Few years back if I remember right in 1998 when I was about to close my clinic around 11.30 PM a lady around 24 years came along with a man around 30 years who is nothing but her husband came to my clinic in anxiety, stress and emotion stating that “doctor this is the fourth year of our marriage but so far first night – first intercourse/ did not happen”. Then I asked her husband what is the reason for this situation. He did not answer me readily but he told though he was trying to do intercourse he was not getting erection of his penis that is the genital organ. He further told that he went to Kondadoras, who gave him Pasaru (leafy paste) and some powders of roots and lehyam despite using them not being able to get an erection, and hence the so-called first night did not occur. His wife cried in front of me and requested a solution to this problem. She blamed her husband for the delay of this consultation. It is usual practice to blame the wife and vice versa without scientific evidence. Therefore, treating doctors of this kind of medical problem should examine both partners, wife and husband. In India, studies suggest that approximately one in ten men experience erectile dysfunction (ED), otherwise called impotency, or the inability to perform intercourse satisfactorily, with a concerning trend of increasing ED among younger men. Some research indicates that nearly 25% of patients seeking ED treatment are younger than 30 years.
I counselled the couple to come next day during my clinic hours so that I could consult with my colleague gynaecologist to examine both, and necessary tests would be conducted to plan for the management. In the present era impotency of any grade can be successfully treated with modern medicines. Co-existing diseases like diabetes, hypertension, depression, mental illness, stress, certain drugs used for high blood pressure and other ailments can also cause impotency. Proper hormonal assay, if necessary, colour Doppler of penis and other relevant tests would help the physician to treat the victims pleasingly.
In India, erectile dysfunction (ED), often referred to as impotency, among youth is increasingly linked to lifestyle factors like stress, unhealthy diets, and substance abuse, alongside psychological issues and underlying medical conditions. During the last two decades, software employees’ working hours, viz., working the whole night and sleeping the whole day time have led to a biological imbalance of the body and failure by many young guys of this profession to perform happy intercourse is surfacing slowly. There is one publication were people who work on lap tops, the radiation from certain laptops directly concentrates or shatters on genitals (sex parts, testicles) thereby causing impotency. Studies indicate a growing trend of erectile dysfunction (ED) among young men in India, with some research suggesting a significant increase in prevalence compared to older generations, potentially linked to lifestyle factors and psychological stress. According to the latest research published in “Curr Urol Rep. 2024 Sep”, regarding erectile dysfunction organic and psychogenic etiologies, correlations between the COVID-19 pandemic and online pornography consumption have been contributing significantly.
Further it is likely that with stress from anxiety and depression, cortisol levels rise, increasing vascular resistance that is leading to erectile dysfunction. Most patients want to be reassured of normal testosterone levels, offered cognitive behavioural therapy, and be rehabilitated suitably with correct medication.
In India, openly discussing sexual health problems is taboo. Due to this, a lot of sexual health problems are ignored, and people do not get treated on time, besides consulting quacks. This situation is slowly changing, and there is access to specialized care now. Impotence refers to the inability to have an erection for sexual intercourse. Male impotence is an extremely sensitive topic globally. One in every ten Indian men is impotent, and the figure may be greater in the metros. According to the data, India is rapidly becoming the world’s impotence capital. According to research, any age group can suffer from the condition. Young people, in particular, are more likely to hide and not seek it out as a problem and thus do not want to share the problem with others due to the stigma associated with the issue. As the problem is often ignored and not discussed, it often becomes serious and disrupts personal relationships, breaking marriages and causing commotion in families. Due to a lack of awareness of the fact that it is a serious condition that requires medical attention, it becomes more difficult to share and get treated. Young people going through it feel embarrassed and lonely, and finally, all these feelings result in sheer depression. Severe depression has led to suicides in some cases in the recent period.
Reasons for Impotency
The causes of erectile dysfunction in men can be manifold. The onset of impotence should signify the quest for an underlying cause. Impotency can be caused by conditions that damage the heart and its capacity to pump blood efficiently. A man cannot have an erection if there is insufficient blood flow to the penis. Impotency can be caused by atherosclerosis, a disorder in which blood arteries become congested. Also, in this condition where plaque, a build-up of fatty substances, cholesterol, and other substances, forms in the artery walls, leading to narrowing and potentially blocking blood flow. Diabetes mellitus is an important cause of impotence and it is almost mandatory to screen for diabetes and heart disease, especially in young men. The causes of impotency, some diseases and some medicines use can lead to impotency and relevant factors also the management of impotency will be discussed in the coming issue. (To be concluded).