IMPOTENCE

Impotence is rarely a long-term sexual difficulty, but if it is a man can go to his doctor without embarrassment.

Strictly speaking, only the second factor is impotence. The first comes under the heading of infertility and the third is distinguished as problem on its own.

Premature ejaculation, meaning the problem of reaching orgasm too quickly, is also different to impotence, although it has similar treatments.

All types of men, in all walks of life, are more likely than not to experience impotence at some stage of their lives.

This is because impotence is most commonly caused by stress, partnership problems or lack of self-confidence.

Aging is the other universal factor in impotence . Sexual functioning, just as other physical processes, naturally declines with age, so that once again, all men are susceptible though impotence caused this way is by no means inevitable.

SEXUAL AROUSAL

The purpose of sex is the penetration of the vagina by the penis so that fertilisation (if contraception is not used) can take a place. To do this the penis has to be stiff and erect, rather than limp or flaccid as it usually it. The stiffness is caused by blood flowing into three spongy cavities within the penis, and being kept base of the penis.

For the blood to flow to the penis, there must be a sexual response-in other words a reaction to something which is sexually exciting. In humans the ‘trigger’ for sexual excitement is mainly in the mind. Non-mental triggers for sex do exist, such as the cycle of hormone production, hormones being the body’s chemical messengers. But unlike animals, we are not automatically ‘turned on’ sexually.

Once a man has an erection, physical stimulation does the rest. Friction of the walls of the vagina on the head of the penis which is rich in nerve endings, stimulate various muscles until, at orgasm, the contract, pumping semen out through the penis.

It should be no surprise, therefore, that a system so dependent on mental and nervous triggers should occasionally fail for reasons. By far the most common psychological reason for failure is the fear of failure. Society puts men (and women) under great pressure to be sexually successful.

It can take something quite small to plant the seed of fear. Scornful words may who, understandably enough, is disappointed when her partner is too tired to or stress.

Closely related to fear as a psychological reason for impotence. This is caused typically, by redundancy, or failure to win promotion at work. Or there may be partnership problems-perhaps a lack of confidence in the relationship, or in the girls herself. But in all these cases importance is only a real problem if it persists.

PHYSICAL CAUSES

In young and not-so young men, alcohol is the most common (and joked about) physical cause of impotence. There may be an erection, but ejaculation either takes a long time, or does not happen at all.

Aging is the physical cause of impotence to worry about least. At 60, a man is less able to perform sexually-in terms of frequency of erection, the length of time it can be ‘held’ and the time taken to reach orgasm. However, there is no pattern, and some may find the rate of decline eases after 60

If you have a about of flu other serious degenerative diseases, which as cancer of the colon or prostate- although they may not always do so.

Childhood events can make a man impotent in later life. Unhappy dealings with females-perhaps in his family may give him an in-built resentment of women. Or he could have a naïve tendency to idealise them.

Some men fear the consequences of sexual intercourse, not wanting the responsibility of children, or they may have fear of hereditary disease.

TREATMENT

Temporary psychological impotence is almost always treated, at first occurrence, by the doctor. He will try to identify the cause and offer reassurance.

If the problem does not go away, it is likely to need treatment by psychotherapy. Today, this offers reassurance.

If the problem does not go away, it is likely to need treatment by psychotherapy. Today, this offers great hope to couples who are prepared to co-operate with the therapist.

Sexual therapy entails a couple going to therapy sessions together to learn techniques which they then practice in their own home. They might begin with ‘sensate focusing’ exercises, which show that pleasure can be achieved simply through physical contact free of any demand to perform successfully. Soon the man begins to forget his tendency to judge his sexual performance simply because he is not being asked to perform-and begins to associate physical contact with simple pleasure.

For the most common physical cause of impotence-excess drinking-pointing out the cause is usually treatment enough. The same may well apply to young people who complain of impotence young people who complain of impotence as a result of heavy use of cannabis.

If impotence is caused by a short-term illness or over tiredness, the treatment is equally simply simple, explanation, followed by reassurance that normal sexual functioning will return. More than 90 per cent of cases are psychological, and most respond to treatment.

When it is caused by disease, for example diabetes, patients can often look for improved sexual ability in step with the progress of their treatment.

Decline due to aging is not a medical problem, but doctors, or sex therapists may offer advice on love marking positions which are easy and comfortable .