If you experience an occasional incidence of impotence, you should not view it as a signal that your sex life is about to end. If your family doctor prefers not to treat you, he or she may refer you to a urologist, who specializes in treating conditions related to the genitourinary system. Your doctor will help determine the cause of your impotence, and assist you in selecting an appropriate treatment. It's best to start with your family doctor, or primary care physician - who is probably a family practitioner or an internist - because he or she already knows your medical history and your current state of health. This differential pressure phenomenon may explain the paradox that almost all the antihypertensive drugs have been reported to cause impotence. Once the antihypertensives take effect and the blood pressure is normalized (120 mm Hg), the pressure in the cavernous artery also drops (eg, to 80 mm Hg), resulting in a partial erection (eg, 60 mm Hg intracavernous pressure). Additionally, in a patient with a stenotic penile artery from chronic hypertension, a high systolic pressure (eg, 180 mm Hg) may be required to maintain cavernous arterial pressure (eg, 120 mm Hg) and a solid erection (eg, 90 mm Hg of intracavernous pressure).

For example, blockers may enhance a-adrenoceptor function, and thus may make the erectile smooth muscles and arterioles more difficult to relax. Because many older men are lonely, are somewhat depressed, and take multiple medications for a number of diseases, it is difficult to determine whether the impotence is a side effect of a particular drug or of the interaction of several drugs, the manifestation of the underlying diseases, or results from a combination of the above. Several types of doctors treat ED. If you think a medication may be responsible for your ED, if you find that you are unable to have an erection at all, or if your episodes of impotence persist despite your attempts at self-care, it may be time to see a doctor. Dwelling on it and anticipating that it will happen again may actually turn into the proverbial 'self-fulfilling prophecy.'