Impotence Affects Almost All Men
Almost all men have been affected by impotence – the old term for erection difficulties – at some time in their lives. It may not be an on-going problem, but most men can relate to episodes of impotence when:
- You want an erection and you’re not getting one
- You lose an erection at an embarrassing point
Men Experience Impotence Different Ways
However the way male impotence is experienced can be be very different. As pioneer sex therapist Bernie Zilbergeld notes in The New Male Sexuality, some impotent men:
- Have problems getting or maintaining erections at the beginning of a relationship, but as they become more comfortable with their partner their erections become more reliable
- Have problems getting an erection with a long term partner, but can be sexually excited by a new woman
- Regularly have problems attaining erections
- Get erections but have trouble maintaining erections
- Consider their erections aren’t as hard as they like
- Get no erections at all, regardless of stimulation
Impotence as Devastating as Job Loss
Impotence is devastating to a man’s sense of worth, says Zilbergeld, a US sex therapist who worked with impotent men for over thirty years.
Impotence Affects Women Too
Female impotence is also a wide spread problem, but it is much easier for women to conceal their difficulties.
If a woman has:
- Lost interest in sex
- Never experienced orgasm
- Been prevented from enjoying sex by physical pain or other organic problems
- Or thinks up excuses to not have sex because she feels inadequate
she is suffering from the same problems as men who are impotent.
Some of the solutions for female impotence are different from male treatments, but there are a range of treatment options for female impotence as well.
Treatment Options for Impotent Men
Many urologists now suggest 90 per cent of impotence has physical causes usually related to:
- Interference with penile blood flow
- Interference with penile nerve response
- Low testosterone levels
However sex therapists who see more of the psychological and relational side of sexual health suggest more men are impotent because of a combination of physical and emotional issues than is generally recognised.
Impotent men have three possible treatment options:
- Oral pills or mechanical interventions – best for impotence from physical causes
- Sex therapy – best for impotence from emotional or psychological causes
- Combination of the two – if you have relationship issues a pill may not be enough
Although most men would rather have a tooth out than talk about being impotent, it’s a great idea to be honest about impotence difficulties with your partner, even if you don’t feel the need for a qualified therapist.
Diagnosing Impotence – Five Questions to Ask
Impotent Question 1
What chemicals are you putting in your body?
A host of drugs – legal and illegal – contribute to impotence:
- Prescription drugs (over 200 medications for a range of chronic health problems)
- Recreational drugs (opiates, stimulants, psychedelics, nitrous oxide, marijuana)
- Alcohol – social drinking inflames desire but kills erections
- Long term alcoholism
- Destroys testicular cells
- Lowers testosterone production
- Increases female hormones
- Research backs up direct cause and effect relationship between smoking and impotence
Impotent Question 2
Do you desire sex with your partner, yourself or anyone?
If your desire for sex is low or non-existent:
You don’t fantasize about sex
You don’t want to masturbate
You don’t notice attractive women
You don’t want sex with a partner
Impotence is likely to be the result of:
- Low Testosterone – get hormone levels checked
- Depression – find a med that doesn’t affect erections and desire will likely return
Impotent Question 3
Are you getting erections under some conditions but not others?
If you have erections firm enough for vaginal insertion but not necessarily hard as a rock:
By yourself but not with a partner
With one partner but not another
On vacation but not at home
Impotence is very likely not primarily physical but has more to do with your feelings about your potential partners or levels of stress
Impotent Question 4
Do you never get or keep erections under any circumstances?
If you get no erections at all
- Not when sleeping
- No morning erections
- Not with partner stimulation
Impotence is very likely to be from physical causes or be the result of a medication side effect.
Impotent Question 5
Do you get erections but usually can’t maintain them?
Impotence in these circumstances may be either physical or psychological:
Physical Impotence: If you find nothing has changed in your relationship, and you’re not under major stress, but your erections come and then fade you may have a physical cause.
One possible reason: Blood is initially getting through to the penis, but then leaking faster than can be replenished.*
Psychological Impotence: If you find erections fail when vaginal insertion is attempted but are fine otherwise, you may have deeper underlying issues.
One possible reason: Intercourse means “commitment” and reflects a fear of being trapped.*
(Examples adapted from The New Male Sexuality, Bernie Zilbergeld, Bantam Books 1999)