HEALTH: Impotence in men: Is this a growing problem in The Gambia?


By Dr Azadeh

What is male impotence in general
Male impotence is defined as a disorder that affects the quality of the man’s potency, making it insufficient for a normal sexual relationship between man and woman, or impossible to maintain it, or just cannot be achieved.

Infertility is also different from male impotence, as an infertile man produces no sperm in sufficient quantity or adequate quality.


Impotence is the inability for a man to get and maintain an erection. It is also known as erectile dysfunction (ED) and can impact a person’s ability to have satisfactory sexual intercourse.

Impotence is a very common condition and can occur at any age. However, it is most common among older men.

Common causes
Impotence can affect men of any age and may be caused by a variety of problems.

A man’s ability to achieve an erection is based on a number of factors and can result from a variety of physical problems.

Mental health issues and other psychological problems can also cause ED or make it worse.


Physical causes
Erectile dysfunction is most commonly caused as a result of a physical factor. The most common causes include:
· heart disease
· high cholesterol
· clogged blood vessels
· injury to the penis
· diabetes
· obesity
· metabolic syndrome
· Parkinson’s disease
· multiple sclerosis
· smoking and other tobacco use
· alcoholism
· other forms of substance abuse
· sleep disorders
· prostate cancer treatments or treatments for an enlarged prostate
· spinal cord injuries
· Peronei’s disease

Impotence in males is becoming more common worldwide as a serious health problem and The Gambia is not an exception.

The happiness of the couple passes between the normal organic and emotional equality of men and women to fulfill their reproductive role.

Today many of the men are unable to overcome their disabilities, restoring physical, emotional, moral, ethical and psychological balance against women worldwide and The Gambia is not an exception country any longer.

Male impotence – the common contrast to all the fable – is marked far more common problem that rarely deserves a scientist for purposes of disclosure.

It is often associated with the emergence of serious physical and psychological problems in humans and reported a common cause of distortion in the relations of the couple, even leading to failure of some marriages in particular in polygamous marriages.

Impotence is the inability to have relations and among its causes are the decrease, absence or abnormality of eroticism, with potency disorders caused by nerve and vassals injuries, poisoning by drugs, smoking, alcohol, diabetes and gout, diseases of the nervous system and damage to the genitals.

It is interesting to distinguish between impotence and sterility which is the inability to procreate children even if relation is possible.

Experts estimated that 90% of male impotence is due to psychological problems, whether depression, anxiety or fear of the opposite sex.

The causes of this dysfunction are divided into two groups:

Psychological cusses
Almost a third of cases of male impotence are physical in origin, which shows that psychological problems have an impact on male sexuality.

The treatment of this condition depends on the origin of it, being necessary in some cases, combination therapy, compared to cases of male impotence of psychological origin and physical.

It is considered a problem if a man has difficulties attaining or maintaining potency more than 25% of the time. In most men, potency difficulties do not affect sexual desire.

What are the causes of male impotence?
Causes of male impotence: Interact with their brain, nerves, hormones, blood vessels, and any interference with this process can be a problem of male impotence.

– As diabetes, hypertension, heart disease, thyroid conditions, low testosterone levels, circulatory problems, depression, spinal cord injury, nerve damage, neurological disorders.

Medications: regulators of blood pressure (e.g. drug called Bendro), heart medications, certain medications for the treatment of stomach ulcers, antidepressants, sleeping pills.
· Drug use (alcohol, nicotine, cocaine, etc.)
· Communication problems with the couple, stress, fear, anxiety, anger and sexual expectations unrealized.

The incidence of male impotence increases with age, but affects men of all ages. In older men male impotence causes more frequent are those of physiological (organ’s function) origin, while the young men the main reason is more psychological.

Some forms of male impotence such as physically affected:

Nerve and blood vessels injuries caused by diabetes.
· The nerve injury caused in certain prostate and bladder operations, which are irreversible.
· Abnormalities of his genital organs at birth
· Severe liver disease damage by excessive alcohol abuse
· Severe smoking and use of harmful drugs
· Excessive of high cholesterol level in blood
· Excessively overweight
· Had stroke
· Hormonal imbalance e.g. thyroid and kidney diseases
· Severe Heart diseases
· Pelvic injuries
· Eating disorders

Psychological effects cause impotence
· Psychological factors that contribute to the causes of male impotence include an unhappy man and woman relationship
· Being unemployed, anxiety and struggling to find jobs
· Long standing depression
· Man with impotence problems often suffer from the fear of failure
· Men who have suffered from impotence in the past worry about their performance and this removes the pleasure of feeling sexually excited. This contributes to their impotence

Is male impotence treatable or curable?
Impotence causes may be a secondary condition linked to many of his medical conditions. The first step in treating impotence is that the male patient understands the cause of impotence after he has been checked up for his health condition by a medical professional including a psychologist, physiologist and anatomist responsible for the ability to achieve and maintain a potency.

If he can comprehend the cause of impotence then he can better understand the factors that are responsible for impotence and find the most appropriate male impotence treatment.

The incidence of impotence correlates with an individual’s age. Impotence affects some 38% of men by the age of 36 years old. Impotence impacts more than a man’s sexual activity.

The emotions and uncertainties that coincide with this condition often have a significant effect on a man’s self-esteem, as well as his relationship with his partner. Although the incidence of impotence increases with age, it is not an inevitable result of ageing.

What is the advice for males in The Gambia with this problem?
Fortunately there are a large number of health professionals, doctors in particular, qualified gynaecologists and senior nurses at various governments, private and NGO hospitals and clinics to diagnose the problems by giving advice, perform necessary lab tests and treat those suffering.

The author, Dr Azadeh, is a senior lecturer at the University of The Gambia, senior consultant in obstetrics and gynaecology, and the clinical director at Medicare Health Services.