Erectile Dysfunction

What is erectile dysfunction?

ED means an inability to get a good enough erection to achieve satisfactory intercourse.

Some sufferers can’t get a hard-on at all; others get one but it isn’t firm enough to penetrate the partner; and others can manage penetration for a bit, but then lose it.

Why does ED occur?

ED is very common, and it occurs for a variety of reasons and at different ages.

Teenagers and young men

In younger males, the most frequent cause is anxiety – particularly nervousness about having sex, about causing a pregnancy, or about using a condom. A lot of men in this age group complain that they ‘can’t get on with a condom’ because as soon as they try to put it on, they lose their ‘stiffy'.

Middle age

Common causes in this age group are overwork, stress, guilt and bereavement (ED often happens when a widowed man tries to form a new sexual relationship). A few cases are due to diabetes.

Post-middle age

In this group of men, ED gets commoner with increasing age. Nonetheless, 70 per cent of all 70-year-olds are sexually potent.

It is now clear that in a very high proportion of cases, the problem is due to deterioration in the blood vessels that carry blood into the penis. Research being carried out in 2007 suggests that in addition there may often be deterioration in the arteries of the brain or the heart. Therefore older men with ED should take care to protect themselves against strokes and heart attacks – for example by keeping their blood pressure and cholesterol down.

You may be surprised to see that I have not listed ‘lack of hormones’ as a common cause of ED. In fact, lack of male hormone is pretty rare.

If you are tempted to go to one of the many private clinics that make a habit of diagnosing ‘male hormone deficiency', and then charging huge sums of money for testosterone treatment, I suggest you think twice!

What is an erection?

An erection occurs when blood is pumped into the penis and stays there, making it hard. It generally happens because a guy is thinking about sex, or because his penis is being stimulated - or both.

The result is that signals go down the nerves that lead from his spinal cord to his genitals. They tell the blood vessels which supply the penis to open up. Blood flows in and the organ ‘blows up’ like a balloon. A valve mechanism near the base of the penis keeps the blood from flowing out again – a least, until sex is over.

As you can see, getting an erection is a complex process. It’s awfully easy for various factors to interfere with it - for instance, worry, tiredness, too much alcohol or in later life, narrowing of the blood vessels.

Nicotine is now known to narrow those vital blood vessels – which is why ED is much commoner in smokers. But often, there is nothing physically wrong with men who develop ED.

Are many cases due to psychological causes?

Yes, particularly in the young. In general, erectile dysfunction is quite likely to be psychological rather than physical if the man:

• is still waking with morning erections
  
  
• can still get a good erection by masturbation.
  
  

Common psychological causes of erection difficulties include:

• nerves - especially about performing
  
  
• guilt - notably if you’re trying to have sex with somebody else’s wife
  
  
• relationship problems - especially if you’re no longer keen on your partner
  
  
• latent gayness - for instance, if you’re a basically gay guy, trying to have sex with a woman
  
  
• depression
  
  
• exhaustion.
  
  

In a lot of cases, ED turns out to be due to a mixture of psychological and physical causes.

What physical causes are there?

Common physical causes include:

• deterioration of the arteries – this is a physical change which is common in older men, including those with high blood pressure
  
  
• diabetes
  
  
• smoking
  
  
• excessive drinking (hence the phrase ‘Brewer’s droop’)
  
  
• being obese and out-of-condition
  
  
• side-effects of certain drugs, notably ones for blood pressure and depression
  
  
• effects of recreational drugs, like cocaine.
  
  

Less common physical causes include:

• excessive drainage of blood from the penis (‘venous leak’)
  
  
• diseases of the nervous system
  
  
• injury to the spinal cord
  
  
• major surgery in the abdomen, particularly prostate operations
  
  
• hormone problems, including excess production of a pituitary hormone called prolactin.
  
  

What should I do if I'm having potency problems?

If you have difficulty getting an erection, seek help. Don’t suffer in silence – as so many men do!

Also, don’t hide it from your partner. A lot of guys behave like this, and very often the result is that the other person decides that she is being scorned, or that ‘he doesn’t love me any more'.

Your first move should be to consult your GP.

If for any reason you don’t want to do that, then contact another medical/relationships agency, such as the ones listed at the end of this article.

Please don’t do daft things like:

• buying yourself some pills or potion off the Internet
  
  
• signing up with some clinic that asks you for £1,000 deposit
  
  
• going to a prostitute to see if she can cure you
  
  
• deciding that your life is over (it isn’t).

 information found @ http://www.netdoctor.co.uk/diseases/facts/impotence.htm

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