Impotence
 

An erection problem is the inability to get or maintain an erection that is firm enough for a man to have intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction.

If you have difficulty having or keeping an erection more than 25% of the time, it is considered a problem.

In the past, erection problems were thought to be "all in the man's mind." Men often were given unhelpful advice such as "don't worry" or "just relax and it will take care of itself." Today, doctors believe that when the problem is not temporary or does not go away on its own, physical factors are often the cause.

One way to know if the cause is physical or psychological is to determine if you are having nighttime erections. Normally, men have 3 to 5 erections per night, each lasting up to 30 minutes. Your doctor can explain a test to find out if you are having the normal number of nighttime erections.

In most men, erection difficulties do not affect their sex drive.

Premature ejaculation (when orgasm comes on too quickly) is not the same as impotence. Together with your partner, you should seek counseling for this problem, which is usually due to psychological factors.

Male infertility is also quite different from impotence. A man who is unable to maintain an erection may be very capable of producing sperm that could fertilize an egg. An infertile man is usually able to maintain an erection, but he may be unable to father a child due to problems with sperm count or other factors.
 

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[Causes]

An erection requires the interaction of your brain, nerves, hormones, and blood vessels. Anything that interferes with the normal process can become a problem. Common causes include:

"Vicious cycle" of doubt, failure, or negative communication that reinforces the erection problems
Erection problems tend to become more common as you age, but it can affect men at any age and at any time in their lives. Physical causes are more common in older men, while psychological causes are more common in younger men.
 

[Home Care]

For many men, lifestyle changes can help:

Cut down on smoking, alcohol, and illegal drugs.
Get plenty of rest and take time to relax.
Exercise and eat a healthy diet to maintain good circulation.
Use safe sex practices, which reduces fear of HIV and STDs.
Talk openly to your partner about sex and your relationship.  If you are unable to do this, counseling can help.

Couples who cannot talk to each other are not likely to be able to make love to each other. Men who have trouble communicating their feelings may find it difficult to share with their partner any anxieties about their sexual performance. If you keep worries to yourself, you are more likely to lose erections. Men who cannot express and resolve feelings of anger or frustration towards their partner may hold back their erection as a weapon in the conflict.  In these circumstances, counseling can be very helpful for both you and your partner.
 

[Psychological Causes of Impotence]
 

The psychological aspects of erectile dysfunction are considered to have major significance so have to be addressed when seeking treatment. Psychological issues often stem directly from physical problems but psychological factors could also be the prime reason for erectile dysfunction. The most common psychological problems can generally be related to:

Inhibited sexual desire
Anxiety Disorders
Depression
Mental fatigue
Stress
Guilt
Relationship problems
Lack of interest in sex by partner
 

[We Know Possible Causes But Will That Help Me?]
 

The thing about impotence is that just because we know possible causes it does not follow that they are certain to be the cause. Impotence is so caught up with men's image, socialization as well as psychology and the way our bodies function, or in this case do not function to our satisfaction.

The important thing is if you have a problem achieving and/or maintaining an erection that you get help, treatment for impotence.

If erection problems seem to be caused by a medication you are taking for an unrelated condition, consult your doctor. You may benefit from reducing the dose of the drug or changing to another drug that has the same result but not the same side effects. DO NOT adjust or discontinue medications without consulting your doctor first.

Talk to your health care provider if your erection problems are related to fear of recurring heart problems -- sexual intercourse is usually safe in these circumstances.
 

[Facts about erectile dysfunction and impotence]
 

Despite a general reluctance to seek medical help when men do finally make the effort they are more likely than women to seek help and treatment for sexual problems.  Sometimes quite simple interventions, information, reassurance, talking to someone, contraceptive advice etc, can resolve the problem.

[When to Contact a Medical Professional]
 

Call your doctor if:

Self-care measures do not resolve the problem and you continue having difficulty with erections, effective treatment alternatives are available.
You suspect that a medication is causing the problem.
The problems begin after an injury or prostate surgery.
You have other symptoms like low back pain, abdominal pain, or change in urination.
Call your doctor immediately or go to an emergency room if medication for erection problems give you an unwanted erection that lasts more than 4 hours. Permanent impotence or other lasting damage to your penis may result from this condition.
 

[What to Expect at Your Office Visit]
 

Your doctor will perform a physical examination, which will likely include checking your circulation, a rectal exam, a neurological exam, and an exam of your penis.