Erectile Dysfunction: Complete and Partial Loss of Erection (2)

Quite large numbers of drugs affect the sex drive and cause temporary erectile dysfunction. This is particularly true of antibiotics and other anti-depressant drugs. Unless a man realizes that it is the drugs causing the impotence, the first time the penis refuses to become erect he is likely to panic, fearing the worst - that he will never be potent again. Unless he tells himself that the erectile dysfunction will only last while he is using these drugs, and that when he has stopped using them all will be well again, he will, by his fear, make himself impotent.

Many cases of long-standing erectile dysfunction are caused by one single failure to achieve erection. Every man experiences erectile dysfunction at one time or another. The cause may be one of many - a very heavy bout of smoking or drinking, or a temporary dysfunction which affects the testicles so that they are unable to produce sufficient quantities of the hormone testosterone, which is responsible for creating sexual desire and influences the erection process (in both men and women), stress, tiredness, or anxiety. The man who can shrug off one failure, or even two, is in no danger of becoming permanently impotent; on the other hand, the man who is struck by fear of becoming permanently impotent on account of one failure is likely to experience more persistent erectile dysfunction. The usually virile man who suddenly finds himself impotent can say something like this to his partner, "Sorry, it's not going to work this time. It will be all right next time!" and should finish this up by pleasuring his partner manually or orally. Afterwards he should think over what he has been doing lately and try to determine a possible cause from among those listed. If he is not able to find one, he should still not worry about his failure but maybe seek medical advice.

There is one type of erectile dysfunction which can be extremely puzzling. A man may be impotent with his partner, and yet have a strong erection and yet the same husband may be unable to ejaculate during intercourse with another woman. This is a classic case of psychological erectile dysfunction and may result from resentment against the relationship, fear of what his partner may say about his sexual inadequacy, and so on, though the root may lie in something wrong having developed in the relationship which has nothing to do with sex.

The converse of this situation often occurs; that is, a man who is able to make love satisfactorily with his partner fails when tempted to have sex with another woman. Quite often, when he has got into bed with the casual partner, he finds himself impotent. This is brought about by feelings of guilt at being unfaithful to his partner, though he may be totally unconscious of having such feelings. The same thing can happen to a single man who regards sex as sinful or who has religious convictions that sex outside marriage is wrong.

Now and again, deficiency of testosterone is the cause of the erectile dysfunction. The sufferers from this cause are usually late middle-aged and older men, but some young men can develop the same deficiency. In older men, the deficiency in naturally produced testosterone can be made up by injections or the implantation of pellets of testosterone, patches or oral medication. This treatment does not work for all men, but all the same this technique has produced some quite dramatic recoveries. Unfortunately, some doctors are not very keen on administering testosterone injections; there is a quite false belief that testosterone promotes prostate cancer. Injections are more successful than implanting pellets because quite often a fibrous tissue develops round the pellet, which prevents the hormone from getting into the bloodstream. Injections have the drawback that they have to be given at fairly frequent intervals. But if the man is prepared to visit his doctor every ten days or so, the treatment is very effective.  Alternatively, patches or oral medication may require only an occasional visit to the doctor.

In almost all cases erectile dysfunction which is not the result of high testosterone deficiency in older men, can be corrected provided the cause of the erectile dysfunction has been discovered. Masters and Johnson devised a course of treatment which is not dissimilar to the one they devised for premature ejaculation. Sensate Focus relies upon the co-operation of a sympathetic and understanding partner. The couple are required to to overcome any inhibitions they might have in their sexual encounters, and the man is taught full muscle relaxation. The partner is taught how to stimulate the man's penis in a 'non-demanding' way. When this has produced an erection which can be sustained for some minutes, 'non-demanding' penetration takes place; that is to say, the penis is put into the vagina but it is perfectly understood by both partners that the man will not be expected to ejaculate. The man lies on his back and the woman faces him; kneeling, bending forward at an angle of 45 degrees, she inserts the penis and slides back on it, rather than sits on it. When this has been successfully accomplished at three or four consecutive sessions only then does the woman make pelvic movements. This happens on a further one or two sessions, and then the man also makes pelvic movements. Full details can be found in Helen Kaplan Singer's book, "The Illustrated Manual of Sex Therapy."

What of the man for whom no method of treatment is successful, who is, in other words, condemned to lifelong erectile dysfunction? The main need for restoring erection is to make possible the insertion of the penis in the vagina. For the great majority of couples this is a deep psychological need. It is also a fact that many impotent men can be stimulated to orgasm and ejaculation while the penis is limp. If, therefore, some means can be found of getting the limp penis into the vagina, the couple's problem is practically solved. The best way is to use a vacuum pump and erectile constriction ring, which initiates an erection by sucking blood into the penis then maintains it with a rubber ring placed around the base of the erect penis.

Partial Erectile Dysfunction

Partial erectile dysfunction is psychologically induced. A man begins to make love and has a really strong erection, which he is able to sustain all the way through foreplay. But as he moves to penetration, he suddenly loses it; or if he has been able to get the penis into the vagina, it goes soft on him before either partner can reach orgasm. The causes of partial erectile dysfunction are much the same as those which induce full erectile dysfunction - resentment against and a desire to punish the partner, feelings of guilt or shame, and so on. Many cases, however, have their origins in one particular incident which created fear of discovery just at the crucial moment.

An email we received from a young man: When we first got married Jane and I had to live with her parents for a month or two. We were making love one Sunday morning before getting up and I had only been in Jane for a few seconds, when suddenly the door opened, and in walked Jane's father with a cup of tea. Jane cried out and I jumped off her. My penis, which had been so stiff that it ached during foreplay, went absolutely soft in a flash.

The old man made some jocular remark, but was obviously embarrassed. When we had drunk our tea we tried again. But it was no good, even though we locked the bedroom door. No matter what Janey did to me, I just couldn't get another hard on. We've been in our own house eight months now, and though I know perfectly well we can't be disturbed, because there is no one else in the house, we have never been able to finish intercourse in the proper way. I get a magnificent erection during foreplay, and then when I try to go into Janey, I lose my erection - just like that. It's been like that every time we've tried to make love, and we are both going up the wall with frustration. Please, what can I do to get things right again?

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