When Erection Fails, Seek Help


Dr. Goke Akinrogunde

For men, the reality of the failure to achieve penis erection at will and when sociallynecessary could be so devastating, since this is naturally perceived as a challenge to the very essence of masculinity and all the pride that goes with it.

Notwithstanding this reality of failure of the penis to respond to sexual stimuli, especially at the point of need, I venture to plead on the side of caution against self-blame or taking extreme measures like suicide that sometimes occur in some cases of erectile dysfunction.

Erectile dysfunction (layman’s term: Impotence) is medically defined as “the persistent or recurrent inability to achieve or maintain an erection sufficient for satisfactory sexual activity.”

Now to details; the above definition might mean that the male partner cannot have an erection, or having a week one when trying to have intercourse, or that he loses his erection soon after intercourse starts. “Persistent” and “recurrent” problems with sexual intercourse might occur every time one tries to have sex, or only some of the time.
In practice, I have also come across cases with selective erection failure, where the guy cannot get it up when it’s time for intercourse with an established partner but have erections during sexual fantasies.

Seek professional help
Having symptoms of erectile dysfunction is not the end of the world; there is more to life than reducing its essence to one’s ability to start or conclude sexual intercourse effectively. At any rate, erectile issues are readily treatable with a variety of medications, surgical interventions and psychotherapies as applicable.

However, before considering treatment for erectile dysfunction, the individual and the partner should be sure of the actual cause. So, it is better to see a doctor. Experiencing occasional difficulties with erection does not necessarily mean one has erectile dysfunction as a continuum entity; sometimes it might be a natural break for the penis that soon starts to function the next moment.

The truth is that many men have one or more episodes of being unable to have erection due to fatigue, distraction, alcohol, over-excitement, among others without developing erectile dysfunction. But a persistent pattern of difficulty is a cause for concern.

Telltale signs – a couple’s problem
A telltale sign may be that the man begins to avoid sexual contact or intimacy because he is unhappy with his sexual performance. He may stop initiating sex, or ignore the partner’s hints. Or he may become anxious during sexual encounters, and his anxiety makes it even more difficult to get an erection. Related to these is that depression, shame, embarrassment and frustration are also common feelings.

Erectile dysfunction is a couple’s problem even though it is the male partner that has the physical symptoms. Hence, if one of the sexual partners is concerned that there might be a problem, it is worth following up with the other partner in order to take necessary steps to solving it,

Hence, in seeking treatment, learning more about sexual health may be the first step. Treatment which helps one to experience the kind of satisfying intimacy once had can help restore confidence as well as the entire relationship.
Don’t suffer in silence

It is not out of place to feel a little uncomfortable talking to the doctor about erectile dysfunction. I noticed this with some patients but it is always a relief to fire the first shot and they are always happy for the bold step thereafter.

There is no reason for sexual partners to suffer the effects of erectile dysfunction in secrecy because the solution is just around the corner.

Commonly the general medical practitioner is usually the first healthcare professional one speaks to about impotence. If the doctor of first call does not seem comfortable or interested in discussing erectile dysfunction, then see another doctor; note that this is not uncommon with some conservative-minded doctors, who unduly mix their personal beliefs with their professional resource.

Depending on your situation, the doctor may treat or refer you to the urologist (a surgeon that specialised in male genital and urinary problems), a sexual therapist or to other related specialists.

Erectile dysfunction may have a serious underlying cause, such as undiagnosed diabetes, heart disease, or prostate cancer, which might be revealed with medical interaction. In other words, it is probably the tip of an iceberg.

Treating erection problem
Before starting any medication or other treatments for erectile dysfunction, lifestyle modifications e recommended are exercising; dieting to reduce fats and cholesterol; quit smoking; reducing alcohol consumption; managing stress and fatigue

Oral medication
These represent a relatively new field of treatments for erectile dysfunction. Phosphodiesterase 5 (PDE5) inhibitors are a class of oral medications commonly prescribed this day for erection failure. Examples here are sidenafil (Viagra), tadenafil (Cialis), among others etc. These medications are however best taken with appropriate medical guide and prescription.

Sex counseling/ therapy
Consultations with a trained counselor/psychologist may help identify, understand, and cope with sexual concerns. Specific techniques can help to remove stress from lovemaking, increase sexual stimulation, and enable one to focus on sensual pleasure and intimacy.

Penile implant
This is an option for men with established erection issue for whom other treatments were unsuccessful. This is a device that is surgically inserted into the penis. The device is inflated when there is a desire for sexual intercourse and deflated as necessary.

Penile injection therapy
Medication that increases blood flow in the penis is injected by the patient into the side of the penis shortly before sexual activity.

Vacuum therapy
This procedure holds blood in the penis using a ring at the base of the penis.
Noteworthy here is the important public health message: Erectile failure should be seen as a medical condition that can be managed effectively with appropriate professional assistance by those trained for the purpose. Don’t suffer in silence; don’t harm your being; seek professional help.

Akinrogunde is a general sonologist and a columnist with THISDAY