Impotence vs. infertility

Many believe that being impotent means they are infertile. But there is a difference.

December 08, 2012 04:55 pm | Updated 08:13 pm IST

Among many closet issues plaguing men and women, erectile dysfunction or male impotence and sexual dysfunction or female impotence tops the chart. Many believe that being impotent means they are infertile.

Though these terms are synonymously used, impotence and infertility mean different things. Erectile dysfunction in men refers to the persistent inability to achieve and maintain an erection adequate for satisfactory sexual activity.

Females experience sexual dysfunction, which can be defined as the inability to attain or maintain arousal during sexual activity. Infertility refers to the inability to achieve a successful pregnancy.

While impotence is not a cause for infertility, it can make conception extremely difficult. Nearly 40 per cent of women experience decreased sexual arousal, diminished vaginal lubrication, pain and discomfort while intercourse and difficulty in achieving orgasm. These are classic symptoms of sexual dysfunction, which dramatically affects fertility too.

There are two major reasons for women being averse to sex: dyspareunia or extreme pain and discomfort in the genital area and vaginismus or an involuntary spasm of muscles around the vagina that causes it to close.

Sexual impotence also has psychological roots with anxiety, depression and stress playing a role. Sexual arousal depends on an intricate interplay of psychological, neural, vascular, and endocrine factors.

Infertility, on the other hand, could have many reasons. Increased stress due to changing lifestyles in one major cause. Constatn stress releases a cocktail of hormones that play havoc with many systems.

Stress has been shown to increase the levels of prolactin, a hormone secreted by the pituitary gland. This can hamper ovulation in females and sperm production in males. Hormonal imbalance can also lead to erectile dysfunction. The inability to achieve pregnancy could be due to below par sperm production or due to poor sperm motility.

Another negative effect of stress is poly cystic ovarian syndrome (PCOS) in females, which is a leading cause of infertility. In the urban setting, PCOS is a common disorder characterized by abnormal cysts in the ovaries. Stress releases hormones like adrenaline, which aggravates symptoms of PCOS. If not detected and treated, PCOS leads to infertility, heart disease, kidney dysfunction, and many other ailments.

Both impotence and infertility have a negative impact on intimate relationships, quality of life and self esteem. To identify the underlying issues leading to erectile dysfunction in men, initial diagnostic tests include serum glucose test, lipid panel, thyroid stimulating hormone test, and morning total testosterone levels. Female sexual dysfunction is less understood as many women refuse to admit to the problem.

There are many ways to treat impotence. The first line of therapy consists of lifestyle changes. Sometimes the cause may be a prescription drug, so a new medication may be necessary.

Infertility, on the other hand, could have hormonal roots or there could be structural deformations leading to lower sperm count or poor sperm motility.

Fertility treatments involve the use of medications or assisted conception techniques like intrauterine insemination (IUI) and in-vitro fertilization (IVF).

With the advent of new techniques that help in easy conception, fertility experts insist on a stress-free and healthy lifestyle to prevent fertility-related problems.

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