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NavneetImpotency


Impotency means inability to perform normal sexual intercourse due to either premature ejaculation or failure to have or maintain satisfactory erection. This should not be confused with sterility. An impotent may be sterile or fertile, so also sterile man may be potent or impotent.


Penile erection and involuntary ejaculation of the semen depend on a reflex act at the sacral level. Two opposing nerves regulate the phenomenon of ejaculation. The reflex is under the control of automatic nervous system. Sympathetic nerves (L2 & L3) through hypogastric nerve control the act of ejaculation; while parasympathetic nerves (S2, 3 & 4) through nervi erigentis control the erection. When the centre becomes hypersensitive or over sensitive, the premature ejaculation occurs. While physiological stimuli transmitted by the central nervous system from the higher centre and androgen secretion in conjunction with higher cerebral impulses govern libido. Impotence may result from organic or psychic disturbances. It may be complete or partial. It may be with normal or impaired libido.


Organic or secondary impotence may be further divided:

  • Endocrine affections
  • Neurological disturbances
  • Toxic affections
  • Atherosclerosis of the aorta and iliac arteries.

Endocrine affections or disorders may be due to eunachism, pituitary syndrome, hypopituitarism, dwarfism, Frohlich’s syndrome, Cushing’s syndrome, acromegaly, gigantism, myxodema, Addison’s disease, androgen deficiency, pigmentary cirrhosis, hypogonadism and absence of libido.


Neurological disorders may be diabetic neuropathy, peripheral neuritis, medullary or spinal cord lesion, tabes dorsalis, general paralysis of the insane, trauma, Aorto-iliac endaterectomy or tumour of the spine, spina bifida, cauda equine, disseminated sclerosis, and blocking of sympathetic ganglia by drugs for hypertension.


Toxic affections: Farmers who happen to handle chemicals, insecticides and pesticides are known to develop impotency. But it is reversible on suspension of work.


Psychic impotence also called primary or functional may be due to:

  • Fear of inadequacy,
  • Emotional conflicts,
  • Faulty attitude towards sex,
  • Fatigue, anxiety or convalescence,
  • Guilty feeling, and
  • Rejection by wife.

This group comprises of 90 percent cases of impotence, while the remaining 10 percent is due to organic lesions which are often obvious at sight. In psychic impotence, there is no harmony of the body and mind or the brain and mind.


In all cases of impotence, a careful comprehensive and systemic examination to exclude organic lesions is of utmost importance. This also helps to gain confidence of the patient. Once this is done, one would be dealing mostly with common cases of psychological impotence.


Premature ejaculation is most common especially when a male is worried, fatigued or apprehensive. When it occurs occasionally in between long periods of sexual relations, one need not worry about it. It may be taken as temporary set back. But when it occurs frequently and persistently, it ought to cause concern and needs an
urgent attention. Premature ejaculation may be “post-partus” or “ante-partus”.
In the former the involuntary ejaculation occurs immediately on intromission or very soon after that. In the latter, the more serious of the two, ejaculation occurs even before the penis is introduced into the vagina. Ejaculation may take place with semi-erect condition or without erection.


Premature ejaculation is often due to hypersensitivity which may be due to:

  • Physical causes such as tight prepuce or extra sensitivity of the glans penis,
  • Pathological causes such as inflammatory condition or congestion of the posterior urethra, or
  • Emotional cause such as fear, guilt feeling or an intense desire or passion especially after prolonged separation.

In both forms of premature ejaculation, the female partner does not get an opportunity to achieve full satisfaction and orgasm. She naturally feels hurt and rejected. This finds itself in her behaviour, expression and talk. The male, being very touchy and sensitive of his potency, begins to feel inadequate, maladjusted and unhappy. He remains under constant tension and fear. This is the time when the wife has to be very tactful, considerate, and affectionate and refrain from remark and criticism. In fact she must do everything in her power to reassure him of his manliness and potency. This assurance must be by word, action, gesture and thought. In absence of her genuine co-operation, he is not likely to improve his functioning as a husband. A wife can be directly responsible for her husband’s poor performance. A tactless wife who often nags her husband, who is sarcastic or caustic in her remarks, who is over-critical of his actions, which constantly argues or devalues her husband, is very likely to be neglected by her husband. Her attitude towards ‘sex is shameful’ or her refusal to participate in certain sexual fore-play may have profound effect on his potency. In some cases, a man’s impotency may be due to his anxiety about the past experiences such as masturbation, guilt feeling or due to his homosexual tendencies. Occasionally, a man may be impotent with his own wife but potent with other women. This is called relative impotency.


