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Impotence
What is erectile dysfunction?
Erectile dysfunction (impotence) occurs when a man cannot achieve or maintain an erection. It is one of the most common sexual problems, affecting most men at some time during their lives. What causes erectile dysfunction and who is at risk?
Erectile dysfunction affects one in ten men, and to appreciate why it is so common you need to consider the three steps in producing and sustaining an erection. The first is sexual arousal, which men obtain from stimulation of their senses and from thoughts. The second is the brain's communication of sexual excitement to the body, which increases blood flow to the penis. The third step is when the blood vessels that supply the penis relax, allowing plenty of blood to flow into the shafts that produce the erection.
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Psychological causes There are many psychological causes of erectile dysfunction. They may be temporary (such as mental fatigue or stress) or long- standing (such as anxiety or guilt). Fear of sexual failure is a very common factor in erectile dysfunction. This is self- perpetuating: a man may be so concerned about not being able to get and maintain an erection that he cannot relax during sex and therefore the problem is compounded. Other psychological causes include depression, relationship problems, or lack of interest in sex by your partner.
Physical causes There may be too little blood flow to the penis in people with hardening of the arteries, which is more common in smokers and with diabetes, high blood pressure and high blood cholesterol. Blood flow may also be impaired by many (although not all) drug treatments for high blood pressure and by diuretic drugs (sometimes called "water tablets"). The penis may be unable to store blood during an erection (called venous leak), so that the erection is not maintained, if blood vessels have been damaged, through injury, radiotherapy (cancer- killing X- rays) to the pelvic area, or surgery to the rectum, prostate gland or bladder.
What are the common symptoms and complications of erectile dysfunction?
The problem may occur every time sexual activity is attempted, or its occurrence may depend on the circumstances. A man experiencing erectile dysfunction often tries to hide the problem from his sexual partner. He may manipulate events to avoid sexual contact, and especially penetrative intercourse. This usually only makes the problem worse.
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Examples include: Staying up late to ensure the partner is asleep first Working longer hours so he is 'too tired' for sex Going to bed early so he is asleep before his partner joins him Inviting friends home to reduce the amount of time alone with his partner
What is the treatment for impotence?
Self-care action plan Most erectile dysfunction can be treated. The first step is to talk about the problem as openly as possible with your partner, a doctor or a qualified therapist. Some men prefer not to involve their partner, but you should recognise that your partner is almost always affected too. Generally, the best treatment is one that you and your partner both agree will fit comfortably and naturally into your lovemaking. Reassurance and understanding from a regular sexual partner may help greatly. You may also need to reassure your partner that you still desire them.
Complementary therapy Any therapies which reduce stress will almost certainly help if the cause of the erectile dysfunction is psychological. Complementary therapies such as homeopathy are, however, of no known direct benefit.
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