Treatment of impotence at the age of 40, 50, 60

Every sexually mature man knows what impotence or erectile dysfunction is. It is she who is one of the main fears of men of all ages and social status. Today there are many different drugs to restore potency, but almost all of them are intended only to eliminate the symptoms and not to affect the cause of the impotence, which, in other words, can be quitemuch. As a result, such drugs only give temporary results, need to be increased slowly and eventually lose their effectiveness.

Accordingly, in modern andrology and urology, the influence on the etiology of the development of erectile dysfunction, which is very different in the mechanism of impotence, is brought to the fore. Only by directly addressing the causes of the potency disorder can the problem be completely resolved, not temporarily restored to the ability to have intercourse.

male potency problem

Male anatomical features

The male reproductive system, that is, the activity of the penis, testes, appendages, . . . is controlled by the frontal lobes of the cerebral cortex, the sympathetic and parasympathetic nervous systems. At the same time, the endocrine - humoral and sex hormone mechanisms also have a direct impact on its activity.

The frontal lobe, through the involvement of neural factors, the autonomic and somatic nervous systems, is responsible for controlling sexual behavior. Achieving an erection is ensured by the activity of the parasympathetic nervous system, while ejaculation is controlled by the sympathetic nervous system.

The parasympathetic nervous system is a part of the autonomic nervous system with centers in the spinal cord and brain that relaxes the muscle fibers of the blood vessel walls. . . The sympathetic nervous system is the opposite of the parasympathetic nervous system. the autonomic nervous system, the centers of which are located in the spinal cord and are responsible for contracting muscle fibers, bringing the body into a state of "fight" readiness, and generally mobilizing its capabilities.

structure of the penis

Doctor's expert opinion

The autonomic nervous system sometimes malfunctions in each person, and as a result we have poor general health, contributing to the onset of autonomic dystonia, impaired autonomic function andautonomic crises, as well as somatoform disorders, the so-called visceral nerves. All of these are also a trigger for erectile dysfunction. Such neuroses are treated with the help of massage exercises, physiotherapy and physiotherapy.

During an erection, the walls of the corpus cavernosum of the penis dilate and the lumen of its blood vessels increases. This process is activated by the somatic and autonomic nervous systems with the involvement of regulatory centers located in the spinal cord. From there, through the spinal cord roots that branch at the level of the 3rd lumbar vertebra and further branch into smaller nerves, nerve impulses are transmitted directly to the vascular wall and cavernous body of the penis. object. Therefore, changes in the lumbar spine can interfere with this process, which in turn leads to impotence.

In men, the spinal cord ends at the level of the first lumbar vertebra, entering the large nerve plexus known as the cauda equina. It received this name due to its considerable external resemblance to the tail of a horse, as it is formed by a large number of nerve fibers descending along the spinal canal and secreted in pairs throughnatural openings in the vertebrae to produce the corresponding fibers. Viscera.

herniated disc leading to impotence

In addition, sexual function is also controlled by endocrine - humoral mechanisms, i. e. the testis - pituitary - hypothalamus system. In this case, the synthesis of semen and tissue nutrition is determined by the level of sex hormones. The adrenal glands are responsible for their production. They secrete almost two-thirds of androgens and up to 80% of estrogens, which are precursors of male sex hormones. But the functioning of the adrenal glands is directly related to the work of the thyroid gland. Therefore, violations of its functioning, as well as the adrenal glands, and the pituitary-hypothalamic system can lead to persistent impotence.

The hypothalamus is a part of the brain that is both a hormone-secreting gland and a center for autonomic regulation.

As a result, during sexual arousal by activating the synthesis of testosterone by hormones of the hypothalamic-pituitary system and transmitting nerve impulses in the cells of the penile artery wall, nitric oxide initiatessynthesized head. It stimulates relaxation of the smooth muscle fibers of the vessel walls, which is the cause of their dilation. As a result, the amount of blood entering the penis increases. It fills the cavernous bodies or cavernous bodies, ensuring an increase in the size of the penis and achieving the necessary firmness during sexual intercourse. In this case, the veins, where blood flows from the penis, are reduced. As a result of the decline in their lumen, the rate of blood outflow is reduced, which ensures the maintenance of an erection for a required period of time.

Causes and characteristics of development

Not so long ago, it was believed that up to 90% of cases of erectile dysfunction develop due to psychological disorders. But the studies carried out have forced not only to doubt this, but also to refute such claims. They show that 60-80% of impotence cases are caused by organic disorders. It is worth noting that we are not talking about potency reduction and different degrees of erectile dysfunction, but about impotence, i. e. extreme degrees of erectile dysfunction, in which an erection is not possiblepersists with the achievement of the hardness, mass, and immediacy of intercourse required for intercourse.

