Every so often, a man may have difficulty achieving and maintaining an erection. While it may distress him, it’s really no cause to worry. In fact, occasional impotence is normal. But for about 10 15 to 20 30 million American men (most of whom are over 60), the chronic inability to achieve and maintain an erection long enough to have satisfactory sex is a problem.
Contrary to popular opinion, persistent impotence is not a natural part of the aging process. What’s more, it can usually be treated.
An erection occurs when sexual arousal causes vessels in the penis to widen, allowing blood to rush in and engorge the tissues. The term “impotence” applies whenever anything regularly interferes with that process.
Researchers once believed that impotence was an “all-in-the-head” problem, but today they know that it’s often related to a medical condition such as diabetes, vascular disease, high blood pressure or a neurological disorder. Medications, especially certain antihypertensives, are the culprits in some cases, and smoking and alcohol use can also play a role. Emotional problems, such as stress and depression, may be to blame, too.
If an occasional episode of impotence is no reason to panic, what is? Experts say that when three out of four attempts to achieve and maintain an erection consistently fail or if the problem persists for more than a month, it’s time to seek treatment.
The vacuum pump. Just before intercourse, the penis is inserted into a clear, plastic cylinder. A hand pump connected to the cylinder forces blood into the penis, causing an erection that lasts up to 30 minutes. A rubber ring is slipped onto the base of the penis to hold the blood in place.
Injection. The injection of a vasodilator (a drug that allows arteries to expand) into the base of the penis increases blood flow to the area. An erection occurs within five to 15 minutes and lasts up to two hours. Doctors recommend using the injection no more than twice a week to prevent side effects.
Implants. A popular solution for men between 40 and 70, implants come in three different types—a semi-rigid type, a two- or three-component inflatable type and a self-contained inflatable type.
Urethral Suppositories. A vasodilator inserted by hand-held device into the opening of the penis is absorbed by the surrounding tissues.
Counseling. Often, impotence is caused by anxiety about work, finances, getting older or some other nonsexual issue. In those cases, resolving the underlying problem may restore the ability to achieve an erection. Sometimes doctors recommend a combination of psychological and medical therapies, and increasingly, the spouse participates.
If depression is a problem, consider that some antidepressants, while raising spirits, can cause impotence. If that occurs, your doctor may try another antidepressant or allow you a mini- holiday from the drug, such as long weekends without taking the medication.
Medication. Viagra, Levitra and Cialis can be taken in pill form to help men achieve and maintain an erection.
If impotence is a worry, discuss it with your healthcare provider. You’ll learn about the source of the problem, consider possible solutions and find out how to resume a satisfying sex life.