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Male Impotence (or Erectile Dysfunction)

by David Levinson
July 19, 2006
Male Impotence (or Erectile Dysfunction)
There you are: you've dimmed the lights, lit a candle, and put on some music - you're all ready to perform - but when the time comes to show her how much she turns you on, you just can't get it up. At least, you can't get it up like you used to and you can't stay hard for as long as either of you would like. You might feel shame and regret, even as she swathes your ego by saying that it doesn't matter, that you'll try again later. You might feel angry for not being able to please her and for letting yourself down (no pun intended). You think it's all in your head, because that's what everybody's told you. What you might not know is that male impotency - or erectile dysfunction, as it is widely referred to these days - is perhaps the most poorly misunderstood and mismanaged of all medical disorders, according to, an informational website specializing in the science of dysfunctions of the male reproductive system.

Erectile dysfunction affects at least 10% of the male population and contrary to popular belief, it is never as black and white as doctors think. In as many as 80 to 90% of all chronic cases of erectile dysfunction, the problem isn't in the mind but in the body itself. Most of the time, the afflicted have normal desires and can attain erections, though only partially, which accounts for the term erectile dysfunction.

Because men in general rarely like to discuss the fears about their sexuality, the study of impotency has remained in darkness. The qualities that drive a man, his male chauvinism and machismo, are also, ironically enough, the very same qualities that contribute most to his troubles in the bedroom. And while many men are tackling their troubles by seeking out professional help and advice, many men still cling to the idea - perhaps the most damaging of all and set down by Sigmund Freud - that the root of all their problems is in the mind itself. This couldn't be further from the truth, according to andropologists, who pinpoint specific clinical conditions and diseases that account for sudden erectile dysfunction:

1) Arteriogenic impotence occurs when an artery carrying blood to the penis is blocked. This might happen in the elderly, men with diabetes or with high blood pressure. It is also very common in bicycle riders who sustain enormous amounts of friction in the groin region.

2) Venogenic impotence occurs when the veins of the penis leak blood and prevent a full erection from developing. This form of impotence is extremely common and is said to account for 30 to 70% of all cases.

3) Neurongenic impotence, while not as common, is when the nerves that activate the arteries and the veins and alter the dynamics of blood flow within penis malfunction. Injuries to the back, operation on the penis itself, any kind of degenerative nerve condition - all of these can lead to and cause impotence. But it is diabetes mellitus that affects the nerves the most. In fact, as many as 50% of all diabetics are impotent.

4) Endocrinologic (or hormonal) impotence accounts for 5 to 10% of all organic cases and occurs when there are decreased or insufficient levels of sex hormones in the bloodstream.

5) Psychogenic impotence, the most stigmatized of all known cases, is perhaps the hardest to treat because it assumes that the problem lies only in the mind and not in the body at all.

The treatments for erectile dysfunction are vast and usually 100% effective, when coupled with a healthy lifestyle, quality sleep patterns, and low stress: Sexual counseling and sex therapy help patients with sexual problems, especially when they're psychogenic in origin. There are oral medications, like yohimbine therapy, which frequently improves libido and 30 to 40% of all patients reported increased sexual desire and improved erections over time. (Trazadone, an antidepressant, has also been found to help treat some patients with psychogenic symptoms.) Hormone replacement therapies work on those patients with inadequate levels of testosterone, which gives men their sexual characteristics (deep voices, body hair, etc.). If you're someone with an imagination and a strong grip, external vacuum devices have proven highly effective treatments against erectile dysfunction. For what they are, these vacuums are cost-effective and have a very high success rate: 90% of the men who used them reported to have attained full erections that lasted even after orgasm.