In hypogonadism, if present from the puberty, the patient seldom complains of impotency because he has little or no libido. The same is true of cases of impotence due to generalized debility or convalescence following severe illness. When an organic neurologic lesion is present, the patient may complain of impotence and fail to achieve an erection. Impotence is a common complication of diabetes mellitus and hypertensive state. In actual practice, organic lesion count for about ten percent of cases of impotence; while the rest owe their condition to psychological factors. History of these cases is very important, in making the diagnosis. Early morning erection with full bladder or rectum is a good evidence of normal anatomical and physiological function. It has been noted that mean urinary testosterone level is significantly higher in psychogenic impotence than in constitutional impotence.


TREATMENT:


The treatment of impotency must be on the etiologic basis. To deal with various causes individually would be beyond the scope of this article. A physician has to identify the actual cause at the root and guide the patient and his wife towards correctness and adjustment, if the treatment has to be effective and successful. Any cause in the operation has to be found out and removed by appropriate measures. Most patients need reassurance and full cooperation from their wives and physicians.


It must be impressed on every male that a man, at some time or other during his life, suffers from either want of erection or premature ejaculation or both, and that this does not mean that the condition is permanent. It should be regarded as temporary inconvenience, which passes of itself in majority of cases. It is a mistake to depend solely and immediately on drugs and their massive doses. The wife’s role in reclaiming and rehabilitating her husband’s manhood should not be belittle or made small. A good deal of success will depend on her sincere cooperation. Yet many wives are prone to be guilty in weakening and worsening their husband’s sexual power. She must learn not to feel rejected or hurt because of his failure. She must build up his ego and at the same time her ability to arouse him. At times which may suit her partner, she must take initiative in love-making. The wife who shows undue shyness and is afraid to manifest of evidence of being aroused, is really uninviting to her
husband. When she behaves in bed as she should, her husband is less likely to find himself impotent.


In patients with hypogonadism, potency can be initiated and restored by giving androgen but this is not likely to influence his infertility. Neurological causes can seldom be treated effectively. Prognosis is generally poor except in cases of spinal compression, where timely surgery can be of great help.


Mechano-therapy to help erection:


Active and Passive Desensitization as suggested by Dr. J.H.Semen and Dr.J.Wolpe (U.S.A) respectively:


In the former method, the wife is required to stimulate the male organ manually till he feels the sensation that precedes ejaculation. Repetition of this exercise or procedure day by day establishes a condition in which intense sexual stimulation is tolerated without ejaculation. Thus he learns to postpone precipitate ejaculation.


In the latter method, the couple is to engage in sexual closeness without either expecting an intercourse. They indulge in only as much actively as the male can tolerate without anxiety. As there is no set goal he must reach or no level of sexual performance he must attain, his anxiety is considerably reduced. By repeating this procedure daily, he gradually becomes more and more relaxed and is able to indulge in more intense closeness and embrace without being least anxious. He thus learns to tolerate greater amount of stimulation without precipitate ejaculation. His sexual mechanism gets re-trained to respond in the union without fear.


Authors of these techniques of desensitization have successfully used these methods in their practice.


CASES:


A patient with psychic impotence could possibly help himself to relax and decrease the amount of tension by taking on himself a less active role during coitus. He can assign the active role to his female partner. One case of a young man who had indulged in the practice of masturbation merely for physical relief was brought to my attention. He married and no more than one week after the ceremony his bride came weeping to me asking for advice. She coded that the young husband’s attempts at intercourse were revolting to her, as well as disturbing to her nervous system. Because she wished to have a family, she was crushed by grief at the predicament in which she found herself for she was in love with the man of her choice. Above everything else I recommended her to be patient, sympathetic and to do everything in her power to reassure him of her confidence. Both were nervous frightened and thrown into the deepest chagrin. Rest and emotional relaxation were needed and no attempts at intercourse should even be attempted for several weeks. Intimacy and affection and knowledge of each other were in this case the first essential. I advised the young woman that all the outgoing streams of affection and confidence should be strengthened before the final act of sex should be thought of again.


