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Erectile Dysfunction

Erectile dysfunction is estimated to affect more than ten million American men. Studies have shown that men 18-24 have a low percentage of erectile difficulties, but there is a high percentage of men 51-60 who have this problem.

Age is not the only factor. Many factors contribute to erectile dysfunction, including hormonal imbalances, circulation problems, medications, severe stress or fatigue, diseases, and damage to the spinal or pelvis area. Psychological factors that can contribute to this problem include anticipatory anxiety, relationship problems, and job problems. Any problem that diminishes concentration on enjoyment can contribute to erectile dysfunction.

An erectile dysfunction is identified by the diminished ability of a man to get an erection or maintain an erection. After a man has been properly self-stimulated, or stimulated manually or orally by a mate, and no erection is achieved, this is diagnostic of an erectile dysfunction. An erectile problem is also suspected when (a) a male is no longer strongly visually stimulated by a partner, magazines, etc., (b) an erection requires much more time to achieve than it once did, or (c) exotic stimulation is required (wild fantasies, exotic behavior or acts) (Westheimer 1994,248).

There are many disorders that can cause or contribute to erectile dysfunction. Any circulation problem can affect the penis. The penis itself may have circulation problems, such as increased blood flow out of the penis or decreased blood flow into the penis. This will prevent or delay an erection. Another problem that can occur in the penis is an abnormal relaxation of muscles inside the penis (Westheimer,148).

Many health problems cause erectile dysfunction: diabetes mellitus, high blood pressure, heart disease, high cholesterol, multiple sclerosis, and alcoholism. The link between diabetes mellitus and erectile dysfunction is not known exactly, and to have this disease does not mean one can not have an erection (Westheimer,149).

Nicotine use, alcohol in both low and high doses, heroin, and other narcotics all can contribute to erectile dysfunction. Nicotine use slows the circulation of the blood, causing an erectile dysfunction in some people. Snuff chewing tobacco causes the blood pressure to rise, creating not enough control of blood supply to the pelvic area. Alcohol in low doses heightens the desire for sexual activity, but alcohol in high doses can inhibit an erection, as well as decrease sexual desires. Narcotics can cause erectile dysfunction in many people, with decreased sexual desire (the desire is replaced by the high in the narcotics) (Hyde and DeLamater 2000,498-500).

Medications also cause erectile dysfunction. Some antidepressants, such as Prozac®, may inhibit sexual desire and erectile function. Under medical supervision, the antidepressant Zoloft® is much less damaging to erections and sexual activities (Playboy 1995,96). Other medications may lower testosterone levels, which can be overcome by adding hormones or by lowering doses of the medication which was causing the hormonal imbalance.

Physical injury to the pelvis area also can cause erectile dysfunction. Injury to the lower part of the spinal cord, prostate surgery, or trauma or surgery to the pelvic area can create nerve-related impotence or erectile dysfunction. When the nerves are damaged or even deadened in the area, blood flow to the area may be restricted, causing inadequate blood flow into the penis for a satisfactory erection (Westheimer, 149).

Relationship problems may have a physiological effect on a man. If he feels that nothing he can do in a relationship will make his mate happy, including all aspects of being intimate, an erection problem can occur. The stress of the relationship can take his mind off intimacy. He may not want to be intimate if he knows that there is a major problem in the relationship (Goldberg 1987, 133-41). The same may occur with respect to with finances, job stresses, and general life problems (Westheimer,248).

Anticipatory anxiety, or better known as performance anxiety may be a factor. If the man has an erection problem one or two times, he may anxiously anticipate the same problem occurring at the next intimate moment. Because of that high anxiety level, he may have another erection problem. A continuous circle of fear of not being able to maintain an erection, or to please his partner, can cause him not to have an erection (Westheimer, 39).

From more and more research in the medical field in recent years, solutions have developed for men with erection problems. Some methods for recovery or a functional penis are relatively easy to achieve, while others are more expensive and may require surgery. For medication and hormone imbalances, including medications that control high blood pressure, a doctor can balance or change the prescriptions (Westheimer, 150). The new wonder drug that has come onto the market, Viagra®, will also help the impotent males under the supervision of a doctor (Hyde and DeLamater, 511). A doctor or urologist can conquer any circulation problems in the pelvic region, if there is no permanent nerve damage to the area (Westheimer, 150). Erection problems caused by narcotic use, alcoholism, or high doses of alcohol, smoking and nicotine use, including snuff tobacco, should be avoided, or the user should completely quit. High blood pressure and high cholesterol can be lowered or controlled to help maintain a firm erection (Hyde and DeLamater,498-99).

Semi-hard silicone penile implants and hydraulic penile implant devices for men with severe erectile dysfunctions are available. The silicone implants are also called a non-hydraulic penile implant. Solid cylinders are implanted in the corpora cavernosa, to act as main arteries. When the man gets aroused the implants maintain an erection (Hyde and DeLamater,513). A hydraulic penile implant also has silicone implants in the penis, as well as a pump inside the scrotum that is pumped to the reservoir near the prostate, the reservoir then gives air to the silicone tubes to create a full erection. The device also has a release valve that is inside the pump activated by finger pressure, to release the erection (Westheimer, 150).

Not so drastic, are two other known techniques for a man with erectile dysfunctions to have a healthy erection. One method if achieving an erection is with penile self-injection therapy. A diabetic type needle is inserted into the side of the penis to activate the nerve and blood supply to the area (Hyde and DeLamater,512).

Another method is with a device called a vacuum constriction device, or simply a penis pump. A cylinder is placed over the penis, and air is sucked out of the cylinder, either manually or orally, and an erection occurs, from the blood being forced to the area. A rubber clamp-like object is placed at the base of the penis to prevent the blood supply from leaving the area (Westheimer, 150).

Many men may feel that an erectile dysfunction is the end of their sexual and personal relationships. But coping with an erection problem can be the beginning to achieving improved intimacy. It can give a man the chance to see and solve problems in his relationships. A counselor, pastor or clergy, may help explore issues surrounding the problems in a man’s life and how the man can change for the better. With the solution of some problems in his life, as well as growing to be emotionally stronger, the man will again be able to focus on the pleasure that sexual experiences give him (Goldberg, 142-43).

If a partner is making the man feel insecure about the erection problem, this will only increase the man’s anxiety. An understanding mate will boost his ego to help him get his mind off the erection problem and worrying if is going to fully please her or not (Goldberg, 143-45). A man might try to use fantasy with masturbation to regain his confidence. Doing this will make it easier to maintain an erection, and achieve an orgasm (Hyde and DeLamater, 508-9). If the man successfully performs intercourse, achieving an orgasm with the fantasy he used with the masturbation, he will relieve the anxiety. It will slowly decrease, and the man will again be a successful performer.


Golgberg, Herb Ph.D, The Inner Male. Nal, New York. 1987.

Gray, John Ph.D., Mars and Venus in the Bedroom. Haper- Collins, New York. 1995.

Hyde, Janet Shibley and DeLamater, John D., Understand- ing Human Sexuality. McGraw-Hill, Boston. 2000.

Playboy Magazine, Antidepressants and Impotence. December, 1995.

Westheimer, Dr. Ruth, Dr. Ruth s Encyclopedia of Sex. Contuinum, New York. 1994.

MonsterPapers, 2003.

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The information presented here is not meant to be medical advice nor to act as a substitute for medical advice. Serious side-effects, including death, could result if one were to take any prescription medicine without the supervision of a physician.

Copyright 2003, Thomas Manaugh, PhD