Impotence, also known as erectile dysfunction (internationally referred to as ED), refers to the inability of the penis to get an erection or a weak erection when sexually desired, or the inability to maintain sexual intercourse for a sufficient amount of time despite having an erection and a certain degree of hardness, thus preventing sexual intercourse or the inability to complete it. Impotence is one of the most common sexual dysfunctions in men and is a chronic disease that affects both physical and mental health. It not only affects the quality of life of patients and their partners, but may also be an early symptom and danger signal of cardiovascular disease. 1.What is impotence? Impotence, also known as erectile dysfunction, refers to a man’s inability to consistently obtain and maintain an erection sufficient to complete a satisfactory sexual life. 2. Is there a high incidence of impotence? Impotence is a common and frequent disease among adult men. The Massachusetts Institute of Male Aging found that the total prevalence of impotence in the United States is 52%. In China, the total prevalence of impotence among urban adult men in Beijing, Chongqing and Guangzhou is 26.1%, and the prevalence among people aged 40 and above is 40.2%. 3.How is impotence diagnosed? The main basis for the diagnosis of impotence is the chief complaint. An objective and accurate medical history is the key to diagnosis, and the patient’s spouse is encouraged to participate in the diagnosis of impotence. The present medical history includes the time of onset, concomitant symptoms, concomitant diseases, personal condition, history of corresponding surgery and trauma, psycho-psychological and family situation, and the International Index of Erectile Function-5 scale score. 4.What is the main clinical surface of impotence? Impotence is a condition in which a man has sexual desire, but his penis cannot get an erection or can get an erection but it is not hard and he cannot have sexual intercourse. If the penis cannot be erected at all, it is called complete impotence. If the penis can be erected but does not have sufficient hardness for sexual intercourse, it is called incomplete impotence. 5.How is impotence classified? In general, impotence can be divided into two categories: psychological impotence and organic impotence: ① Psychological impotence: the onset of impotence is urgent, the penis has spontaneous erection, during sleep or first awakening at night, masturbation or erotic association will have an erection, when wanting to have sexual intercourse but can not erect. The penis is hard and erect when it first touches the female body, but then withers when attempting to penetrate. In addition, accompanied by mental symptoms, such as anxiety, anxiety, depression, mental depression, etc., some may be accompanied by premature ejaculation or sexual intercourse without ejaculation. Organic impotence: The main manifestation is that the penis cannot be erected under any circumstances, and the onset is slow and progressive. In addition, accompanied by the symptoms of the corresponding organic disease, such as diabetes. 6. Is there any way to determine which type of impotence I belong to? Simply put, if the penis is normally erect, and when you sleep at night or when you first wake up, you have an erection when you masturbate or have erotic associations, but you cannot get an erection when you want to have sex, this is definitely psychological impotence. Pathological impotence, on the other hand, is the inability to get an erection regardless of the circumstances. The stamp test is the easiest way to determine the type of impotence: before going to bed, wrap a small piece of paper about 0.5-1.0cm wide around the penis, fix it with glue at both ends, and observe if the paper breaks when you get up the next morning. 7.What are the risk factors for impotence? Vascular diseases (such as hypertension, atherosclerosis, arterial injury, etc.), neurological diseases or injuries, perineal surgery and trauma, endocrine diseases (diabetes), genitourinary infections, genitourinary malformations, radiation exposure, heavy metal poisoning, etc. are all risk factors for impotence. In addition, poor psychological state such as tension, anxiety, depression and other psychological factors can lead to impotence. And marital discord or spousal ridicule and accusation are very likely to lead to impotence. 8.What tests are needed for impotence? First of all, each patient should undergo a comprehensive physical examination, focusing on the development of the reproductive system, secondary sexual characteristics and cardiovascular and neurological examinations. In addition, routine blood and urine tests, fasting glucose, high and low density lipoproteins, liver and kidney function, and sex hormone measurements are necessary. If necessary, chromosomal examination will be performed. It is also necessary to check nocturnal penile erection test (NPT), penile ultrasound blood flow test, etc. If vascular impotence is considered, penile cavernosography can also be done. 9. Are impotence and premature ejaculation the same thing? Clinically, many patients confuse impotence with premature ejaculation. In fact, impotence and premature ejaculation are two completely different diseases. Impotence mainly refers to whether the penis can be effectively erected for sex, while premature ejaculation mainly refers to the short duration of ejaculation. Although both can appear together, the two are completely different in terms of causes and treatment methods, so it is important to first distinguish whether you are impotent or premature ejaculation before visiting the clinic. 