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Symptom: IMPOTENCECause: Endocrine disorders
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Description:
Hypogonadism from testicular or pituitary dysfunction may lead to IMPOTENCE from a deficient secretion of androgens (primarily testosterone). Adrenocortical and thyroid dysfunction and chronic hepatic disease may also cause IMPOTENCE because these organs play a role (although minor) in sex hormone regulation



Symptom: IMPOTENCECause: Alcohol and drugs
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Description:
Alcoholism and drug abuse are associated with IMPOTENCE, as are many prescription drugs, especially antihypertensives. (See Drugs that may cause IMPOTENCE, page 364.)


Symptom: IMPOTENCECause: Surgery
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Description:
Surgical injury to the penis, bladder neck, urinary sphincter, rectum, or perineum can cause IMPOTENCE, as can injury to local nerves or blood vessels


Symptom: IMPOTENCECause: Psychological distress
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Description:
IMPOTENCE can result from diverse psychological causes, including depression, performance anxiety, memories of previous traumatic sexual experiences, moral or religious conflicts, and troubled emotional or sexual relationships


Symptom: IMPOTENCECause: Penile disorders
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Description:
With Peyronie-s disease, the penis is bent, making erection painful and penetration difficult and eventually impossible. Phimosis prevents erection until circumcision releases the constricted foreskin. Other inflammatory, infectious, or destructive diseases of the penis may also cause IMPOTENCE



Symptom: IMPOTENCECause: Central nervous system disorders
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Description:
Spinal cord lesions from trauma produce sudden IMPOTENCE. A complete lesion above S2 (upper motor neuron lesion) disrupts descending motor tracts to the genital area, causing a loss of voluntary erectile control but not of reflex erection and reflex ejaculation. However, a complete lesion in the lumbosacral spinal cord (lower motor neuron lesion) causes a loss of reflex ejaculation and reflex erection. Spinal cord tumors and degenerative diseases of the brain and spinal cord (such as multiple sclerosis and amyotrophic lateral sclerosis) cause progressive IMPOTENCE


Symptom: PRIAPISMCause: Drugs
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Description:
Priapism can result from the use of a phenothiazine, thioridazine, trazodone, an androgenic steroid, an anticoagulant, or an antihypertensive. It may also occur after an intracorporeal injection of papaverine, a common treatment for IMPOTENCE


Symptom: CYANOSISCause: Arteriosclerotic occlusive disease (chronic)
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Description:
With arteriosclerotic occlusive disease, peripheral cyanosis occurs in the legs whenever dependent position. Associated signs and symptoms include intermittent claudication and burning pain at rest, paresthesia, pallor, muscle atrophy, weak leg pulses, and IMPOTENCE. Late signs are leg ulcers and gangrene. dependent position. Associated signs and symptoms include intermittent claudication and burning pain at rest, paresthesia, pallor, muscle atrophy, weak leg pulses, and IMPOTENCE. Late signs are leg ulcers and gangrene.



Symptom: MIOSISCause: Neuropathy
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Description:
Two forms of neuropathy occasionally produce Argyll Robertson pupils. With diabetic neuropathy, related effects include paresthesia and other sensory disturbances, extremity pain, orthostatic hypotension, IMPOTENCE, incontinence, and leg muscle weakness and atrophy


Symptom: URINARY INCONTINENCECause: Diabetic neuropathy
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Description:
Autonomic neuropathy may cause painless bladder distention with overflow incontinence. Related findings include episodic constipation or diarrhea (which is commonly nocturnal), IMPOTENCE and retrograde ejaculation, orthostatic hypotension, syncope, and dysphagia
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