- Erection difficulties is an inability to achieve satisfactory
- It is a common problem, with 25 percent of men at age 65
- The majority of men have medical reasons which stop them
- Some medication causes impotence
- There have been major treatment advances in the past few
- Viagra is first tablet which has proven effective
- Viagra will help a man get an erection during sexual
- The Caverject injection is a popular choice and is effective
in 90 percent of patients.
What is it?
Erection difficulties are also known as erectile dysfunction and
impotence, and occur when men experience regular problems in
achieving an erection suitable for sexual intercourse.
It is a common problem among men. It is estimated five to 10
percent of men at 40 years and up to 25 percent of men at 65 years
have trouble getting erections.
Men may not be able to get an erection at all, only have them for
a short time, or have them inconsistently.
The problem is psychological in about 20 percent of sufferers. One
third have medical reasons for not getting erections and the
remainder have a combination of both causes.
There are now highly successful treatments for erectile
What are the symptoms?
A sufferer will experience regular problems achieving an erection
satisfactory for sexual intercourse.
This may involve only being able to achieve an erection for a
brief time, having them on inconsistent occasions or not being able
to get one at all.
A combination of mental and physical stimulation causes a man's
penis to become erect. Impulses from the brain allow muscles in the
penis to relax and fill with blood.
Men who get normal erections during their sleep may have
psychological problems which inhibit erections.
Psychological factors include stress, guilt, fear of sexual
failure, depression and low self-esteem.
Damage to arteries and muscle tissue will prevent an erection.
Diseases like heart disease, diabetes, and multiple sclerosis account
for about 70 percent of erection problems.
Prostate surgery and other pelvic surgery can also damage nerves,
causing erection problems.
Some medicines also cause impotence including antidepressants, and
What can be done to help?
Counselling may be useful for some men with psychological
impotence. However, this can take a long period of time and have
limited value for many sufferers.
There is a wide range of products available to treat the
condition, with major advances in the past few years.
Viagra (sildenafil) has been the most recent advance, and has
already been used by millions of sufferers around the world.
Taken as a tablet, it works by relaxing the blood vessels in the
penis when a man is sexually excited.
The tablet is taken one hour before you have sex. The erection
will normally subside after ejaculation. The drug will stay in the
body for four to six hours and men may be able to obtain more than
one erection during that time.
Viagra works well in an estimated 70 percent of sufferers.
Do no take Viagra if you are taking nitrate medication for angina
or other heart conditions, or using amyl nitrate, or have allergies
to any of the ingredients. Tell your doctor about any other medicines
you are on before taking Viagra.
The Caverject injection is still considered one of the best
options. The effective ingredient is prostaglandin which is injected
on one side of the penis and aids blood flow into the penis.
The injection works within 10 minutes and erection subsides after
It is effective in about 90 percent of patients including those
who have prostate surgery.
The drug has hardly any side effects, however, some men find
injecting themselves difficult and have complained of pain in the
penis or testicles after injection.
Other treatment methods include the MUSE system in which a pellet
of prostaglandin is placed in the urethra and produces an erection
within 15 minutes.
Vacuum therapy is now becoming outdated as new advances take
Surgery to insert a penile prosthesis is considered a last resort,
but is useful in patients with diabetes, hardening of the arteries or
have had pelvic surgery. There are various models available including
a semi-rigid product which does stick out or a more discrete, and
expensive, inflatable model.
Laboratory tests can help confirm impotence, including tests to
measure the amount of testosterone in the blood to establish whether
testosterone replacement may be helpful.
How can it be prevented?
Men whose sexual performance is affected by psychological factors
such as stress or fear of failure may find counselling and stress
The discovery of Viagra has opened up more opportunities for
developing new and better drugs to treat the condition.
Researchers around the world are studying better ways to cure the
Men are reluctant to seek help but this need not be so. Most
doctors are aware of the problem and will be able to make suggestions
for you on which treatment may be most helpful.