10. Is impotence caused by prostatitis? In the risk factors for impotence, we have talked about that genitourinary system infections can cause impotence. Prostatitis is the most common reproductive system infection, therefore, prostatitis can be a symptom of impotence. However, not every patient with prostatitis will experience impotence, and at the same time, not every impotence patient is caused by prostatitis. The actual fact that many internet materials and experts are one-sidedly exaggerating the hazards of prostatitis and think that prostatitis must lead to impotence is one-sided and undesirable. The correct understanding is that prostatitis may lead to impotence, but the causes of impotence are complex and multifaceted, and the relationship between prostatitis and impotence cannot be overstated. 11. Can impotence lead to male infertility? Impotence and male infertility are also two different diseases, but impotence can certainly lead to male infertility because the patient cannot have an effective sex life and cannot ejaculate in vivo. 12. Can impotence be cured? Clinically, the vast majority of impotence patients are psychological impotence, and these patients can certainly be cured with effective psychological guidance and appropriate medication. For organic impotence, such as diabetic patients actively controlling blood sugar, patients with genitourinary system infection actively controlling infection, and patients with venous impotence can be treated with deep vein ligation, etc., which can also be cured. 13.What are the main treatment methods for impotence? ①Lifestyle adjustment: A good lifestyle is important for the treatment of impotence. Moderate exercise, reasonable diet, good sleep and weight control can improve vascular function and erectile function and increase the efficacy of PDE5 inhibitors. ② Control of underlying diseases: For patients with clear underlying diseases, clear causes should be treated, such as: cardiovascular disease, diabetes, endocrine abnormalities, depression, etc., and should be treated simultaneously with or before impotence. ③Psychological guidance: Compared to normal people, impotent patients are more likely to have psychological problems such as reduced well-being and a decrease in self-confidence and self-esteem. Patient education or counseling may then enable them to regain good sexual function. If patients have obvious psychological problems, they should undergo psychological guidance or treatment, and some patients may need adjunctive drug therapy. ④Sexual life guidance. ⑤ Oral drug therapy: mainly includes PDE5 inhibitor therapy and androgen therapy. At present, the commonly used PDE5 inhibitors in China include sildenafil and tadalafil. And the commonly used androgen is testosterone undecanoate. (6) Physical therapy: At present, there are mainly vacuum erection devices and extracorporeal low-energy shock wave therapy, which have a certain auxiliary effect on the treatment of impotence. (vii) Intracavernosal vasoactive drug injection: mainly includes prostilbestrol and poppy booster, which are considered only when oral drugs are ineffective. (viii) Surgical treatment: Surgical treatment modalities mainly include vascular surgery and penile prosthesis implantation. For example, venous leakage can choose dorsal deep penile vein ligation or dorsal deep penile vein subleukodystrophy, while for organic impotence where medication is ineffective there is also the option of three-piece penile prosthesis implantation. ⑨ Chinese medicine treatment: Chinese medicine can act on the whole body as a whole through multi-target, multi-system and multi-site, which is mild, slow and long-lasting, improving the systemic symptoms, and many Chinese medicines have androgen-like effects, which have obvious advantages in the treatment of impotence. 14.What are the main aspects of psychological treatment? ① make patients correctly understand impotence and its causes; ② find the causative factors and risk factors leading to impotence and self-regulation; ③ eliminate anxiety and depression and other adverse emotions, pay attention to self-adjustment; ④ strengthen effective communication between husband and wife; ⑤ avoid excessive attention to the disease and divert attention; ⑥ build up confidence, try more and learn more. 15.Is Viagra suitable for treating impotence? Will there be any side effects? Viagra is in fact the common term for Sildenafil (Viagra) and Tadalafil (Cialis). They are both PDE5 inhibitors that increase blood flow to the penile arteries by inducing the smooth muscle of the corpus cavernosum to stretch and the penile sinuses to fill with blood and swell, thus promoting erection. Currently, oral PDE5 inhibitors have become the drug of choice in Western medicine for the treatment of impotence. Both may have certain side effects when used, mainly including headache, facial flushing, and indigestion. However, both are transient and will disappear after stopping the drugs. In addition to the combination with nitrates (such as nitroglycerin, isosorbide mononitrate, isosorbide nitrate, etc.) is absolutely contraindicated, and other drugs are safe to use together. 