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What is Erectile Dysfunction (ED)?

Erectile Dysfunction (ED) can be defined as the inability to get or sustain enough of an erection to allow penetration. Just as many people confuse erection with an interest in sex, they also confuse lack of erection with a lack of interest. Females are most likely to make this error and to personalise it.

Having an erection ..

Having an erection means that the penis is hard. Whether or not you want sex has to do with how you feel or how excited you are. Whether or not you should have sex has to do with how you judge the situation. In other words what your head tells you. You may be with your partner and be turned on but if you are with another woman who may be attractive but whom you know little about and you are not carrying a condom you may need to think carefully about what you will do.

Not Having an Erection..

If a man does not get an erection in a sexual encounter his partner may assume he is not turned on by her or that she does not know what to do to turn him on. She may be right because she is not doing what he would like or he is not aroused by her at that time.

In a sexual situation when a man is aroused and wants to have sex but his penis does not respond there is always an answer as to why. Though this is a frustrating experience for both the man and his partner. The answer maybe his partner does not know what he needs to stimulate him to get hard. Maybe he has not communicated those needs or perhaps he is engaged in too much masturbation and his penis is too tired to get hard again.

What Helps, What Hinders ?

To get an erection many things must come together. A bit like a “perfect storm”. A man’s nervous and vascular system must be well enough to respond properly and his emotions must be supportive to the physical response i.e. his head must not get in the way. His head must be in the moment with the pleasure i.e. not preoccupied with other thoughts. Because anything that gets in the way of sufficient blood flow staying in the penis will cause problems.

In the past it was thought that erection problems were always due to psychological factors. In recent years we have learned this is not always the case. We now know many erection problems are caused by disease or drugs, by themselves, or in combination with emotional factors.

Some medical conditions are known to affect the nervous systems e.g. ability to control blood flow or the ability of blood to get into and remain in the penis. Hormonal imbalances, diabetes, heart disease, multiple sclerosis, spinal cord injuries, back problems, injuries to the pelvis, long term cigarette smoking and alcoholism are some of these conditions.

If a man has a diagnosis of hardening of the arteries or any of the other problems mentioned above it does not necessarily mean that this is the cause of the erectile dysfunction. Erectile dysfunctioncan also be caused by anxiety and other emotions.

The penis can be affected by anything ingested into the body e.g. drugs taken for depression, anxiety, elevated blood pressure and many other conditions including recreational drugs.

A man’s ability to get and maintain erections can also be influenced by the quality of the couple relationship and the man’s emotions regarding this. Anxiety about whether a man will get or maintain an erection is a common obstacle. This is known as “performance anxiety”.Other feelings can also be an influence. Anger, no matter whom it is directed at, can block a man’s ability to get hard.

Lack of arousal or absence of feelings or attraction to the sexual partner may result in a man not being turned on. If he is anxious or preoccupied with work or other things or if he is no longer sexually attracted to his partner. Any of these issues can be enough to prevent stimulation from leading to erections.

Sex Therapy can Help..

If you believe sex therapy is an option for you it would be important to check that your therapist is an accredited member of COSRT (College of Sexual and Relationship Therapists). This will ensure that your therapist has specific dedicated training in the field, is qualified and is engaged in continuing professional development

Written by Anne Mathews, Psychosexual Therapist

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