What is impotence?
Impotence is an inability to achieve or sustain an erection. This condition is also called erectile dysfunction.

What causes impotence?
There are many possible causes of impotence:

• Age

• Medications (antidepressants, heart medication, pain medication)

• Anxiety and Depression

• Smoking and alcohol use

• Vascular problems

For cancer patients, the cause of impotence is often cancer treatments, including:

• Chemotherapy (damages testes and reduces testosterone production; some drugs, such as cisplatin (Platinol®) and vincristine (Oncovin®) may interfere with nerves that control erection)

• Surgery for prostate cancer (may damage nerves)

• Radiation therapy to the pelvic region (may damage testes)

• Hormonal therapy for testicular cancer (reduces testosterone levels in the body)

The cancer itself may also damage nerves involved in having an erection.

What is the treatment for impotence?
Talk to your doctor about options for treating impotence. Depending on your circumstances, your doctor may recommend hormone replacement, medication or exercises.

Hormone replacement therapy (HRT): HRT may be an option if your cancer is not hormone-related, such as prostate or testicular cancer. Your doctor may refer you to an endocrinologist who can administer hormone patches and/or testosterone replacement.

Drug therapy: In recent years, several drugs have been developed that inhibit an enzyme to help you maintain an erection. These include sildafenil (Viagara®), tadalafil (Cialis®), and vardenafil (Levitra®).

Exercises: The Kegel exercise focuses on improving circulation and strengthening muscles that are used for intercourse. This exercise involves  contracting the muscle that control urination and attempting to hold each contraction for at least 10 seconds, then releasing. Do these exercises as directed by your doctor, or 3-5 times per day, 5-10 contractions each time.