The husband should of course make a determined effort to free himself of the pernicious habit which had caused this temporary tragedy and which had such a deleterious effect upon his nerve centers. The advice was followed along with a single dose of CONIUM 1M (ill effects of masturbation- Anac, Con, Ph ac, Pic ac, Salix Nig, Staph) and within six months not only had this marriage been successfully consummated but a baby was on its way into the world. By a strict adherence to the simple rules advised and the wife’s tactful sympathy complete potency was regained and with it an added ambition and mental understanding.



Another case of impotence through masturbation was brought to my attention but in this case the young man indulged not merely for physical relief. His imagination was fired by feminine attire by magazine covers. His imagination had been perverted and fixed by the practice and he failed to break through the slavery of the habit. This man with a proper counselling session and along with a single dose of AGNUS CASTUS 1M (Perverted sexual desire – Agn Cast, Nux Vom, Plat, Staph) is now perfectly normal & is a father of a sweet little girl.


It reminds me of one more case of a 26 yrs old male who believed that he would be unable to perform normal sexual act as he was impotent. Therefore, his fiancée should not suffer unnecessarily on account of him. He insisted on her forgetting him and to marry someone else. On medical examination it was found that there was nothing wrong with his sex organs and his fear had no organic cause. Thus it was clearly impotence of psychological origin. A dose of ONOSMODIUM 1M (Fear, impotence of – Nat Mur, Onos, Pitu) along with a counselling session changed this young man’s life.


Thus Homoeopathy offers remarkable results in impotence or erectile dysfuntion cases, which may have arisen from both physical and psychological causes. Both, the mental as well as physical components of the disorder can be addressed using homoeopathic treatment. Homoeopathy offers almost 203 remedies for men suffering from erectile dysfunction (ED) or impotence. Unlike allopathic medicines, homoeopathic medicines are non toxic and non addictive. Homoeopathy doctors frequently treat patients suffering from anxiety, fear of failure to do sex, erectile dysfunction (ED) or impotence associated with stress and high blood pressure. Work stress, mid-life crisis and other issues affect men's health in various ways. Men facing the challenge of aging, retirement and finding new identities for themselves, find a particularly appropriate therapy in homoeopathy, which addresses them on mental, emotional and physical levels. When combines with benefits of good nutrition, exercise and relaxation, homoeopathy provides optimum support for such patients. Where the cause of impotence is with other system diseases and due to drug effects, there also homoeopathy provides better option.


REPERTORY OF MALE INFERTILITY


SYNTHESIS Male, Sterility:


Agn, Alet, Aur.m, Bar. M., Bor, Caul, Cis.c, Con, Dam, Fil, Form, Goss, Graph, Gun.p, Helon, lod, Lapp, Mill, Nat M, Nat.p, Phos, Sabal., Sol. lyco, Sul.ac, Teucr, Wis, X-ray.


These medicines are taken from four authors

-Dr. J.H.Clarke

-Dr.A.T.Bryant

-Dr.Jhar, and Dr.Stephenson

-Dr.J,H.Clarke (c2): From ‘ A Clinical Repertory to the Dictionary of Materia Medica’,


Agn, Alet, Aur.m, Bar.m, Borx, Caul, Con, Dam, Fil, Form, Goss, Helon, lod, Lapp, Mill, Nat.m, Nat.p, Phos, Sabal, Sul.ac, Ther, Wies..


-These medicines are mentioned under the rubric sterility in Clinical repertory. But whether it is male or female is not specified.


-The medicines seems more deviated to the female side on reference.


-In Synthesis these medicines are seen added to the rubric - sterility in both the chapters, Male and Female.


