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Impotence (getting it up, or not)

The truth is that most men will experience impotence at some time or another. It’s a fact of life, it’s not uncommon and it’s often temporary. Not being able to get an erection (or 'get it up') is usually referred to as erectile dysfunction or impotence.

Physical impotence

This is usually the result of exhaustion, stress and anxiety, recreational drugs or too much alcohol. Other reasons include:

Certain prescription medications, eg: sedatives and anti-depressants
High blood pressure and/or high cholesterol and heart disease
Other illnesses, eg: diabetes, Parkinson’s disease and multiple sclerosis
Faulty plumbing in your cock and/or traumatic injury and surgery
Smoking and /or being overweight

Psychological impotence

If you can get an erection but not necessarily when you want to, the problem is likely to be a psychological one. Reasons are likely to include lack of sexual stimulation, fear of performance, low self-esteem, stress and depression.

It may sound obvious, but if you’re not turned on you’re not likely to get an erection. For example, you may not find someone as attractive as you used to, or something which once aroused you sexually may have lost its allure (which is one of the reasons why we experiment sexually).

The significance we place on sex, performance and physical perfection creates high expectations – of ourselves and our partners – which can be impossible to meet. Consequently, a fear that we cannot perform adequately can affect our ability to get a hard-on, although it doesn’t mean you don’t feel horny. This can make the situation doubly frustrating.

Physically, if we’re uncomfortable with our bodies or the way we look, or if we don’t feel good or relaxed about ourselves, getting an erection can be a major problem. Ironically, beauty is in the eye of the beholder, and what turns you off about yourself can easily turn someone else on.

Steps to solving impotence

Embarrassment prevents many men from seeking help, making them miserable and putting a strain on their personal and social life. Acknowledging that there is a problem is the first step. In the first instance, it can be helpful talking it through with a friend or your partner, difficult though this may be.

Then you should visit your sexual health clinic or GP. Determining the source of impotence will determine treatment, which includes changes to existing medication (if you are taking any) additional medication and/ or counselling/ therapy.

PDE5 inhibitors

PDE5 inhibitors help the body's natural response to sexual stimulation by blocking an enzyme in the smooth muscle cells in the cock. Brand names include

Viagra (sildenafil)
Cialis (tadalafil)
Levitra (vardenafil)
Stendra/ Spedra (avanafil)

DO NOT use poppers and PDE5 inhibitors.

While we can see the appeal of intense feelings of horniness and a raging hard-on, the combination can make your blood pressure drop dangerously low, resulting in dizziness, fainting, heart problems and potentially a coma and/ or death.

Vasodilators

Vasodilators are a group of drugs which can increase blood flow by expanding blood vessels, increasing the blood flow to the cock, and giving you an almost instant erection. The drug is identical to a naturally occurring substance found in your body that helps keep the blood vessels open and increases blood flow. Brand names include Caverject® (a small injection in the side of the cock) and Muse® (a pellet inserted into the end of the cock).

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