Questions to ask yourself
Can you achieve an erection by masturbation but not with your partner, and do you still sometimes wake with an erection? If the answers are ‘yes’, a psychological reason, such as stress or depression, is likely.
Did loss of erections come on suddenly, or have erections gradually been failing over a long period of time? Erectile failure which comes on suddenly is usually psychological; physical causes usually have a more gradual onset.
Have you been under extra stress lately? If so, is there any way you can lessen the stress in your life?
Are you taking any drugs (see above) that might be responsible? If so, ask your doctor for alternatives.
Are you drinking too much? Blood alcohol concentrations of up to about 25 mg/100 mL improve erections slightly, but when the level reaches about 40 mg/100 mL erection is inhibited. In some people, only one or two drinks is enough to raise the blood alcohol to this level. Heavy drinking over a long period can cause erectile failure because of nerve damage.
Have you noticed anything else wrong? For example: Peyronie’s disease, where the penis develops a lump and often kinks, can cause impotence; tightness of the foreskin can prevent full erections; and enlargement of the breasts or loss of body hair might mean a hormonal problem.
Who is really bothered by the problem – you or your partner? Talk to your partner about what each of you wants from sex. As sex counsellor Susie Hayman says, “It’s amazing how many people just lie there wishing their partner was a mind reader.”
Are you a smoker? If so, can you stop? Stopping smoking will not reverse the problem, but may stop it getting worse. Also, impotence is often a sign that your arteries are unhealthy, so stopping smoking is important to lessen the risk of a heart attack.
Have you had your blood pressure checked recently and been tested for diabetes? Many men with impotence have unhealthy arteries and high blood pressure, so checking your blood pressure and blood lipids (e.g. cholesterol) is essential. Impotence can also be a symptom of diabetes.
Common beliefs about erection problems
Erection problems are uncommon
This is untrue – most men simply do not talk about it. A survey sponsored by the pharmaceutical company Pharmacia & Upjohn found that more than 1 in 4 of the UK male population over the age of 16 has experienced erectile disorder to some degree. Of these, over half experienced the problem as one-off incidents and a quarter suffered erectile disorder most or all of the time. There are probably 20 million men with erection problems in the USA, and 2–3 million in the UK.
Erection problems are usually psychological
This is an old-fashioned view; impotence is most commonly due to a physical cause.
Testosterone injections/patches are a good cure for erection problems
Testosterone is of use only in the uncommon situation the man has a proven shortage of testosterone.
Viagra-type drugs don't work for everyone
These drugs are successful in only 50–80% of cases.
Erectile failure (also called impotence or erectile dysfunction) means that you cannot achieve or maintain an erection of the penis sufficient for sexual intercourse. Sex drive is often normal. Impotence can occur at any age, but becomes more common with increasing age. Because the average age of the population is getting older, experts predict that by the year 2010 almost half the men in the UK will have erection problems. But impotence is not inevitable with ageing – 40% of 90-year-old men are able to have a normal erection.
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Thursday, October 23rd 2014
In part 3 of his penis trilogy, Dr Phil Hammond discusses penis size, shape and function, and what you can do about erectile dysfunction. Click on the video below for more information.
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