With impotence, men complain of a lack of sexual desire, combined with the complete absence of not only the desired erection but also spontaneous episodes.

lack of sexual desire with impotence

Understanding the relationship and function of the male reproductive system, it is not difficult to identify the main reasons for the development of impotence. It:

  • spinal and pelvic trauma;
  • degenerative-dystrophic changes in the intervertebral discs of the lumbar spine (herniated discs, protrusion);
  • scoliosis (scoliosis, scoliosis);
  • disorders of the work of the hypothalamic-pituitary system and hormonal disorders;
  • vascular disorders, including stroke, atherosclerosis, hypertension, abnormalities in the structure of the cavernous body of the penis and circulatory disorders in the reproductive system due to the development of prostatitis orprostate tumor.

Today, according to official data, impotence is diagnosed in 40-50% of men aged 40 to 50 years, in 50-60% of men aged 50-60 and in 60-80% of men over 60 years of age. . At the same time, there is every reason to believe that the situation is, in fact, more difficult, since not all men have the courage to go to the doctor with such a delicate matter.

In many respects, such statistics are due to the decline in testosterone produced after 40 years and the progression of previously acquired spinal and vascular diseases. Between the ages of 50-60, there is a natural hormonal change with a decrease in the amount of synthetic testosterone. This leads to a decrease in desire and, with it, the need for sex. But even men in their 60s can still maintain a normal erection for full intercourse without other disturbances. The only difference is their frequency reduction.

One of the most common causes of impotence in men of various ages, including in the 40s, and sometimes even earlier, is a neurological disorder caused by invasion of the spinal roots, responsible for the growth of the blood vessels of the penis. Their compression or damage occurs from trauma to the spine or from a curved spine, protruding discs, or other structures.

impotence due to invasion of spinal roots

In this case, they talk about the presence of neurogenic impotence. Because the filling of blood into the cavernous bodies of the penis is controlled by the nervous system, in the case of disturbances in the transmission of nerve impulses from the brain to the penis, even if there is desire, the body cannot transmit it. Okay. a signal about this and stimulates a positive blood flow to the cavernous bodies. Most often, this is observed when the nerve is pinched, passing through the spine at the level of the 3rd vertebra.

Another common cause of impotence is inflammation of the prostate gland, also known as prostatitis. Today, this disease in a chronic form occurs in men even before the age of 40, and after the age of 50 it is observed in almost every third person. In this case, impotence is often the only symptom of prostatitis.

Prostatitis, like impotence, can be a consequence of circulatory disorders in the pelvic organs due to the development of vascular or neurological disorders.

Prostatitis causes discomfort and pain in the perineum. In addition, the swollen prostate leads to compression of the blood vessels, reducing the intensity of blood circulation in the pelvic organs. In addition, cytokines produced in response to inflammation interfere with the transmission of nerve impulses to the prostate. At the same time, its function is disrupted, which contributes to a decrease in the synthesis of testosterone, which is responsible for sexual function. All of this in a complex inevitably fails to fill the cavernous bodies with adequate blood and leads to loss of potency.

Prostate tumor with impotence

Doctor's expert opinion

Prostatitis in the modern world is the result of a careless attitude towards one's health. As a rule, this is a consequence of untreated colds, which have become chronic, postural disturbances and physical inactivity. Therefore, it is necessary to clean the foci of chronic infection, since conditionally pathogenic flora (for example, coccyx), which develop in the cavities of the prostate gland, can also be the cause of inflammation. Prostate. In addition, you need to change your attitude towards sex life, activate it.

Types and consequences

Based on what is the cause of the development of impotence, the following types are distinguished:

  • Nerve impotence - occurs very often and is caused by a disorder in the transmission of nerve impulses to the smooth muscle of the penis. It is characterized by a decrease in penile sensitivity and a gradual decrease in the frequency of erections, including spontaneous erections, in the morning.
  • Vascular, arterially divided and toxic. The first is a consequence of a violation of blood flow to the corpus cavernosum, which becomes a consequence of changes in the state of the gonadal and cavernous arteries. The latter occurs against the background of dilation of the veins of the penis, which causes excessive outflow of blood. In the case of vascular impotence, incontinence is characteristic in the early stages of formation, as is a decrease in the ability to have an erection.
  • Hormonal - it becomes the result of hormonal imbalance, which is often observed against the background of diabetes mellitus and other endocrine pathologies, leading to inhibition of production and anabolismtestosterone.

There are several other types of impotence, for example, due to anatomy, genetics, etc. v. , but they are much less common than those described above.

