Erectile dysfunction (impotence) is the failure to get an erection, or keep an erection long enough for satisfactory lovemaking. It isn’t a disease, but a symptom of some other problem, either physical, psychological or a mixture of both. Contrary to popular belief, the majority of cases have physical causes, with only one in ten cases of impotence being caused by psychological problems. It is normal to experience the occasional bout of impotence. Unless it persists, there is no reason to be concerned.
Most cases are physical in origin
The four main causes of impotence include:
- Physical illness - there are many diseases that interfere with functioning of the penis by either reducing blood flow or affecting the nerves. Some of these diseases include heart and blood vessel diseases, diabetes, multiple sclerosis and alcoholism. When the impotence is caused by a physical illness it usually develops slowly. Most causes of impotence are physical. Some prescription drugs, like narcotics, sedatives and blood pressure medication can give you impotence as a side effect.
- Psychological factors - a man’s sexual drive or performance can be affected by stress, such as problems at work, relationship difficulties or financial worries. Psychiatric conditions and feeling depressed or anxious about poor sexual performance can also result in a failed erection. Only one in ten cases of impotence are caused by psychological factors.
- A combination of physical illness and psychological factors - physical problems with maintaining an erection may cause the man to feel anxious about lovemaking, which makes the problem worse.
- Unknown - in a few cases, neither physical nor psychological causes can explain the loss of sexual functioning.
Occasional impotence is normal
Don’t worry about the occasional failure to get or keep an erection. Occasional impotence is normal. Some of the causes include drunkenness, anxiety and tiredness. In fact, one of the most common causes of impotence in middle aged men is lack of sleep.
A variety of treatments
It is important to see a doctor. You need to find out whether your impotence stems from physical or psychological causes so that you can get the proper course of treatment. The treatments for impotence include:
- Changing your prescription drugs if they are the cause
- Psychotherapy and counselling
- Oral medications such as Viagra, Cialis and Levitra
- External vacuum devices to create blood flow
- Injections directly into the penis
- Hormone therapy
- Penile prosthetic implants.
Things to remember
- Most cases of impotence are physical in origin.
- It is normal for a man to experience occasional bouts of impotence, perhaps from tiredness or drunkenness.
- If the failure to get or keep an erection persists, there are a variety of treatments available.
Where to get help
- Your doctor
- Sexual health clinic
- Family planning clinic
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