Unfortunately, many men do not receive treatment or wait a long time before seeking treatment.
Erections can change over time, sometimes stronger or weaker than other times. When men are in their teens they often have little control over their erections and obtain erections when not in a sexual situation. For most men this stops in their late teens to early twenties. As men get older, erections may not always be obtained when they want one. Almost every man has the occasional time when their erection is less strong than they would like but sometimes it becomes a problem.

What Causes ED?
The cause may be physical or psychological. For most men the cause is both physical and psycological. In 75% of cases of impotence there will be a physical cause.

Physical causes of ED include:
· Diabetes
· High cholesterol
· Heart disease
· Post prostate cancer
· High blood pressure
· Alcohol or other drug use
· Some prescribed drugs
· Disease of the liver and kidney
· Surgery to the bladder, prostate gland, lower bowel and spine
· Poor blood flow to the penis resulting from blocked arteries

Psychological causes of ED include:
· anxiety or stress
· anxiety about sexual performance or sexual identity
· fear of sexual contact (from issues such as pregnancy or HIV/Sexually Transmitted Diseases)
· psychological trauma or abuse
· sexual problems with partner
· sexual boredom
· depression
· lack of communication in the relationship or other relationship issues
· grief or the effects of illness of self or family member

 

Seeking help?

A general practitioner will complete a medical assessment (including testing blood sugars, cholesterol and blood pressure) Depending on the findings, they may refer the patient for specialist care.

Sexual Education
The old saying that sex is natural is not true. Some men experience impotence because of lack of sexual education, in other words, they do not know what to do. Usually, once the man is given correct sexual information and any concerns have been discussed then this difficulty is overcome.

Help is available for both psychological and physical causes
Having psychological problems with sex does not mean that there is anything wrong with your mental health. Sexual Health Counsellors and Psychologist trained in sex therapy can assist you. They will take a sexual history and then tailor a set of exercises or correct misinformation to assist you. Most states in Australia have a Sexual Health Clinic attached to the local Hospital or Community Health Centre. A list of private therapists can be found in your telephone directory or by phoning Impotence Australia's help line.

Approximately 75% of Impotence cases will have physical causes. A general doctor will complete a medical assessment; depending on the findings, they may continue management with you on their own or may refer you for specialist care. The medical assessment would include testing blood sugars, cholesterol and blood pressure. Doctors will also check hormone levels, examine you for signs of circulation or neurological (nerves) disorders as well as check your genitalia. It is also important to disclose all medications you are taking, including recreational and herbal. Drugs, oral or injections, to help obtain and maintain an erection are available from your doctor.

For further care, your doctor will refer you to either an Urologist or Sexual Health Physician.

Other treatments
Vacuum devices, which draw blood into the penis where it can be trapped with a special ring placed at the base of the penis are also useful.
In a smaller number of people who have extreme vein damage, surgical implants, which strengthen the penis from the inside, are available.

1Reference: Chew KK, et al. Erectile dysfunction in general medicine practice: prevalence and clinical correlates. International Journal of Impotence Research 2000; 12: 41-45. Prevalence figures are based on questionnaire responses from 1240 Australian men of various age distribution.