Questions to ask yourself

Is it really an erection problem? Or is the actual problem premature ejaculation or a lack of sexual desire?

Can you achieve an erection by masturbation but not with your partner, and do you still sometimes wake with an erection? If the answers are ‘yes’, a psychological reason, such as stress or depression, is likely.

Did loss of erections come on suddenly, or have erections gradually been failing over a long period of time? Erectile failure which comes on suddenly is usually psychological; physical causes usually have a more gradual onset.

Have you been under extra stress lately? If so, is there any way you can lessen the stress in your life?

Are you taking any drugs (see above) that might be responsible? If so, ask your doctor for alternatives.

Are you drinking too much? Blood alcohol concentrations of up to about 25 mg/100 mL improve erections slightly, but when the level reaches about 40 mg/100 mL erection is inhibited. In some people, only one or two drinks is enough to raise the blood alcohol to this level. Heavy drinking over a long period can cause erectile failure because of nerve damage.

Have you noticed anything else wrong? For example: Peyronie’s disease, where the penis develops a lump and often kinks, can cause impotence; tightness of the foreskin can prevent full erections; and enlargement of the breasts or loss of body hair might mean a hormonal problem.

Who is really bothered by the problem – you or your partner? Talk to your partner about what each of you wants from sex. As sex counsellor Susie Hayman says, “It’s amazing how many people just lie there wishing their partner was a mind reader.”

Are you a smoker? If so, can you stop? Stopping smoking will not reverse the problem, but may stop it getting worse. Also, impotence is often a sign that your arteries are unhealthy, so stopping smoking is important to lessen the risk of a heart attack.

Have you had your blood pressure checked recently and been tested for diabetes? Many men with impotence have unhealthy arteries and high blood pressure, so a check of your blood pressure and blood lipids (e.g. cholesterol) are necessary. Impotence can also be a symptom of diabetes

• What is impotence
• How the system works and what causes it to fail
• How to approach your doctor and what your doctor can do
• Treatment – getting treatment and types of treatment
• Useful contacts

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