-So, medicines under the rubric are to be further studied clinically to come at a conclusion whether they are to be considered as valuable and reliable for the treatment of male sterility.


SYNTHETIC REPERTORY

Male Sterility: Sulfa, X-ray.


Here the author reference for ‘Sulfa’ is mentioned to Dr.O.A.Julian’s Materia Medica.



REPERTORY TO THE HERING’S GUIDING SYMPTOMS OF OUR MATERIA MEDICA.

Dr.K,B.KNERR.

Male sexual Organs: Testicles: Sterility: Ferr.


Dr. K.N.MATHUR DIABETES MELLITUS, ITS DIAGNOSIS AND TREATMENT,

In the therapeutic part: Concomitants (of Diabetes Sterility: Aur.m.n, Aurm, Borx, Con, Graph, Helon, lod, Med, Nate, Nat.m, Phos, Thyr. (No specification- whether Male or Female)


Dr. BERKLEY SQUIRE: A REPERTORY OF NOSODES AND SARCODES.

Male Genital: Aspermatogenesis, Oligospermia : Lepr.


Male Genital, Male Sterility, Impotence: Ambr, Bac.7, cortico, Lac.d, Lepr, Med, Psor, RNA, Syco, ThaI, X-ray.


Dr. C. M. BOGER: SYNOPTIC KEY.

Sexual Impulse:

Sterility: Aur, Bor, Mere, Nat M, Phos.

(No specification- whether Male or Female)


Dr. RAUE.C.G. : SPECIAL PATHOLOGY AND DIAGNOSTICS WITH THERAPEUTIC HINTS.

Under the section Impotence and Sterility, the medicines mentioned in therapeutic hints are: Agar, Agn, Baryta, Calad, Eup.pur, Gels, Hamam, Helon ,Lyco, Nat.m, Nit.ac, Phos, Phyto, Selen, Stilling.


CLARKE.J.H: A CLINICAL REPERTORY

Sterility: Agn, Alet, Aur.m, Bar.m, Bor, Caul, Con, Fil, Gos, Iod, Nat.p, Pho, Sabal, Sul.ac, (Ther), Tur, Wis.


Dr. RAI BAHADUR BISHAMBAR DAS: SELECT YOUR REMEDY

Azoospermia: (Absence or diseased condition of spermatozoa in the semen)

Chininum sulph, Conium, Damiana, lodium, Strychninum.


DICTIONARY OF HOMOEOPATHIC MATERIA MEDICA.

Clinical Repertory part by P Freche and M flaffen

Sterility: Arg. Nit, Cobalt-nitr, Rauw serp, Sulfanil, Thyr.


Dr.J.N.SHINGHAL: QUICK BEDSIDE PRESCRIBER Sterility male: Agnus, Bufo, Nat.m, Phos, Sel


TOTAL MEDICINES:

Agar, Agn, Alet, Ambr, Arg.m, Aur, Aurm, Aur.m.n, Bac.C, Bor, Bufo, Calad, Caul, Chin.s, Cis, Cobalt.nitr, Con, Cortico, Dam, Eup.pur, Ferr, FiI, Foll, Form, Gels, Goss, Graph, Gun.p, Hamam, Helon, lod, Lac d, Lapp, Lepr, Lyc. Med, Merc, Mill, Nat.c, Nat.m, Nat.p, Nep, Nit.ac, Phos, Phyt, Psor, Rauw.serp, RNA, Sabal, Selen., Sol.lyco, Still, Strych, Sul.ac, Sulfa, Syco, Thio, Ther, Thyr, Wies, X-ray.


Therapeutics:

Agnus castus: This remedy may be helpful if problems with impotence develop after a man has led a life of intense and frequent sexual activity for many years. A cold sensation felt in the genitals is a strong indication for Agnus castus. People who need this remedy are often very anxious about their health and loss of abilities, and may have problems with memory and concentration.


Argentum nitricum: This remedy may be helpful if a man’s erection fails when sexual intercourse is attempted, especially if thinking about the problem makes it worse. People who need this remedy are often nervous and imaginative. A person who needs Argentum nitricum is usually warm-blooded, with cravings for both sweets and salt.


