Impotence

Also known as erectile dysfunction, here are some of the reasons why a man's playmate goes soft.

Don't worry. You're not the only one.

What is impotence?

A term used to describe the inability some men experience in achieving or maintaining a full erection. It’s estimated that 1 in 10 British men suffer from impotence, or erectile dysfunction, at some stage in their lives. This can mean men who are unable to get an erection at all, to those who find their erections aren’t firm enough to achieve satisfactory sexual intercourse.

So what goes wrong when things are supposed to get sexy?

• Basically, the brain stimulates the release of a chemical in the penis called cyclic GMP.
• This causes the muscles in the erectile tissue of the penis to relax and the arteries to expand, allowing more blood to flow in.
• In a fully-functioning erection, the expansion of the erectile tissue also squeezes shut the veins that normally drain the blood away. This effectively ‘traps’ the blood inside the penis, and stiffens it up.
• Impotence problems occur when the erectile tissue fails to expand enough for the veins to be squeezed shut. As a result, blood flows into the penis as well as out, and things begin to wilt.

What are the causes of impotence?

There are numerous different causes of impotence. In young, healthy men, difficulty gaining or sustaining an erection is most often associated with psychological factors, but there is sometimes a physical cause. Sometimes it’s a mixture of the two.

• Psychological: Performance anxiety, relationship problems, depression, stress, fatigue, loss of interest in sex.
• Physical: Diabetes, vascular disease, spinal cord injury, surgery, some prescription medicines, smoking, drinking, drug abuse, hormonal imbalance, epilepsy, multiple sclerosis.

Regaining control

For many impotence sufferers, no obvious cause is evident. Even so, 95% of all cases are successfully remedied. Here are some of the most common treatments:

• Talk to your partner – Impotence won’t go away unless you face up to it. If you’re in an ongoing sexual relationship, then being open and honest with your partner can help identify any anxieties that might be causing the problem.
• Psychosexual counselling – Relationship counsellors can help explore any link between impotence in men and problems in their relationship. Psychosexual therapy helps couples address the situation and gradually achieve better results.
• Lifestyle changes – Cutting out alcohol, tobacco and recreational drugs can lead to significant improvements.
• Medication – Prescription drugs are available that mimic the natural changes of the blood supply during an erection. These are administered in different ways:
  Pill form – Viagra has received a lot of media coverage recently because it is the first impotence treatment to be taken orally. The effects are not immediate, so users are advised to take the pill one hour before sex. Hormonal treatments are also available, but first consult your GP.
  Pellet form – A medication inserted into the tip of the penis, using a special applicator. Using this method, the resulting erection can last up to an hour.
  Self-injection – Involves using a special hypodermic needle to self-inject medication into the base of the penis. While it is a relatively painless treatment, with instant results, the erection does not subside following ejaculation. The effects of the drug can last between 1 and 4 hours.
• Vacuum therapy – A cylindrical device that is fitted over the penis, and from which air is then pumped out to create a vacuum. This makes the penis engorge with blood and produces an erection. To keep it up after the device has been removed, a special clip is then inserted around the base.

Photo of couple in bed by Shutterstock