Impotence: what is it and what can you do about it?

Impotence or erectile dysfunction is a condition which can stop men from getting a (complete) erection.

In some extreme cases a man suffering from impotence can’t get an erection at all anymore. In milder cases it only happens now and then, or the erection is not complete. The penis doesn’t fill up with blood to complete capacity during erection, the penis is less hard and intercourse becomes difficult or even impossible.

For all clarity, a large part of all men have had difficulties with getting or keeping an erection, but that is not the same as having erectile dysfunction or impotence, although the reason for this sporadic problem with erections can be the same as the cause of the real condition.

Forms of Impotence

Impotence can be a physical as well as a psychological affection.

In about 70% of the cases it is caused by a physical problem.

The physical condition of erectile dysfunction occurs mainly when the blood stream to the penis is partly blocked for a certain reason.  This can be a blood clot or an arterial affection, but very often the reason is blockage by cholesterol. Sometimes the onset of erectile dysfunction starts slow, sometimes it’s like a sudden problem.

Impotence because of cardiovascular problems

About 60% of men over the age of 55 suffer regularly or constantly from erectile dysfunction. This is the age bracket where men tend to have a higher cholesterol level in their blood.

At this age men also often become less physically active, which increases the risk for vascular problems even more.

Heart problems can also be a cause of impotence in this age category. Although not as prevalent, there are cases of arrhythmia during sexual excitement which can stop a man from achieving a full erection.

Impotence caused by hormonal imbalance

80% of men over 65 suffer from impotence

The level of testosterone in a man’s body strongly influences his libido. A strong libido means a strong sexual urge.

When a sexual urge is strong the conditions needed to achieve an erection will be easily achieved.

However, if the hormone levels are unbalanced, the testosterone level in a man can decrease which makes it more difficult to achieve an erection.

This can be related to age. On average the testosterone production in a man decreases by 1 to 2 % from age 30 onwards. But that is not the case for all men. There are many known cases of 70 year old men with a testosterone level of a 30 year old.

It has to be decided for every individual if erectile dysfunction is age related.  A doctor can do a blood test to determine your hormone levels.

Another form of erectile dysfunction with a physical cause is when it occurs after nerve damage. This could happen after an operation on the penis, but also after back operations. The nerve which directs the erection process is damaged, this hampers or entirely stops the stimuli of reaching their destination. This form of impotence is in some cases irreversible, but it is also the least occurring cause.

Mental/psychological forms of erectile dysfunction

Physical causes of erectile dysfunction are rarely the only reason. In nearly all cases part of the problem of erectile dysfunction is the man’s psychological condition.

The big evil doers here are stress, sexual pressure, performance stress and fear of failure.

 

Stress and impotence

Stress influences a lot more bodily functions than we realise. It also manifests itself differently in different people. These are common factors during a stressful stage in life:

• A higher blood pressure and heartbeat
• Higher adrenaline production
• Higher muscular tension
• Difficulty to relax
• Sleep disturbances
• Slower metabolism

Stress is not the factor that stops men from getting or keeping an erection

Performance pressure and fear of failure are more likely causes. But stress will make a man feel these pressures more intensely which will initiate problems related to impotence.

Sexual performance as a cause of impotence

Sexual performance is a difficult subject for men.  The idea that a partner will ‘judge’ you by your sexual performance, while you struggle with uncertainty about your erection or any other sexual problem can cause a man to lose control because of pressure, which makes the sexual excitement  plunge, making an erection impossible.

This form of impotence is very prevalent. We only call this condition an erectile dysfunction or impotence when the problem persists and affects a man’s sexual life; but in reality every man occasionally faces this.

A large amount of factors can play a part here. A healthy sexually excited male who has never had any problem with sexual affections, can at times have a problem with getting or maintaining an erection. You can imagine how tough it can be for someone who is easily stressed, or for someone who feels insecure during sex for whatever reason.

Performance pressure as a cause of impotence

The idea that a woman is very demanding about her partner’s performance during sex is maybe not entirely untrue, but in the end sex is mainly an act which takes places between two people who really like each other. The woman will rarely judge her partner’s performance during sex. A lot of men have a distorted view of this, often because they are influenced by porn. Porn films create an ideal that can seldom or rarely be realised by most men. Only few men can keep going endlessly and only a few men have enough stamina to make sex last for hours.

The problem is that men measure themselves against this distorted image and then conclude that they are inferior.

This self-imposed performance pressure can become a trigger for erectile dysfunction.

This is a very prevalent problem in the Western world.

Fear of failure as a cause of erectile dysfunction

Fear of failure is another source of pressure that can make it difficult for a man to get sexually excited enough to get an erection.

The problem with this form of impotence is that men are often unaware of the fact that their fear of failure is obstructing them.

Very often a physical reason is thought to be the cause of the erection problem, while it really all happens inside his head.

Physically they are perfectly healthy. Past traumatic events are often the cause.

Solutions for impotence

The purely mental form of erectile dysfunction in men between the ages of 30 and 40 occurs at an average 1 in 15.  So the number of Dutch men facing this problem is very high.

Because of this therapists have long been looking for therapeutic solutions to this “mental” form of impotence.

This is what they came up with:

It has to be clear that getting and maintaining an erection is a complicated process which is difficult to control as a man.

Getting an erection is not the same as tensing a muscle like your biceps or cheeks. The penis becomes hard because we get into a certain “mental” state.  Sexual impulses are very important to achieve this state.

Once the first sexual impulses are created by the brains, the process can kick off, but for a lasting erection there is still a long way to go. From the moment the sexual stimuli are interpreted the man needs freedom and relaxation to give him the opportunity to expand his sexual feelings. They have to be present for a little while until our evolutionary developed procreation system is certain that this is an ideal situation for procreation.

This is the key to getting an erection.  If the mental space is not right for the development of sexual excitement to this point,  an erection will hardly occur.

Treatment for erectile dysfunction

Therapy is aimed at two points

First of all: Reaching a state of relaxation before and during sex, to stop stress and distracting thoughts of hampering the development of sexual stimuli.

Secondly: The creation of a positive feeling during sexual excitement. A lot of men have problems with keeping an erection due to past sexual experiences or traumatic youth experiences.

In 80% of all cases of impotence, one of these two therapies can partly or entirely solve the problem.

Solutions for physical impotence

As said before, erectile dysfunction is often caused by a physical problem.

In most cases the problem is a blockage of the supply arteries to the penis.

In some cases a medical intervention or treatment is needed to solve this problem. In the case of a high blood pressure and cholesterol blockages, blood thinning medication can bring a solution, although this medication does nothing to take away the source of the problem.

The real solution here is the lowering of the cholesterol level in the blood. Dieticians can prescribe a cholesterol lowering diet. These diets are always healthy and I would advise men of a certain age to create healthy eating habits and a healthy lifestyle before starting on medication, which can have bad side effect. You’ll see this will make a big difference!

Related article: You might also like  this article on being unable to orgasm and what to do about it.