Aurum Mur Natronatum:Psychogenic erectile dysfunction. It is useful when there is a decline of the sexual powers, with periodic seminal emission and feeble erection or complete impotency. The erections are weak and inefficient, patients with hypochondria, melancholia and suicidal intent.


Bufo Rana: A remedy remembered for loss of erection due to involuntary emissions; discharge too quick, spasms during coition.


Caladium: This remedy may be helpful to a man whose genitals are completely limp, despite having sexual interest. Nocturnal emissions can occur without an erection, even if dreams are not sex-related. A person who needs this remedy often craves tobacco.


Causticum: This remedy may be indicated if physical pleasure during sex has diminished and sexual urges are reduced. The person feels tired and weak, and may experience memory loss, with a compulsive need to check things (to see that doors are locked, etc.) Prostate problems may be associated with impotence, and urine may be lost when the person coughs or sneezes.


Conium Maculatum: Impotence, insufficient erections, and absence of erections. Want of energy in coition. Erections imperfect, and of too short duration. Easy emission of semen, even without firm erections. Dejection, after coition. Sometimes emission at mere presence of women.


Lycopodium: People who need this remedy may have problems with erections because of worry, and can also be troubled by memory loss. They often lack self-confidence (though some may overcompensate by acting egotistically). People who need this remedy often have digestive problems with gas and bloating, and an energy slump in the late afternoon and evening.


Medorrhinum: Impotency after suppression of gonorrhoea. Emission during sleep. Semen watery. No stiffness. Pain, burning along urethra when semen discharges.

Muira Puama: It is used as a tonic and aphrodisiac. Erectile dysfunction with weakness and depression are covered.

Onosmodium: It is useful in priapiasm (penis is continually erect) and in cases of Psychic Impotency.


Phosphoricum Acidum: A feeling of heaviness in glans especially when urinating. Absence of sexual desire. Neurasthenia after sexual intercourse. Weakness of sexual organs with onanism and little sexual desire.
Frequent and very debilitating pollutions. Onanism. Discharge of semen while straining at stool.


Sabal Serrulata: Discharge of prostatic fluid. Pain in back much aggravates after coitus. Drawing pains in spermatic cords ; shrunk testes. Penis shrunk and cold with urinary troubles. Hard erection, slight twisting chordee as if stretched from the root. Organs feel cold. Coitus painful at the time of emission. Sexual neurotics.


Selenium metallicum: This remedy is often helpful to men who have diminished sexual ability, especially if the problem starts after a fever or exhausting illness. The person feels weak and exhausted, but interest is usually still present. Unusual hair-loss (body hair or eyebrows) can also suggest a need for Selenium.


Staphysagria: Gentle-natured, quiet men with deep emotions may respond to this remedy. Problems with impotence often occur from embarrassment or shyness. People who need this remedy often have a history of emotional suppression and very sensitive feelings.


Turnera Aphrodisiaca (Damiana): An excellent remedy for impotency. Sexual debility from nervous prostration. Chronic prostatic discharge.


The above mentioned medicines are just a hint & should not be considered as final remedies. A constitutional remedy and the guidance of an experienced Homoeopath is always a better option & may help bring balance to a person’s system, both emotionally and physically.


Published in: SDHA CHRONICLE (Mar-Apr 2010)

Views: 18569

Comment by Dr Muhammed Rafeeque on September 8, 2010 at 7:32am
Thanks for the detailed article.

