairs or restricts that blood flow can cause impotence. Arteriosclerosis, or hardening of the arteries, is a perfect example. It damages the elasticity of the penile arteries, thus interfering with their ability to allow the organ to fill with blood. This occurs because of the presence of fatty deposits (from high cholesterol) that...