While these are just a few remedies, there are others like microsurgery, penile implants and penile injections, which are recommended for those who simply do not respond to any other treatment. What's perhaps most important to remember, as you determine the best course of action, is that you are not alone in this and that there are people, scientists and doctors, out there always working toward a day when penile dysfunction is a thing of the past.

razorsgurl wrote:
July 29, 2006
My husband can get a hard on but he feels like the size is not as good as it shoud be, I think that this is why his sex drive is so low. in our relationship I am the one who wants it all the time and he can go a week or two without it. If I go that long I am a bitch t olive with! is there anything that can increase a mans sex drive? and he "jokes" about getting something to "make it bigger" but are the products safe? Im fine on top so i dont care about that, I just want it to be more often and not like Im begging for sex all the time. (i feel like a perv wanting it all the time)
July 30, 2006
Dear Razorsgurl,

Trust me. You aren't a perv for wanting sex all the time. It's as
much a part of life as anything else, sometimes more. My feeling is
that you probably want it all the time because you aren't getting it
regularly. If you were having sex routinely with your husband and the
sex was satisfying, chances are you wouldn't feel compulsive about
it. As far as your husband's "size," there's not a lot that can be
done. Penis pumps (vacuum pumps that stretch the erection have little
sustaining effect) are an expensive way to find out that the penis is
the penis and not a wad of taffy. There are no significant ways to
lengthen the penis, not on the open market and not from surgery. A
man is born with what he has and that's about the end of it. Your
husband might think about getting some counseling if he feels truly
inadequate. But why should he, when he has you there, telling him
he's perfectly fine?

To increase his sex drive, you might want to try the old-fashion
methods: romantic dinners, baths, massages. There are some ointments,
like Spanish fly, that apparently work. If all else fails, there's
Viagra, a little blue pill that does wonders for helping a man
sustain his erection. Like any other medication, Viagra should be
prescribed, not bought online. If you and your husband decide on this
course, then make sure to see your doctor first.

Demanding sex from him, however, is not the way to go. Maybe you
should back off for a bit and let him come to you. The old adage,
"Flee and I follow; follow and I flee," might be your best bet yet.

Hope this helps.

Paizley wrote:
July 26, 2006
My husband and I have only been together for about a year and at first everything was perfect- even though we had problems with his "erectile dyfunction" in the beginning- but now anytime we attempt to have sex he can't keep an erection and I haven't had an orgasm in two months! Well, I mean I masturbate but when he gives me one it is better- and he feels much better too. We are very very open in our communication about our sex life and we have come up with a few ideas for why this could be happening but we don't really know. We think that either he still has some resentment because I cheated on him a couple of months ago (once), I'm still not past the emotional distress I went through when I miscarried about three weeks ago, or maybe because he has a heavy drinking problem that maybe his liver is turning his testosterone into estrogine so he is not able to sustain an erection and therefore we can't have sex long enough for me to have an orgasm. I have no idea what to do and our problem just won't go away! What do you think it oculd be? Please help?
August 03, 2006
Dear Paizley,

There are some might interesting things going on in your marriage,
huh. If you put your sex life into perspective, you might be able to
trace the causes and concerns that led to this bedroom impasse. I'd
say that everything you've listed - cheating on your husband, the heavy
drinking and the miscarriage - have all played a key part in the slow
curtail of your own orgasms and your husband's erectile dysfunction.
I'm not a judge, but it sounds like you have some serious guilt
issues to work out, while your husband might need some serious
therapy. Heavy drinking most definitely leads to lackluster sex and
the problem will only get worse unless he addresses it NOW.

I suggest couples' counseling ASAP, where you both can share your
misgivings, he can vent his mistrusts, and you can let go of your
resentments. I am curious, however, about why you cheated in the
first place. Was it because you weren't getting it at home or because
you simply wanted more or were bored? You need to ask yourself some
serious questions and come up with some equally serious answers
before you can move forward. Counseling will speed up this process
for you.

Hope this helps.

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Author:David Levinson
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"David Levinson is a young writer who has mastered all the elements that make up a classically structured short story: drama, suspense, humor, empathy. There are no fancy pyrotechnics or meta-fictional devices here. He's a neo-traditionalist so the stories are direct, emotional and compulsively readable, plus there's enough mystery and action in them to propel at least a dozen novels."<br>Bret Easton Ellis