Regardless of the type of impotence, it is always a serious problem for men. First of all, the inability to have intercourse leads to difficulties in personal activities, loss of self-confidence and affects psychological well-being. Often, impotence becomes the cause of an increase in aggression and the development of severe depression in men of any age, especially when it develops at a fairly young age - in the 40s-50 years old. This cannot pass without leaving a trace, so relationships with close people and colleagues are heating up, conflicts often flare up, which can lead to job loss and depression. more significant to the point of suicidal ideation or, conversely, antisocial thoughts.

family problems due to incompetence

But, in addition to psychological difficulties, impotence has extremely negative effects on men's health. Constant stress aggravates existing chronic diseases, and also negatively affects the immune state. As a result, a man becomes more susceptible to infectious diseases. In addition, psychological stress often causes disorders of the digestive tract, heart and lungs. Therefore, often against the background of impotence develops or worsens:

  • gastritis and peptic ulcer;
  • Ischemic heart disease, angina attacks;
  • bronchitis, etc. v.

Therefore, it is extremely important not to ignore the problem of impotence, due to age and toleration of circumstances, but to start taking action, to find the cause of sexual dysfunction and how to solve it. . This is true not only at the age of 40, but also at the age of 50 and 60. A comprehensive diagnosis and targeted treatment of detected disorders not only helps to restore normal capacity and return to sexual life. A man's full sexual health, at the same time psychological comfort, but also eliminates diseases that, if left untreated, can lead to seriousness and sometimes even life. - Complications caused. as well as disability.


In the absence of effect or early stages of erectile dysfunction, a man needs to consult a urologist and in the absence of a specialist in the city, a doctorurinary. During the initial consultation, the doctor will listen to the patient's feelings, assess the psychological state and examine the groin area for signs of pathologies in the genital organs. In the absence of such, the doctor prescribes a series of diagnostic procedures, the main purpose of which is to detect the pathology of other organs and systems that cause the development of impotence. It:

  • UAC and OAM;
  • analysis of the level of sex hormones, thyroid hormones, etc. ;
  • check blood sugar;
  • determine the level of blood pressure;
  • PCR for the presence of sexually transmitted diseases;
  • Ultrasound of the genitals;
  • palpate the prostate to assess its condition.
Impotence treatment by doctor

If these studies do not show visible deviations from the norm, the patient will be advised to consult a neurologist, as this is a fairly common neurogenic impotence today. . At the consultation, the neurologist will examine the patient, and he will first be interested in reflexes, the condition of the spine, and the completeness of the limb movements. To determine the presence of changes in the state of the spine, the doctor uses palpation and conducts functional tests. On the basis of the results obtained, he can establish the presence of changes in the state of the spine. But in order to determine the diagnosis, as well as to accurately determine the extent and nature of the pathology, instrumental research methods are necessarily carried out:

  • X-ray or CT is the main method for diagnosing abnormalities in the skeletal structure of the spine, so they are often used to detect scoliosis, scoliosis, etc. v . . . ;
  • MRI is the best method to detect changes in the state of soft tissue structures, including discs, spinal cord, etc. v. ;
  • Myelography is a method that allows to assess the quality of nerve impulse conduction to the muscle, providing information on the degree of nerve deficit due to spinal cord root compression.

Features and shades

In general, treatment for impotence can be divided into symptoms and causes. In the first case, all efforts are directed at obtaining the appropriate effect, and in the second, at eliminating the causes of its loss. The first way involves getting the results here and now, the second is more complicated and allows you to completely eliminate problems with potency, but gradually. Therefore, today they often combine symptomatic therapy and treatment, helping patients quickly recover psychological comfort, as well as improve general health.

Therefore, treatment for impotence usually includes:

  • drug therapy aimed at restoring potency and treating diseases that cause impotence;
  • manual therapy, which allows to improve the quality of blood circulation in the pelvic organs, as well as eliminate pathologies of the spine and restore the normal transmission of nerve impulses to the smooth muscle fibers of thepenis;
  • Kinesiotherapy, which involves training the pelvic floor muscles, as well as the back and abdominal muscles, helps reinforce the results of manual therapy and is extremely important for neurogenic impotence.
Impotence treatment promotes happy family life

All patients are advised to:

  • give up smoking, alcohol and drugs;
  • increasing levels of physical activity, especially when leading a sedentary lifestyle, sedentary work, etc. v . . . ;
  • make dietary adjustments, bringing it as close as possible to a healthy diet;
  • to lose weight when there are signs of obesity, especially in the abdomen;
  • Avoid stressful situations.

