Erectile Dysfunction is more often known as Impotence. Erectile dysfunction is the inability to maintain or have a firm enough erection for intercourse. Over 10% of men in the US have experienced erectile dysfunction at some time. One of the most common occurrences is for men to have, at some point in his life, a time when he was unable to achieve an erection. Erection difficulties can occur at any age.

Impotence is due to a number of factors, including biological, psychological, or both. Biologically, the penis has difficulty maintaining an erection due to the lack of blood flow. Men can often still feel aroused, desire intimacy, and even ejaculate with their penis flaccid, or soft.

Impotence can often occur from the stress that men place on themselves to have and maintain erections.

Fearing that he will not be able to get an erection can actually enable his impotence. There are a number of ways men can have impotence. From maintaining an erection clothed, but unable when undressed to being unable to maintain an erection for intercourse, impotence can be situational or emotionally based. It can be associated with a person, action, or pattern developed by the male.

The impact of impotence on a man can be devastating, humiliating, frustrating, and embarrassing.

Culturally, men associate a large portion of their self-esteem on their erection and sexual stamina. Men often get erectile dysfunction as they age, due to the decrease in testosterone levels. Often impotence can lead to depression in men. And depression can make the erectile dysfunction worse.

Impotence can also play a vital role in a marriage. It can lead to an unhappy and bitter relationship. Women will often feel rejected, unloved, unattractive, or angry at his inability to maintain an erection. They may make the situation worse, by demanding him to perform sexually or create a pressure sexual situation that exacerbates the problem.

It is important for a man to visit his physician to get a medical and possible neurological work-up before seeking counseling. There are a number of physical factors that can actually cause impotence. Some common factors can be stress, fatigue, low androgen levels, diabetes, smoking, alcohol, narcotics, and a number of medicines can cause impotency. Neurologically there are a number of diseases that can affect sexual performance. There are a variety of medications available to help men maintain erections. However, they do not work for all men and some men cannot take them due to other medication they are currently taking. It is essential for all medicines to be prescribed by a physician.

Psychologically, impotence is usually a deep underlying issue. Many times “performance anxiety” causes a number of sexual dysfunctions, including impotence. However, those deeper issues need to be addressed to help treat erectile dysfunction.  Stress and the underlying issues appear to be a key factor in impotence.

Impotence is often a reaction to stress in daily life or sexual demands. Also fear of rejection, fear of intimacy, guilt, or negative associations to a partner can also play roles in impotence.

Treating All Sexual Dysfunctions

It is important to go and see a physician and psychologist/clinician to help determine if a man has a sexual dysfunction. A physician would help to determine that the male sexual response cycle is not inhibited by any physical factors. Sometime hormone replacement therapy may be necessary if his testosterone levels are less than normal. If there is a blood flow problem, then some vascular treatments may be done. Also, other physical factors could affect male sexual performance. While biology does play a role in impotency, the psychological factors are also extremely important in treating it.

A sexologist, sex therapist, or psychologist would help determine the psychological factors that may be aiding in the sexual dysfunction. The evaluation would include looking at his past and current sexual practices, as well as providing educational tasks to assist in treating the dysfunction. All male sexual dysfunctions benefit from a clinicians education of the male sexual response cycle, environmental stimulation, as well as promoting self-knowledge regarding sexual practices.

Psychological Treatment – Impotence

The first goal in working to treat impotence is to reduce or eliminate the anxiety causing the impotence. It is also goal to help facilitate an erection and eventually a successful sexual intercourse experience. 

Determining the ability of erections usually begins with some at-home work that includes erotic touch, stimulation, and non-pressured sexual play to help create situations that encourage erections. These acts are to be done without intercourse or ejaculation. It is just the goal to enhance erotic pleasure and encourage a different source of sexual relationship between the couple. By not having intercourse or ejaculation it removes the pressure to perform.

It may take awhile, but the non-performance pleasuring usually leads to erections and boosts his self-confidence. Erections may often be temporary and can actually benefit the next step in treatment. It is important to show that erections can come and go during sex play. To do this the couple, especially the partner, is encouraged to stimulate the penis to erection, and then stop until flaccid and repeat process. This is often recommended without sexual intercourse allowed. It is also important that the counseling helps to distract the negative and obsessive thoughts regarding the potential impotence.

Many times men have separated themselves from his erotic feelings while he worries over his partners. He may be so focused on her and what she thinks that he actually enabling his own impotence. Counseling will often encourage a bit of selfishness. To temporarily focus solely on his needs. To find sexual enjoyment and to find a way to liberate his sexual desires. This is only a temporary concept and should be encouraged to turn the attention on his partner after he has achieved orgasm, through caressing or masturbating her afterwards. The first successful intercourse is still just the beginning of treatment.

Men can easily have impotency relapses, but they are encouraged to continue with what they learned. It is a process until he is fully confident in his ability to maintain erections. Talking about his stress, fears, and starting a new open communication regarding sexual play is always present in the counseling process.