Impotence, Erectile Dysfunction, or Infertility: Differences and Similarities

About 20 percent of all German men between 30 and 80 years suffer from potency disorders. But the number of unreported cases is probably much higher: because the term “impotence” has a decidedly negative connotation, many men shy away from addressing the problem in their partnership or even with a doctor.

What is impotence?

First of all, this term, which is often used in different ways, needs to be explained in more detail. In the medical sense, impotence is the inability of a man or woman to procreate. It is also referred to as impotentia generandi. In addition, however, there is also a less narrow definition, according to which impotence generally includes the lack of ability to exercise satisfactory coitus.

Forms of impotence

In everyday language, it is often difficult to make a distinction between erectile dysfunction, impotence, or infertility. When impotence is considered under the broader definition, three common forms can be grouped under it:

Sterility/impotentia generandi

If a man is sterile, he is incapable of procreation. This means that sexual intercourse can certainly be carried out, but no reproduction takes place as a result. Infertility in men can be triggered by diseases of the testicles or vas deferens, sperm dysfunction, or as a result of various diseases, such as Prader-Willi syndrome or a heart attack.

Anejaculation

Anejaculation refers to the failure of ejaculation during sex. However, orgasm may still occur. The cause of anejaculation is damage to the nerves that trigger ejaculation. This occurs, for example, due to metabolic diseases, such as diabetes mellitus, as a result of surgery or due to injuries to the spinal cord.

Erectile dysfunction

Erectile dysfunction means that a man is unable to perform satisfactory sexual intercourse – either because an erection does not occur at all or because it cannot be maintained long enough. That is, the increase in size of the penis to complete rigidity (“rigidity”) is disturbed. Erectile dysfunction can be chronic or occur spontaneously and is independent of the sexual arousal experienced by the man.

Causes of erectile dysfunction

For an erection to occur, a complex set of rules involving nerves, blood vessels, hormones and the psyche must work together. Accordingly, there are many possibilities when it comes to potency disorders. In the vast majority of cases, it is organic causes that trigger erectile dysfunction, especially in men over 50. These primarily include:

  • Cardiovascular disease
  • Hypertension
  • Increased cholesterol levels
  • Diabetes
  • Kidney damage
  • Prostate surgery or injury
  • Spinal damage based on wear and tear.
  • Hormonal disorders
  • Diseases of the nervous system, such as multiple sclerosis.
  • Drug abuse, alcohol abuse, smoking
  • Stress
  • Depression
  • Personality conflicts

Thus, potency disorders are often warning signs of a possibly more serious disease, which must be treated in any case. Therefore, erectile dysfunction should always be taken seriously and examined by a doctor, usually a urologist. Tips and home remedies for erectile dysfunction

Examinations and diagnosis

In order to trace the causes of the various forms of impotence, extensive examinations are necessary. For this purpose, the affected person must not only overcome the shyness of the first visit to the doctor, but also be prepared for the fact that the doctor will ask a series of very personal questions relating to sexual life, partnership, everyday professional life and leisure time. In addition, an experienced doctor will include the respective life partner in the consultation and treatment. Once it has been determined which form of impotence is present, physical as well as psychological causes must be investigated. If the search for organic causes continues, ultrasound examinations of the blood vessels of the penis at rest and after injection of an erection-promoting drug (erectile tissue injection test SKIT) can be performed. However, this test can also be falsely negative due to nicotine consumption or stress during examination.In diabetics, electrical stimuli are used to determine whether nerve damage is the cause of the disorder. If sterility is present, the sperm is often examined microscopically (spermiogram). The motility, appearance and volume of the semen are checked. In addition, the affected person is examined for further physical causes, such as damage to the vas deferens.

Therapy of impotence

Adapted to the exact diagnosis, therapy of impotence then takes place with medication or mechanical aids. Surgery is also possible, depending on the cause. For more information on diagnosis and therapy of erectile dysfunction, see this article.