or erectile dysfunction is defined as the inability to achieve or
sustain an erection that's hard enough or lasts long enough to complete
sexual intercourse or another chosen sexual activity. It affects
at least one in ten men.
men suffer for years without seeking treatment. This may be because
they're too embarrassed to seek help or they're unaware that there
are treatments available.
What causes it?
men will experience an occasional failure to get an erection.
This can usually be put down to stress, tiredness, anxiety or
too much alcohol. In these circumstances it's nothing to worry
the past it was thought that more frequent impotence was caused
by almost entirely psychological factors, but we now know that
physical conditions are present in about 70 per cent of cases.
However, the majority of men with erectile dysfunction experience
a combination of psychological and physical causes.
Men whose impotence is due to a physical cause often find
they gradually lose the ability to have an erection, and it tends
to happen with all sexual activities. These physical causes may
* hardening of the arteries, which can lead to high blood pressure,
angina or poor circulation
* kidney disorders
* multiple sclerosis or other neurological diseases
* high cholesterol
* side effects of prescribed drugs
* heavy smoking
* alcoholism and drug abuse
* pelvic surgery
If you experience a sudden onset of impotence and can still
achieve erections in some circumstances but not in others, the
cause may be psychological. Psychological causes can include:
* stress and anxiety from work or home
* problems within your relationship
* worrying about poor sexual satisfaction
* sexual boredom
* performance anxiety
* unresolved sexual orientation
Sometimes the triggering factor can be easily identified, such
as an argument or major disagreement with your partner. Or it
might involve being interrupted while making love or excessive
worry about areas such as work, family life or finances.
It's important to remember that over the past few years there
have been major advances in the treatment of impotence and the
majority of sufferers can now be treated effectively.
the problem with your partner - a problem shared is a problem
halved. For example, it may be your partner is unintentionally
putting pressure on you to "perform". Discussing the
problem with them may relieve this pressure and enable you to
have an erection again.
at your lifestyle. Are you a heavy smoker? Do you drink a lot
of alcohol? Do you suffer from stress and anxiety? Cutting down
on your alcohol intake or giving up smoking could make all the
difference. Try to reduce stress and anxiety by finding ways to
the problem persists, see your GP.
* Psychosexual therapy. When psychological factors or relationship
problems are considered to be the cause of your impotence, a course
of sex therapy or couples therapy might be recommended. Therapy's
very useful in helping you to re-establish a sexual relationship
with your partner when there's been a long period without sex.
* Vacuum pumps. A device involving a plastic cylinder and pump
is used to make blood rush to your penis, enlarging it in a similar
way to an erection. When you remove the pump, the erection is
sustained by slipping a tension ring around the base of the penis.
* Injections. You or your partner will be taught by a nurse or
doctor to inject a drug directly into the shaft of the penis when
you want an erection. An erection usually follows within 15 minutes.
The procedure is easy to learn.
* Transurethral therapy (Muse). This involves taking a small pellet
of a drug, about half the size of a grain of rice, via the urethra
(the tube through which urine is passed) using a special disposable
applicator. The drug is absorbed through the urethra directly
into the erectile tissue of the penis, giving an erection within
five to ten minutes.
* Viagra. This drug is taken in tablet form one hour before sexual
activity. It then remains active for three to four hours. Viagra
won't work without sexual stimulation. It's not an aphrodisiac
and doesn't increase sexual desire.
* Uprima. Uprima is a tablet which is taken under the tongue.
You place the tablet under your tongue and wait for it to dissolve,
which can take about ten minutes. It acts within 15 to 25 minutes
and can be effective for up to two hours. Uprima won't work without
* Cialis. This drug comes in tablet form and can be taken from
30 minutes before sexual activity. With sexual stimulation Cialis
may be effective for up to 36 hours after taking the tablet. Like
Viagra, it's not an aphrodisiac and doesn't increase sexual desire.
* Levitra. This tablet should be taken ten minutes to one hour
before sexual activity. With sexual stimulation Levitra can be
effective up to 12 hours after taking the tablet. Like Viagra
and Cialis it is not an aphrodisiac and does not increase sexual
* Hormone treatment. Only a small proportion of cases of erectile
dysfunction are caused by hormone abnormalities. The most frequent
hormone abnormality is a reduced level of the male sex hormone
testosterone which can be restored by appropriate hormone replacement.
It's unwise to take testosterone preparations unless you've had
tests that confirm a deficiency.
* Penile prosthesis. You shouldn't consider a prosthesis (implant)
until other forms of treatment have been tried. There are two
types of implant. The semi-rigid type keeps the penis rigid all
the time but lets you bend it downwards when you're not having
sex. The hydraulic type is more sophisticated and causes the penis
to stiffen when a pump (implanted in the scrotum) is activated.
* Surgical treatment. A few cases of impotence are caused by abnormalities
in blood flow in and out of the penis and can be treated with