Male Sexual Problems

Causes of Male Erection Problems

What exactly is an erection problem (also known as erectile dysfunction) – and what causes it? 

Certainly, and most obviously, something which stops you from giving your partner sexual  satisfaction, and stops you from enjoying sex. Some sex therapists have claimed that if a man’s erection is not firm enough to allow penetration, then a man has erectile dysfunction – or, in common language, an erection problem.

But this definition doesn’t take account of the fact that many men occasionally have erection problems – when they are tired, stressed, or not attracted to their partner, for example. Perhaps a better definition is that a man has erectile dysfunction when he cannot reliably get an erection firm enough for penetration more than 50% of the times he and his partner wish to make love.

The American Psychiatric Association’s definition of sexual disorders emphasizes the fact that erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. So does the definition of erection problems depend on whether a man can get an erection all the time, half the time, or some other percentage? And what degree of stiffness is his penis required to display before he has a problem?

Furthermore, what if there are emotional factors at work here? What if, for example, the psychology of loving is affecting a man’s ability to get an erection – for example, if he simply does not feel attracted to his partner? This could be a manifestation of the lover archetype. And if he was subject to a high level of fear arising during sex, then one might argue that his magician archetype was over active. If you’re interested in how the archetypal concept can influence our actions, thoughts and feelings, try this website where you can get more information.

There’s no clear answer to many of these questions, but they do serve to put into context the fact that a man might not think he has a problem if both he and his partner are happy with the way their sex life works out, regardless of whether he has an erection or not.

But suppose, in contrast, that a couple want penetrative sex every time they make love, and a man has an erection than is 50% rigid on 50% of the occasions he and his partner want sex. Does he have an erection problem? Maybe yes, maybe no. This emphasizes the element of subjectivity in the definition. 

The rate of erectile dysfunction has not changed significantly since the first comprehensive study done by Alfred Kinsey in 1958, when about 10% of men were found to have a problem with their erections. In a more recent study, there was a significant correlation between age and the scores for erectile function, orgasmic function, sexual desire and intercourse satisfaction.

The prevalence of moderate and severe cases of ED were 1.8% and 0% respectively for men aged 23–29; 2.6% and 0% for men aged 30–39; 7.6% and 1.0% for men aged 40–49; 14.0% and 6.0% for men aged 50–59; 25.9% and 15.9% for men aged 60–69; and 27.9% and 36.4% for men aged 70–79 years. (Ken Marumo, Jun Nakashima, Masaru Murai (2001) Age-related prevalence of erectile dysfunction in Japan: Assessment by the International Index of Erectile Function International Journal of Urology 8 (2), 53–59. Not much has changed between 1958 and 2001!

You can read about the physical causes of erectile dysfunction here. As I inferred above, however, ED is not simply an issue of the body. There is a very significant emotional and mental influence on sexual dysfunction in men (just as there is in women). These mental influences have, perhaps, been insufficiently studied in the past. With the advance of new methods of looking at emotional problems in the human personality, we can take a different and perhaps more expansive view of how the mind and body interact. One good way to look at this is to consider which part, or if you prefer, which archetype, in the personality is responsible for causing sexual / emotional problems. Obviously the Lover archetype is a likely candidate here, for it is responsible for many problems around sexual connection. The Magician archetype can also interfere with sexual arousal by putting a man into a place of fear. The whole concept of archetypal energies is explained in more detail here.

Obviously the prevalence of erection problems gets older as men age physically. One exception are problems that are due to performance anxiety among younger men, whose erection difficulties tend to be more transient and short-lived, being caused by sexual and personal circumstances (i.e. over-excitement, anxiety about the partner, fear of discovery, and so on) rather than health or medical issues such as age-related diabetes or circulation problems.

Erectile Dysfunction and Heart Disease

This kind of erection failure is rather simple to explain: it is an anxiety-based response. Anxiety can effectively turn off the sexual response in young men because it is a product of the activity of the  sympathetic nervous system, which opposes the sexual responses controlled by the parasympathetic nervous system.

In effect, therefore, one can say that over-arousal is the cause of many young men’s erection problems, though this refers more to emotional arousal than sexual arousal. Paradoxically, over-arousal can also cause premature ejaculation: the essence of both problems is that a man’s normal sexual response has been over-ridden by his anxiety.

We discussed the effect of an over-sensitive penis in the debate on premature ejaculation. Can it also be a factor in erectile dysfunction? But first of all we need to define what we mean by an over-sensitive penis: in reality, of course, there is no such thing. It is a short hand term for a penis which sends nerve impulses to a man whose brain is already over-excited, too sexually aroused.

As with premature ejaculation, corrective action requires some reduction in the sensitivity of the nervous system so that it can take more stimulation with no disruption of  a man’s sexual circuitry!

The irony here is that anxiety – fear, worry, call it what you will – about losing your erection actually stimulates a man’s level of nervous system activity so that he is actually somewhat more likely to lose it!

This means that relaxation, or at least a methodology that can help to reduce one’s nervous and emotional arousal during sex,  may be part of the answer. Obviously relaxation and hypnosis may be of help here; so is the experience which comes with age and having had a number of lovers.

