The term "impotence" tends to be used to describe a complete inability
to get an erection; "erection problems" on the other hand is a less challenging problem, in that
a man has erections but they may be unreliable and they may come and go
during sex, or from one session of sex to the next.
The work I have done with men has shown me very
clearly that there are few things that are more important to most men than being
able to respond to a sexual situation with an erection - it's the visible symbol
of a man's potency, of his ability to engage in sexual intercourse, to penetrate
his partner or gain sexual pleasure through masturbation. When a man's erection
goes wrong, his self-esteem suffers hugely. He may want sex, he may desire his
partner, but his penis just refuses to get hard. Or perhaps it gets hard, but as
soon as he attempts penetration, his erection disappears.
The most common
reaction by a man to the loss of his
erection is fear that it has gone away forever, or that his erection will never be
reliable again: this anticipatory anxiety is itself
one of the most significant causes of
erection failure. In other words, the
anxiety that you may not be able to get
erect is an extremely effective inhibitor of
the physical response in your penis! The more worried you
are ahead of sex that your erection may not
work at all, or stay long enough, the more
likely you are to have problems with your
hardness next time you are having sex. This
creates a vicious cycle in which the anxiety
and expectation alone can perpetuate
erection problems.
One of the problems with erection failure is that
a man begins to focus on the wrong things during sex - that is to say, on his
erection, and not on his partner or on what he is feeling as he makes love. The
more he focuses his mind on his erection, the more fragile it becomes; he starts
expecting it to deflate, and sure enough, it does. This weakens his confidence
even further.
Things men do to get over this kind of ED
You can see
men who have this kind of erection problem
resorting to a few well-worn strategies to
try and deal with the problem: they may
start having wild fantasies as they
make love; they may seek out a younger,
sexier partner; they may give up sex
altogether; they may start looking for
hyper-stimulation like internet porn or new
sexual behaviors they have never tried
before (paying for sex, talking dirty with
their partner, trying BDSM, and so on). But
the real answer lies not in seeking more
arousal and more stimulation, it lies in
being relaxed, focusing on what you are
physically feeling rather than on what you
are thinking, and being more sensitive to
the physical touch of your partner. We
shall return to this point later.
Causes of erection problems and impotence
Erection problems are a normal part of getting
older for men. As such it does not need to create stress in a man's life as long
as he simply accepts that his erections will not be as firm and long lasting as
they were when he was in his teens. However, erection problems can also be
caused by some things which a man has control over.
There are
both physical and psychological causes for ED.
And in many
cases, physical and psychological factors combine to cause or sustain a man's
problem with his erections. In this section I
will discuss emotional causes for ED whilst the next section focuses
on the physical causes. In general, psychological factors are more often to blame for
men's problems with their erections than physical problems.
Anxiety
is the most common cause of impotence.
As mentioned above, it is easy for men to
get into a vicious cycle. If you've lost your
erection once, maybe due to having had too
much alcohol, you might
lose confidence in his body and get worried
that it will happen again the next time. The
more anticipatory anxiety a man builds up
the more likely his erection is not going to
work, and so the negative reinforcement
continues.
Another cause
of ED
is the excessive use of fantasy during sex
to get aroused. Sure, all men fantasize
during sex, but some do it much more than
others. Indeed, some young men rely on
fantasy to get erect: even when they are in
a sexual situation, their arousal comes more
from looking at their partner, thinking
about what is going to happen, and
fantasizing about sex, than the actual physical
presence or touch of their partner.
This works when
you're a man in your twenties, because your
penis will leap to attention at a moment's
provocation, but it isn't so good when
you're getting into your forties. Indeed,
relying on fantasy to get physically aroused
is a route to disappointment, for the
response of the penis to mental imagery
becomes progressively less marked as time
goes by. When a man is in his forties and
fifties, he nearly always needs physical
stimulation - such as the touch of his
partner's hand or mouth - to get a full
erection.
A man who has learned to become sexually aroused by
what goes on in his head may have a hard time getting aroused by the touch of
his partner in later life - he may simply have lost touch with his body and his ability to be
physically aroused.
In a few cases, a man who has suffered sexual or
emotional abuse may lose the ability to get erect as he gets older because his
body simply cannot get aroused enough to overcome his lack of trust or his
burgeoning anxiety. Such deep-rooted issues are less likely to be cured by
self-help programs, though other forms of impotence or erection
problems described above are ideally suited to self-help work.
Finally, most
men experience their erectile problems
within a sexual relationship with another
person, be they male or female. Problems
with a partner can create a lot of anxiety,
which can then manifest itself as an erection
problem. One such issue could be around
performance anxiety, i.e. that a man
believes he must have a rock hard
erection to satisfy his partner.
Heterosexual men often feel they are
responsible for their female lover's
orgasms, which is quite an impossible
responsibility to take on. Thinks on this:
have you ever tried to
give somebody "peace of mind"? It's a bit
similar trying to fulfill somebody's sexual
needs. The other person will either be able
to achieve peace of mind for themselves or
not, but it's rather impossible to give it
to them, although being relaxed, open and
loving will probably help.
