male sexual problems

What is impotence?

The most common cause of temporary impotence is anxiety.

Impotence or erectile dysfunction (ED) means not being able to get a good enough erection to have intercourse.

Temporary impotence is very common indeed, particularly in younger men, and especially when they are either anxious, or have had too much to drink.

If you're having erection problems, bear these points in mind:

• the most common cause of temporary impotence is just anxiety - not some serious disease!
• impotence can be helped by medication, sex counseling, mechanical aids, or - very occasionally - surgical treatment.
• impotence may be a symptom of another, as yet undiagnosed, disease requiring treatment; the most common of these is diabetes.

What causes impotence?

An erection happens when blood is pumped into your penis - and stays there - making it stiff and hard. All sorts of things may affect this complex process.

Psychological causes

• Anxiousness about whether you can 'perform' will almost certainly make it impossible to get an erection.
• Problems in a relationship may affect potency.
• Impotence may be caused by depression.
• Bereavement: recent loss of a loved one is notorious for causing impotence.
• Tiredness.
• Stress.
• Hang-ups - for instance, guilt about sex.
• Unresolved gay feelings.
• Having an unattractive partner.

Physical causes

• Problems with the chemical mechanism that makes erections happen - very common in older men.
• Vascular (blood vessel) disorders. Patients with arteriosclerosis, other heart or vascular diseases and high blood pressure are at greater risk of developing impotence.
• Excessive drainage of blood from the penis through the veins (venous leak) - uncommon.
• Diabetes often creates erection difficulties.
• Smoking increases the risk of developing arteriosclerosis and, therefore, of suffering from impotence.
• Side effects from certain drugs, such as some blood pressure (BP) treatments, some antidepressants and some ulcer healing drugs; BP drugs, in particular, do this very frequently.
• Side effects of non-prescribed drugs (tobacco, alcohol, cocaine and others).
• Nervous system diseases - uncommon.
• Major surgery, eg prostate surgery or other abdominal operations.
• Hormonal abnormalities - rare.

What to do if you've got potency problems

If you're having difficulty in getting erections, you should definitely see a doctor for assessment.

We strongly advise you not to go to high-priced clinics, where men in white coats pretend to be doctors while they extract large sums of money from you!

Really, it's best to start with your own GP. But if you don't feel you can face your doctor, other doctors can be found at:

• family planning clinics.
• urology medicine clinics.
• clinics recommended by the Institute of Psychosexual Medicine, the Impotence Association, or the British Association For Sexual and Relationship Therapy (BASRT).
• Brook Advisory Centres (in England, for young people only).