Young men of course tend to be very aroused, and may in addition both fear discovery (especially in societies where pre-marital sex is frowned upon) and pregnancy. All of this can stimulate their nervous systems so that they are more likely to be sensitive to any suggestion by their lover that strikes at their sexual confidence: and makes them lose their erection. Fear and sex do not mix well!

A man who loses his erection may find that this happens instantly during sex: he cannot reduce his anxiety enough to reduce the stimulation he’s receiving to a point where he no longer feels so aroused that he loses control of his sexual responses.

Erection Problems: Physical or Emotional?

One of the fundamental questions that occurs to many men and their partners who’ve suffered a loss of erection is exactly what the lack of erection means.

One reason for this is that it is possible to confuse the loss of an erection with the loss of interest in sex: women in particular seem to make this error and can take impotence very personally.

So, if you’re a man who does not have an erection in a sexual situation, it’s important to be aware that your partner may well think that you are not turned on by her, and it’s also possible that she thinks she doesn’t know what to do to turn you on.

And of course it is possible that this is true: it’s possible that a man simply isn’t aroused by his partner at that particular moment, or that she’s not doing what he’d like to get him aroused.

However, it’s also true that the majority of the time the lack of an erection, or the loss of an erection, in a sexual encounter, means something completely different.

So, for example, say a man is sexually aroused, and wants to have sex. Then he finds that his penis doesn’t respond. This is incredibly frustrating situation for most men, and often for their partners, but there is always an explanation….there is clearly some obstacle preventing sexual arousal from translating into a hard erection suitable for intercourse.

In many cases, the problem will be very simple, and perhaps very obvious. It’s possible, as you may know if this has happened to you, that you require a certain type of sexual stimulation to become sexually aroused and to get hard, and you’re simply not getting it.

Maybe this is because you have a new partner who doesn’t know what you need, or maybe she’s simply forgotten, or maybe she’s acting out some emotion of her own and simply doesn’t want to supply the stimulation you need to get an erection.

Another possibility is that you’ve had so much sex in the last day or so that your penis simply unable to become erect again so soon. Unfortunately, the problem is usually something else.

You see, the thing is, an erection requires a lot of things to go right in side the body, and a lot of co-ordination. Both the nervous system and the blood circulatory system have to be capable of responding in the correct way, and then to do it, which requires sexual arousal and a certain emotional state: if your emotions are not right, they can certainly impede the process of getting an erection.

But of all these issues, it’s circulation which is probably most important for good erections. Anything, be it physical or emotional, that stops enough blood getting to the penis can cause erection problems.

There’s a widespread viewpoint that many erection problems, including loss of erection and lack of erection, are actually the result of disease alone or drugs alone or a combination of the two: and that certainly may be true in some cases, but it’s my experience that the great majority of erection problems are caused by a combination of physical and emotional factors or by emotional factors alone.

As I’ve already said, anything that interferes with enough blood arriving at the penis, or stops it being kept in the penis, or anything that interferes with the ability of the nervous system to control your circulation can cause erection problems. Now, you may be asking what medical conditions could cause this.

The answer is there are several: they include hormonal problems, often due to age-related testosterone decline, the onset of diabetes, heart disease and circulatory problems such as blocked arteries, multiple sclerosis, and certain injuries to the spinal cord and some back problems, as well as injuries and surgery to the pelvis, caused perhaps by prostate surgery. Other culprits are long-term cigarette smoking and alcoholism.

However it’s extremely important to be aware that erection problems are not necessarily caused by hardening of the arteries or any of the other conditions mentioned above, even if you happen to have those conditions. The truth is, in many cases, erection loss is caused by anxiety and other emotions – and of course, having said that, it’s always important to determine what’s actually happening inside the body, just in case there are some real problems developing.

Your penis can be affected by anything that you absorb into your body, such as drugs for depression, and drugs for anxiety, and sometimes drugs prescribed for high blood pressure. The same is true of drugs for many other conditions as well as so-called recreational drugs.

All these products can affect your ability to get an erection. So perhaps the first thing to check is the list of drugs that can adversely affect sexual functioning. You can find this here.

However, your ability to get and maintain an erection is influenced, as I’ve already said, by your emotions, and in particular, by what’s happening within your relationship. If you’re anxious about getting or maintaining an erection, it’s highly likely that you will in fact have some kind of erection problem – perhaps even being unable to get an erection to start with.

Other emotions definitely play a part in erection problems as well. For example anger, regardless of who you’re feeling angry at, can certainly block your ability to get an erection. So, interestingly enough, can the absence of feeling, which in the case of sex roughly equates to a lack of arousal.

In the hundreds of emails that I’ve received over the years from young men trying to have sex for the first time, who want to know why they lost their erection (or never got hard in the first place), it’s clear that many of them suffered impotence or erection loss because they were highly anxious, or their minds were completely preoccupied by something else (probably whether or not they were going to ejaculate too soon), or because they didn’t like their partner, or they didn’t find her attractive.

All of these things can apply to men of any age. And they are all enough to cause loss of erection and erection problems…..nonetheless, the message you should take from this article is that not having an erection does not necessarily mean that you do not want to enjoy sex… expressed as simply as possible, it just means that your penis is less hard and stiff than you desire it to be.

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