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Erection problems

Published by cheree
Published on 12 February 2008

Can’t get it up, can’t keep it up…erection problems are embarrassing for men, but they're more common than we think. Whether their problem is occasional or recurrent, our partners would prefer to keep quiet about it than find a solution...

Can’t get it up, can’t keep it up...erection problems are embarrassing for men, but they're more common than we think. Whether their problem is occasional or recurrent, our partners would prefer to keep quiet about it than find a solution...

What is an erection problem?

Erectile dysfunction is the medical term for male impotence. It’s defined as a difficulty in obtaining and/or maintaining an erection that gives a man and his partner a satisfying sex life. If it happens to your man just once, there’s no need to worry. If it happens repeatedly and lasts longer than 3 months, you're dealing with erectile dysfunction. Note that premature ejaculation and infertility have nothing to do with erection problems.

A few figures

Erection problems mostly concern men over 40. In fact, almost half of all men over 40 will experience problems at some point in their lives. But younger men can also be affected: 1 in 10 men over the age of 21 have had recurring erection problems that have interfered with their sex lives. Whether it’s a real dysfunction or just down to fatigue, it always makes men doubt their masculinity and can often plunge them into crisis.

Causes of erectile dysfunction

Physical causes
- Hormonal: after men reach the age of 50, a deficit of testosterone can lead to erection problems.
- Neurological: it affects men who suffer from multiple sclerosis, paraplegia, strokes, diabetes or who have undergone a prostatectomy. These illnesses often lead to a rupture in the connection between the brain and the penis.
- Vascular: all cardio-vascular illnesses cause erection problems because they restrict blood flow to the penis (high blood pressure, alcohol, tobacco, obesity and a sedentary lifestyle).
- Medicinal: certain drugs can cause dysfunction (anti-depressants, neuroleptic drugs, hormonal treatments, drugs for high blood pressure and anticonvulsive drugs).
Psychological causes
- Individual: causes are linked to stress, anxiety, tiredness, depression and fear of not living up to their partner’s expectations.
- Relationship-based: causes can be linked to conflict, a separation or a negative attitude towards a partner.

How to react
Stay positive! Don’t automatically assume the problem is related to his desire or feelings for you. You shouldn't dramatise the situation or put his masculinity in question. He needs to be able to communicate with you to overcome his difficulties, so show him you’ll get through it together. Before consulting a doctor, you could try new games not centred around the penis, like massage, touching or just kissing, to allow him to focus on his body’s sensations and relax more easily. If the problems persist, see a doctor.

Who should you see?
- The first person to see is your GP. Even if your partner is uncomfortable about the idea of confiding in a doctor, encourage him to go. Some erection problems can be down to more serious medical problems. The doctor will ask about the frequency of his problems and his medical history before examining the external genital organs and the prostate. Additional examinations might be necessary. Depending on the treatment, your partner might be referred to a urologist.
- A sex therapist: you can either get a referral to a sex therapist from your GP or you can find one yourself. For details of therapists in your area, visit the British Association for Sexual and Relationship Therapy (BASRT) website: www.basrt.org.uk. Sex therapy isn’t always available on the NHS, but organisations such as Relate may be able to help with fees.

Miracle pills
These oral treatments produce an increase in blood flow to the penis or central nervous system to encourage and maintain an erection. Remember he still needs sexual arousal, though.
- Sildenafil (Viagra) is the most famous impotence drug. It takes effect in about half an hour and lasts for an average of 3 - 4 hours.
- Vardenafil (Levitra) is taken 25 minutes before sexual intercourse. The erection is generally maintained for between 4 and 5 hours.
- Tadalafil (Cialis) can be taken 12 hours before sexual activity, unlike the other two. Its effects can last for 36 hours!
Precautions: No more than one pill per day should be taken. Different types of impotence drugs should not be mixed. They are not recommended for men suffering from cardiovascular problems, renal impairment, or severe angina. Consult your doctor before taking any of these pills.

Other drug treatments include:
- Injections: a drug is injected directly into the shaft of the penis and an erection is obtained within around 15 minutes.
- Pellets (transurethral therapy): inserted down the urinary pipe, these drugs (in the form of pellets) are absorbed into the erectile tissue of the penis and an erection occurs in 5 to 10 minutes.

Mechanical aids
These solutions are recommended if drug-based treatments have no effect.
- Vacuum pump: the penis is placed in a cylinder with a pumping device which makes blood rush to the penis, making it hard. A rubber ring placed at the base maintains the erection once the pump is removed.
- Implants: rods or tubes are implanted in the penis. Some keep the penis hard all the time while others are hydraulic and only cause the penis to stiffen when a pump is activated.

For more information
Visit the Sexual Dysfunction Association website: www.sda.uk.net

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