It is not uncommon to find recommendations for using a vacuum pump or pump to treat impotence. But this method does not have any therapeutic effect and does not always cause an erection. However, it is associated with a higher risk of pain during ejaculation, bruising, and pain or numbness in the penis itself, so it is not recommended by urologists.

Medicines for treatment

The first step after determining the cause of the development of impotence is the appointment of appropriate drug therapy. It consists of prescriptions meant to restore potency and eliminate diseases that cause problems with it.

happy couple in bed

Symptomatic treatment of impotence consists mainly of the use of drugs to induce erection, i. e. PDE-5 inhibitors. In some cases, the use of vasodilators is prescribed, which temporarily activates blood flow to the cavernous bodies of the penis. But they also do not have a curative effect and only allow a short time to solve the problem of impotence.

Therapeutic treatment of the root or aimed at eliminating the causes that caused the development of erectile dysfunction is more complex and complex. Moreover, its nature directly depends on the causes of impotence:

  • with pathologies of the thyroid gland, diabetes, hormonal drugs and / or hypoglycemic drugs are prescribed, which should be taken continuously to maintain a normal hormonal balance;
  • with prostatitis, antibiotics, α1-blockers, homeopathic remedies are indicated, and therapy is selected individually depending on the cause of prostatitis;
  • in case of vascular pathology, the use of drugs that normalize blood pressure, reduce the level of cholesterol in the blood, manual therapy is shown;
  • For spinal diseases that cause compression on the spinal roots, use drugs to restore modified discs, B vitamins, muscle relaxants, NSAIDs and some others.

PDE-5 . Inhibitors

Phosphodiesterase-5 or PDE-5 inhibitors are a class of drugs known to most men to deal with erectile dysfunction. They are based on active substances that inhibit the production of a particular enzyme, phosphodiesterase-5. It is responsible for blocking cyclic guanosine monophosphate (cGMP), which is a product of biochemical transformations triggered by nitric oxide. cGMP leads to a decrease in smooth muscle tone, and thus dilation of the cavernous bodies of the penis, i. e. , an erection occurs. Thus, PDE-5 inhibitors, by decreasing the activity of phosphodiesterase-5, "extend the lifespan" of cGMP, thereby providing long-lasting and stable erections even in the context of thesenatural age-related changes.

All PDE-5 inhibitors work only on demand, i. e. sexual stimulation is required to be effective.

PDE-5 inhibitors include:

  • Sildenafil was the first drug that appeared on the pharmaceutical market to increase potency. It has the shortest duration of action - up to 4 hours and begins to work 45-50 minutes after ingestion. But sildenafil is incompatible with alcohol, and also often causes side effects (redness, nasal congestion, headache, heart discomfort).
  • Tadalafil - has the longest duration of action - up to 36 hours, and the effect occurs 15-20 minutes after ingestion. Tadalifil is generally well tolerated and rarely causes undesirable effects.
  • Vardenafil is a 5-12 hour medication with effects starting 30-45 minutes after administration. One of the advantages is compatibility with alcohol, but it is still advisable to avoid its use, since it negatively affects the condition of blood vessels.
medicine for impotence

The drugs in this group are available in different dosages. In most cases, urologists recommend starting with the minimum dose and increasing it only if there is no effect. FED-5 inhibitors should be taken no earlier than one hour after a meal. This will ensure the fastest possible absorption of the active ingredient and the ability to achieve an effect. If you take the medicine with food, the speed at which it begins to work will be reduced.

It is important not to take more than the recommended daily dose. This increases the chance of side effects and can adversely affect the functioning of the cardiovascular system.

At the same time, it is important to consult a doctor before using such drugs, since they have a number of contraindications:

  • severe cardiovascular diseases, especially angina and coronary artery disease;
  • anomalies in the structure of the penis;
  • past case of priapism (painful prolonged erection);
  • optic nerve disease;
  • have had a stroke or heart attack in the past six months.

PDE-5 inhibitors should not be combined with α-blockers, nitrite-based drugs. These combinations can cause serious complications.

PDE-5 inhibitors make it possible to achieve adequate potency in most cases. But with their uncontrolled use, the organism initially develops an addiction, which requires increasing the dosage to get the same results.

take medicine to restore potency

Thus, impotence is not today's sentence. Men of almost any age can face it, especially representatives of "sedentary" professions and those associated with excessive physical activity. But when such a delicate issue arises, it's important not to be shy and self-medicate, but to see a doctor. Furthermore, the sooner a man seeks medical help, the quicker he will get rid of the problem of impotence, and reduce his risk of developing other complications that can cause conditions that lead to erectile dysfunction. positive.