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Is impotence a growing problem for men in The Gambia?

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By Dr Azadeh

Impotence in male is becoming more common worldwide as a serious health problem and The Gambia is not an exception.
How serious is this health problem in The Gambia
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 any longer.

Male impotence – the common contrast to all the fable-is marked a 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 a reported common cause of distortion in the relations of the couple, even leading to failure of some marriages in particular in polygamous marriages.

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Impotence is the inability to have relation and among its causes include the decrease, absence or abnormality of eroticism, with potency disorders caused by nerve and vessel 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 that is the inability to procreate children even if relation is possible.
Experts estimated that 90% of male impotence was due to psychological problems, whether depression, anxiety or fear of the opposite sex. The causes of this dysfunction are divided into two groups:

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

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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 what is important for reproductive process in man and woman relationship.
Infertility is also different from male impotence, as an infertile man produces no sperm in sufficient quantity or adequate quality.

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 are more frequently 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 genital organs at birth
– Severe liver disease damage by excessive alcohol abuse
– Severe smoking and use of harmful drugs
– Excessive high cholesterol level in blood
– Excessively overweight
– 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 job
– 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 too many 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 the psychology, physiology and anatomy responsible for the ability to achieve and maintain potency. If he can comprehend 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.

Physical causes
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 reatments for an enlarged prostate
· spinal cord injuries
· Peyronie’s disease

Psychological causes
There are also a number of psychological causes for impotence. These are the most common psychological causes:
· stress
· depression
· anxiety
· other mental health conditions
· relationship problems due to stress, poor communication, or other concerns
Some men may suffer from a combination of physical and psychological issues that can lead to or worsen ED. For example, a physical injury, which may slow a person’s sexual response, may lead to anxiety about achieving an erection. This anxiety can then worsen the ED.

Also state that some men may only experience ED in certain situations. For example, a person may be able to achieve an erection during masturbation, or may find that they wake up with an erection.
If a person is unable to get an erection with a sexual partner, the cause of their impotence is most likely to be psychological.
If a person is never able to get an erection, the cause of their impotence is most likely to be physical.

Questions about Stress and Emotional Health
Your health care provider may ask you questions about depression or anxiety. He or she may ask about problems in your relationship with a partner. Some health care providers may also ask if they may talk to your sex partner.
· Are you often under a lot of stress, or has something recently upset you?
· Do you have any anxiety, depression or other mental health issues?
· Are you taking any drugs for your mental health?
· How satisfied are you with your sex life? Have there been any changes lately?
· How is your relationship with your partner? Has there been any changes lately

What is your advice for males in The Gambia with this problem?
Fortunately there are a large number of health professionals: doctors in particular, qualified Gynaecologist, 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.

DR AZADEH Senior Lecturer at the University of the Gambia, Senior Consultant in Obstetrics and Gynaecology, Clinical Director at Medicare Health Service.
For further information send only to DR AZADEH tel.7774469, 3063333, or send email, [email protected].

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