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Erectile dysfunction: Is it physical or psychological?


Erectile dysfunction: What is it and what do we do about it?

Erectile dysfunction is frequently referred to by medical professionals and the general public as “impotence”. Erectile dysfunction should be defined as a persistent difficulty in attaining and/or maintaining an erection sufficient for sexual satisfaction. It should be differentiated from the occasional, temporary erectile failure which many individuals experience in relation to being tired, experiencing significant stress or excessive alcohol consumption. Erectile dysfunction may be manifested in many forms including a total inability to achieve erection, inconsistency in the ability to do so, or a tendency to sustain only a brief erection. It is a common experience, with some experts estimating that as many as 10 to 15 million American men and 100 million men worldwide experiencing some form of impotence. Although the common perception is that it is an inevitable part of aging, research into the science of aging indicates that perception is simply not true. However, the incidence of impotence does increase with age, effecting approximately 5 % of men at the age of 40 and between 15% and 25% of men by the age of 65. Evidence has usually found erectile dysfunction to have a physical cause such as various diseases, psychological issues, injuries or drug side effects.


In most cases erectile dysfunction has very little to do with desire, the ability to have an orgasm or ejaculate. It means simply difficulty with erections and is not a loss of interest in sex, a sign of sterility, lack of strength or vigor. It not only effects older men but also occurs in younger males. It should not be considered a natural or acceptable part of the aging process when treating erectile dysfunction is such an available option.

Although significant understanding about the causes of erectile dysfunction as well as a growing number of effective treatments are available, many men are still too embarrassed to seek treatment. Approximately 90 percent of men with impotence do not approach a doctor about the problem, and therefore cannot be treated effectively.

Many people are now aware of the little blue miracle pill called Viagra but many are unaware that there are various alternatives in the effective treatment of erectile dysfunction. After a basic medical examination to rule out medical issues such as diseases and the side effects of medication, physicians may then consider various options. General measures to consider include psychological issues such as depression, anxiety and stress, and relationship issues. Also, lifestyle modifications may be recommended including smoking cessation and reducing alcohol intake. Some devices have been developed such as constriction rings and vacuum suction devices. Frequently medication may be prescribed such as Viagra, or  various herbal alternatives may supercharge your sex life such as the very popular Eros . Also, surgery is always an option, including penile prosthesis and penile revascularization. 

Source: DSM-IV Casebook (Francis, First and Pincus,1995)

By Paul Susic Ph.D. Licensed Psychologist (Health Psychology) 

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