16.Will the long-term use of Cialis become addictive? The treatment of impotence with Cialis has two treatment options, on-demand treatment and regular treatment. On-demand treatment means taking the drug orally before intercourse, once a time, while regular treatment means long-term daily use in small doses, which has a therapeutic effect on impotence and is absolutely not addictive, so it can be used with confidence. I prefer to take small daily doses orally, and generally reduce the dosage after two months of continuous use and slowly stop the medication. 17.Does Chinese medicine have advantages in treating impotence? Chinese medicine is the crystallization of the traditional culture of the Chinese nation, and is the summation of thousands of years of experience of medical predecessors in treating diseases. The Chinese medicine treatment for impotence has a low recurrence rate. At present, the effectiveness of Chinese medicine in treating impotence has been generally recognized by Western medicine, and Western medicine’s impotence treatment guidelines include Chinese medicine treatment. 18.Do I need to abstain from sexual intercourse during impotence treatment? There is no need for abstinence during impotence treatment. On the contrary, we advocate a regular sexual life. It is generally recommended that young men have sex 2-3 times a week. 19.Do I need to see the patient in person for impotence treatment? Is it feasible for family members to visit the doctor instead of me? Doctors have to prescribe according to the patient’s specific condition, not every impotence patient will have the same medication. In particular, Chinese medicine emphasizes the differentiation of evidence and treatment, which should be combined with observation and examination before prescribing medicine. In addition, the process of impotence treatment often involves some personal privacy issues, and family members may not be able to describe clearly. 20.How to prevent impotence? ①Learn about sex. ② understand the physiological fluctuations: when men in the case of excessive fatigue, poor mood and so on a momentary or a phase of impotence, most of them are a normal inhibition and physiological fluctuations, the male party do not add to the burden of thought, the female party do not blame, blame, so as not to make falsehoods into reality, resulting in impotence. ③ Sexual life should be regular: long-term excessive intercourse, immersed in pornography, is one of the causes of impotence. Regular sex life is an effective measure to prevent impotence. ④Dietary regimen: dog meat, mutton, sparrow, walnuts, cow whip, kidney, etc., zinc-containing foods such as oysters, beef, chicken liver, eggs, peanut rice, pork, chicken, etc., arginine-containing foods such as yams, ginkgo, frozen tofu, eel, sea cucumber, cuttlefish, octopus, etc., can help improve sexual function. ⑤ Improve physical quality: physical weakness, excessive fatigue, lack of sleep, stressful and persistent mental labor, are all factors in the development, should actively engage in physical exercise, enhance physical fitness, and pay attention to rest, prevent overwork, adjust the imbalance of the central nervous system function. (6) eliminate psychological factors: to treat the “sexual desire”, can not be seen as a shameful thing and disgust and fear, not because of one or two failed sexual intercourse and frustrated worry, lack of confidence. The couple should increase the exchange of feelings, eliminate discordant factors, tacit cooperation. The woman should care, caress, encourage her husband, try to avoid the flow of dissatisfaction, to avoid causing mental pressure on her husband. 21.What are the precautions in the process of impotence treatment? ①The vast majority of impotence hair are psychological impotence, bad emotions such as anxiety, fear, tension, etc. may lead to impotence, therefore, must adjust the mindset. ② Sexual life is a joint participation of husband and wife, good couple feelings is a prerequisite to get quality sex life. The wife’s complaints and accusations often aggravate the symptoms of impotence. ③Morning erection and whether the penis is erect during masturbation are not criteria for judging impotence, nor are they criteria for judging the effectiveness of impotence treatment. (4) Occasional failure to have sexual intercourse once or twice is often related to bad mood or fatigue and cannot be used as a basis for impotence diagnosis. ⑤The treatment of impotence needs a sufficient course of treatment, we recommend that the general treatment for three months, do not stop the medication because of the good effect during the treatment, must be under the guidance of the doctor regular medication. (6) During the course of medication, you must abstain from alcohol, seafood, bamboo shoots and other hairy items. (7) Life should be regular. Overwork, staying up late and mental stress are all detrimental to the treatment of impotence. It is generally recommended that young men have sex 2-3 times a week. ⑧ Men’s weight is often inversely proportional to their sexual performance, and obese patients are advised to lose weight. The majority of the so-called male specialty hospitals are Putian hospitals, which often mislead patients. The physiotherapy can be used as an auxiliary treatment for impotence, but it is definitely not the main treatment, and relying on physiotherapy alone will not cure impotence.