Homosexual men
often feel they have to live up to the
ever-sexual, rock hard images of what a gay
man needs to be, which can also create a lot
of performance pressure. However, the more
anxiety and stress a man experiences, the
less likely his erections are going to work;
pressure to perform is a very strong turn
off for every man's penis (including
yours!).
Other problems
in relationships can also impact a man's
erections. These might be around unspoken
aggression between partners, lack of trust
for various reasons including obvious aggression from a partner,
lack of physical attraction to one's partner, a partner's sexual problems, or
even a lack of
interest in sex. Finally, when a couple is
"too close" in an enmeshed or
co-dependent relationship pattern where
there is no space for individuality,
separation or conflict, then passion and
sexuality often suffer. This may surface
as an erection problem in the man.
Many drugs, both
prescription and non-prescription, interfere
with the erectile response such as
medication for lowering cholesterol or blood
pressure.
If you are taking regular
medication for any health issues, please
check your drugs for known side effects.
Also, Bernie Zilbergeld's book "The New Male
Sexuality", 1999, Bantam Press includes a
list of medications which might affect your
erections. You will find similar listings on
the internet or through your GP.
Because your
erections are a very impressive and complex
achievement of bio-engineering, anything that
affects your cardio-vascular health and
overall
fitness may impact them adversely. This includes lifestyle factors such as drinking or
smoking, being overweight, doing too little
exercise, and so on. Keeping yourself physically
fit and healthy will give your penis the
best chance to keep working well into old
age.
Erection failure - a problem in the mind or the body?
There are various clues which can help you to determine the
origin of your ED. It's
important to know if the lack or loss of your erection originates in your mind or
your
body, because that determines how it can be treated. If
you get an erection fairly easily when you masturbate, or during the night, or
you wake up with a morning erection, then the problem with your penis is not
likely to be physical.
It is essential that you get good medical advice
even if you think your problem is mostly caused by psychological factors.
It is easier to rule out physical problems than psychological ones. Also,
some physical causes could be very serious indeed, for
example, if your erection failure is caused by high cholesterol, this may
indicate that a heart attack is not so far away.
There are several options available to treat
physically based impotence. The first is Viagra, which
has proved to be a minor miracle for many men with erection failure.
You can
read how Viagra works here. It's not always effective especially in cases
where the partner does not accept the use of Viagra.
Another option is the old-fashioned but effective method of using a vacuum pump
which draws blood into the penis, producing an erect or semi-erect penis, the
hardness of which is maintained by placing a lightly constricting ring around the base of
the penile shaft. This process resembles the natural
erection mechanism of the
penis and does not involve surgery. You can read about this method on the website of a company
which supplies this therapeutic device.
For men with spinal injuries or complete
impotence, surgery with penile implants is a
final solution to managing the loss of their
erections. However, it is a
step that should never be taken without
serious consideration
and discussion by both partners.
1 A man should be a
"sex machine", at all times ready, willing
and able to have sex
This is a myth perpetrated by society and popular culture. A
man is no more likely to be perpetually ready for sex than a woman. Certainly,
men do seem on average to have a higher requirement for sexual release through
masturbation or sex than women, but this is a very different thing to saying
that a man should be able to have sex with anyone, anytime! The stress of life
and work, not to mention his own internal emotional and hormonal state, will
dictate whether or not a man desires sex. And that's before he even begins to
consider whether or not he is actually attracted to a woman who is sexually
available to him.
2 A man should be confident and always able to lead during
sex
Of course, the myth of the man as the dominant partner has
become embedded in popular culture for heterosexual couples, perhaps as a result of the belief that
"good" girls have to be demure and innocent. For a woman to be sexual was once
seen as a sign of her moral corruption; from that comes a high burden of
responsibility for the man - he has to know what to do, how to take the lead,
how to "give" his partner an orgasm. In our somewhat more enlightened times, none of these
foolish beliefs need to be seen as true, and certainly none of them should be
acted upon. Strong performance pressures also exist in gay subcultures, which
perpetuate the myth of the ever ready, hypersexual male.
3 A man should know exactly what his partner wants and
needs during sex
The problem is that many couples don't have an easy or
effective way of communicating their sexual needs to each other. Instead,
getting sexual satisfaction becomes something of a lottery, with one partner
guessing what the other wants. When this burden is placed on the man, together,
perhaps, with the burden of giving his partner an orgasm, it's often a load too
heavy for his erect penis to bear. He feels like a failure if s/he doesn't enjoy
sex or s/he doesn't come; he works hard to give him or her what he thinks s/he want and
neither partner ends up satisfied or fulfilled. Fortunately, the answer is easy:
talk about it!
4 A man should be erect at all times, come what may!
This is not how sex
naturally proceeds, though many a young man
might have trouble believing that! Erections
come and go through sex as the sexual energy
between two people waxes and wanes. A man
who believes that he must be erect from
start to finish during sex - whether or not
that involves intercourse - is heading for
self-doubt and anxiety. The fact is that
erections can come and go several times
during sex, but as long as both partners are
actually interested in what's happening, and
want to be there, one will always come back
again. Even when a man is giving oral sex to
his partner his erection may subside - it's
natural! But there are a lot of men who
don't know this, and suffer great anxiety
when they experience transient loss of erection,
seeing it as a major problem
rather than a normal but temporary thing.