I think psychic impotency is the most commonest cause!
Comment by dr mustafa shahid on September 9, 2010 at 9:11am
great work...........thanks
Comment by Dr.(Mrs) Amina Meer on September 12, 2010 at 1:24am
congratulations..a very detailed article on rarely discussed subject..nice combination of pathological conditions explained in easy way unlike usual textbook presentation..best wishes for future articles..keep it up..people like you are required for progress of the science..congrates once again..
Comment by Debby Bruck on September 13, 2010 at 1:48am
Excellent article on this topic. I will share with others. If other HWC members have a case example of the success of some of these remedies for ED, it would be great to add it here. In this day and age, infertility concerns many couples, sex infiltrates all advertising and magazines, plus pressure to perform is major topic which causes more stress for everyone. We are fortunate to have homeopathy and the hundreds of remedies.
Comment by Dr. Wequar Ali Khan on October 5, 2010 at 3:48am
Well written article on a "TABOO subject",Congratulations.Will be of great help as a reference work.Best wishes.
Comment by Dr Ata Ur Rehman on October 11, 2010 at 11:43am
Excellent article.
Comment by Dr Ravindra Saraswat on December 2, 2010 at 12:38pm
Dr. Navneet Bidani,
IMPOTENCE
* Absence of erections. Impotence. ----- Caust., Con.
* Entire absence of erections and desire. ----- Nuph.
* Erections absent, when coition is attempted. ----- Arg-n.
* Erections absent, even after amorous caresses. ----- Calad.
* Erections absent, nothing can produce. ----- Agar.
* Penis relaxed during embrace. ----- Nux-v.
* Complete impotence. ----- Coloc.
* Impotence with mental depression, relaxed penis. ----- Agn., Calad., Con., Lyc., Nux-v., Sel., Sulph.
* During coition feeble erection. Impotence. ----- Sel.
* Impotence in elderly men. ----- Lyc.
* Incomplete coition, erection weak emission speedy. ----- Calc., Nat-c., Nux-v., Sulph.
* No erection even after caress. ----- Calad., Calc., Graph.
* No emission, no orgasm during an embrace. ----- Sel., Sep.
* Incomplete erection during coition. ----- Con., Graph., Lyc., Ph-ac., Phos., Sep., Sulph., Ther.
* Erection fails when coition is attempted. ----- Agn., Arg-n., Calad., Graph., Nux-v., Phos., Sel., Sulph.
Comment by Dr. Navneet Bidani on December 4, 2010 at 1:04am
Dear Dr. Sarswat,

Thanks for your valuable inputs.
Comment by Dr.Vikas Verma on December 9, 2010 at 12:11am
Yohimbinum is a wonderful and instant acting medicine which is used for ED . Few of the important symptoms are :
Useful for anaemic, thin, nervous and partly impotent men. - Neurasthenic impotence.
* Excites sexual organs and acts on central nervous system and respiratory centre.
* An aphrodisiac, used in physiological doses, but contraindicated in all acute and chronic inflammations of abdominal organs.
* Homoeopathically, should be of service in congestive conditions of the sexual organs.
- Strong and lasting erections.
- Urethritis.
In the morning strong and lasting erections without increase of desire.
- Enlargement of testicles and epididymis (animals)
Few Rubrics in Murphys repertory:
ERECTIONS, penis, troublesome - continued
Male - ERECTIONS, penis, troublesome - continued - morning
Male - ERECTIONS, penis, troublesome - painful
Male - ERECTIONS, penis, troublesome - strong
Male - ERECTIONS, penis, troublesome - strong - morning - lasting without increase of desire
Male - GONORRHEA, infection, - chordee
Male - IMPOTENCY, male
Male - SEMINAL, emissions,
Male - SWELLING, genitalia - swelling, spermatic cords
Male - SWELLING, genitalia - swelling, testes.
Few rubrics listed in Schroyens F repetory:
Male genitalia/sex
MALE GENITALIA/SEX - CONGESTION
MALE GENITALIA/SEX - EJACULATION - failing during coition
MALE GENITALIA/SEX - ERECTIONS - continued
MALE GENITALIA/SEX - ERECTIONS - continued - morning
MALE GENITALIA/SEX - ERECTIONS - strong
MALE GENITALIA/SEX - ERECTIONS - wanting
MALE GENITALIA/SEX - EXCITABILITY of genitals
MALE GENITALIA/SEX - SEXUAL DESIRE - diminished
MALE GENITALIA/SEX - SEXUAL DESIRE - increased
MALE GENITALIA/SEX - SEXUAL DESIRE - wanting
MALE GENITALIA/SEX - WEAKNESS
Comment by Dr. Navneet Bidani on December 9, 2010 at 12:38am
Thanks Dr. Vikas for providing a detailed information on Yohimbinum.

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