As many of us will agree, a good percentage of men measure at least part of their proficiency in life by their corresponding prowess in the sack. As a result, impotence (or erectile dysfunction, to give it its proper name) is something of a taboo - more the subject of locker-room jokes and caustic female comedy than something we feel comfortable discussing freely. But over half of men aged 40-70 years report some degree of ED in their lifetime. Impotence is very different from other sexual problems men face. It isn't connected to sex drive, but performance - sufferers can't get or maintain an erection long enough for him and his partner to be sexually satisfied - and is not to be confused with other performance-related conditions such as premature ejaculation, whereby a man is unable to control his orgasms. It's a frustrating, ego-busting condition - not just for the men affected by it, but for the women they (fail to) make love to.
Cause and effect
Men hit their sexual peak in their late teens - a fact that's often ignored when considering how men's sexuality evolves. It's estimated that 5% of all 40-year-old men suffer from complete impotence - a number that trebles in 70-year-olds. However, other factors contribute too: high blood pressure and diabetes - both considerably more common in your middle-aged male than his younger counterpart - are common culprits. Smoking, with its links to heart disease and raised blood pressure, can cause problems too. Imbalances in hormone levels, surgery or injury to the pelvic region and side effects to prescription drugs are other common causes. And let's not discount the impact of psychology here. Around a third of ED cases are purely emotionally based; the result of, among other things, sexual trauma or childhood repression.
In search of a cure
Once men were reduced to relying on dodgy penis pumps and topical creams advertised in the back pages of magazines in the hope of, ahem, raising their game. But the past decade or so has seen a range of effective treatments flood this lucrative market. But it's the recent influx of oral anti-impotence drugs that have rung the most positive changes for ED sufferers (and their grateful partners). A number of these are now available, but the original remains the favourite - Viagra. The 'little blue pill' is taken about an hour before sex and results in an average erection time of around 3-4 hours (although some men report improved erections for about 24). Not all men are suitable candidates for Viagra, however - certain pre-existing medical conditions mean some should avoid it and there are a number of reported side effects, including headaches, flushing and dizziness.
Your problem, too
If your partner suffers from ED it's easy to feel that you are at least partly to blame: sexual performance, we reason, is directly related to our own sexual attractiveness. But if a man wants to be in bed with you, chances are this isn't about desire - there's just something that's stopping that attraction from reaching its natural conclusion. So, what to do? The first thing is to not over-react. There are all kinds of reasons why a man fails to perform that don't necessarily mean he has long-term problems with impotency. Stress, tiredness, prescribed drugs (not to mention the unprescribed ones - recreational drugs, such as marijuana and cocaine, impact negatively on a man's sexual performance over time) and of course that other great recreational mood-enhancer, alcohol, all have their part to play in temporary loss of arousal. If it's a one-night stand, your partner's ED will probably be little more than a temporary frustration that later translates into a hilarious tale to tell the girls (women can be so cruel...). Problems with a regular partner, on the other hand, are something you need to try to work out together.
The following Dos and Don'ts offer a little guidance on how to cope.
Talk to him
Sure, it's tricky, but if you're close enough to have an intimate sexual relationship, you should be close enough to be able to discuss problems within it openly.
Find out if it's happened before
Statistics show that 90% of men will have experienced at least one erectile failure by the time he reaches 40, so it's important not to panic. Knowing whether your partner's ED is a one-off or if there's a pattern of impotence in his sexual history will help you both determine how to deal with it.
Encourage a visit to a doctor
He or she will be able to properly diagnose the condition, test for and treat any underlying medical problems, prescribe a solution, or recommend a sex therapist or psychologist if the cause is thought to be emotional rather than physical.
Male egos, just like ours, are fragile things. It's fair to say that the impact of impotence, for whatever reason, will damage the delicate male psyche even further, compounding the condition into a cycle of fear and failure.
It can be tempting to pretend the problem isn't really there and to settle instead into a relationship that involves little or no full sexual activity. Try not to do this: denial is never helpful, while an unsatisfactory sex life can sour other aspects of your relationship, too.
Keep it to yourself
Gossiping with the gals about your partner's shortcomings does neither of you any favours. But as this is your problem too, chances are you need someone to help you feel good. Confide in one or two close friends whose support you can rely on and you'll feel a whole lot better for it. Perhaps, most important of all, is to remember you're not alone. With a little medical help and a lot of understanding this is something that you and your partner can work through - together.
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