Most
men have experienced difficulties with erection at some time in
their lives. Alcohol, tiredness, stress or simply not being in the
right mood at the right time may all lead to failure to achieve
or maintain an erection. The most frequent cause of temporary problems
is anxiety.
It
is quite common for a man to achieve erection but not be able to
maintain a sufficiently hard penis for sexual intercourse to take
place. Surveys have suggested that 50% of men will experience erectile
dysfunction and around 7% of men will experience persistent difficulties
with erection during the course of their lives. As men get older,
the incidence of problems increases, but that should never deter
anyone from seeking help.
It
is estimated that as few as 10% of men with erection problems seek
assistance, despite the fact that treatment and support can be highly
effective. The first source of help is your GP. If necessary, a
referral to another health professional can be organised.
The
latest thinking among experts in this area is that in 70% of cases
there is a physical cause for erection problems. Psychological causes
are responsible for the other 30% of cases. If a man still has the
occasional erection e.g. when he is asleep or first thing in the
morning, there is a reasonable chance that the problem is psychological.
It
can be difficult to break the cycle with sexual difficulties. Fear
of failure and the pressure to succeed the next time is likely to
worsen the problem. It is not unusual to become enveloped with feelings
of self-doubt that are reinforced each time that sex does not work
out and to feel that the cycle cannot be broken. Each failed act
of intercourse becomes a powerful force that psychologically conditions
the man to fail on each subsequent attempt.
If
possible, you should discuss the situation with your partner. Failing
to be open with your partner about your anxieties can exacerbate
your problem and make your partner feel excluded or rejected. It
is highly beneficial to have your partner's emotional support and
understanding. It may help to have the partner accompany you to
see the doctor.
Causes
of erectile dysfunction
Circulation problems
To achieve an erection, it is necessary that blood flows to the
penis and stays there. If there are circulation problems, there
may be difficulties in maintaining an erection. Blockage of the
blood supply to the penis is a common cause of erectile dysfunction.
This is quite similar to blockage of the heart vessels in heart
disease. Heavy smokers are particularly at risk from poor circulation
and therefore problems with erection. Research has shown that men
who smoke are more likely to encounter erectile problems than men
who are non-smokers. New research also suggests that up to 11% of
distance cyclists are prone to erectile dysfunction.
Diabetes
A large proportion of diabetics will experience ED at some stage,
with the risk increasing as time goes by. Diabetes
can affect blood vessels and nerves in various parts of the body
and is a major cause of erection problems. Diabetes has an impact
on both blood supply to the penis and the nervous control needed
to maintain an erection. It can affect the autonomic nerves which
are responsible for controlling bodily functions. This can lead
to a lowering of male sexual potency. It is a good idea for those
with diabetes to have an open discussion with their GP about sexual
problems associated with the condition.
Excessive drinking
Unfortunately 'brewers droop' is not a myth. It is estimated that
excess alcohol consumption causes about one in six cases of erectile
dysfunction. Contrary to popular belief alcohol is a depressant
drug and although it may lessen sexual inhibitions it may also reduce
sexual arousal. It is worth cutting back on your drinking to see
if this has any impact on the problem.
Drugs
One
of the side effects of certain groups of drugs is a problem with
erection. Drugs for treating high blood pressure, depression, or
some ulcer healing drugs and anticonvulsants can cause erectile
dysfunction. Drugs that contain the female hormone oestrogen or
medications to counteract testosterone may also cause problems.
Illegal drugs like cocaine may also interfere with ability to maintain
an erection.
Conditions of the penis
There are a number of conditions affecting the tissues in the penis
that if left untreated, will have an impact on the ability to maintain
an erection. These include Peyronie's Disease (bent penis) balanitis
(inflamed glans or head of penis) and untreated priapism (where
erection lasts for hours becoming very painful). Infections, including
sexually transmitted diseases may also lead to problems.
Neurological conditions
With spinal injury, multiple sclerosis or tumours there is an impact
on the nerve supply to the penis which can cause erection problems.
Surgery
Sometimes surgery to the prostate where there has been nerve or tissue damage may cause erectile dysfunction." size="2">
Sometimes surgery to the prostate or pelvis where there has been
nerve or tissue damage may cause erectile dysfunction.
Serious
illness
A range of serious illnesses may cause erectile dysfunction. These
include liver or kidney disease, heart attack, heart failure, chest
problems, injury or major surgery. Some people may be so weakened
by their condition that they simply lack the stamina for intercourse.
Psychological
causes
There are a number of possible underlying psychological causes.
These include:
Depression
Anxiety
Fear of failure because of recent problems with erection
Relationship problems or marital disharmony
Loss of attraction to partner
Bereavement
Stress or tiredness
Confusion about sexual orientation (e.g. unresolved gay feelings)
Pressure to perform
Premature ejaculation
Guilt or 'hang-ups' about sex
Child or adult sex abuse
Treatment
There is a range of treatments available and success rates are very
high. Seeking help from your doctor is half the battle. Methods
include prescription treatment, injections or devices.
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