virtually impossible to escape the shameless assault on our sensibilities by
drug manufacturer's promotion of "E.D." medication.
When a man finds himself in a situation where he has
difficulty becoming aroused, gaining or maintaining an erection there
are a number of possible explanations. These fall into two primary categories:
- Could be due to age or poor physical health,
such as hypertension, circulatory system, diet, lack of exercise or lack
of sleep. Certain powerful medications may also diminish sexual appetite.
- Low level of Testosterone
- If the indication is that the problem involves
only the penis, treatments using oral medications,
direct injections, implants or vacuum devices often provide positive
- Depression, financial concerns, work pressure,
boredom with routine sex or diminished interest in their partner.
Basis of sexual
The things which people find sexually arousing vary
considerably. They may be physical or mental in nature.
Most people are sexually
aroused by a physical contact from another person, especially if the other
person is in an intimate relationship, if the contact is in an erogenous
area or if it is accompanied with the anticipation of an imminent sexual
In addition, some people may
find nudity and pornography sexually arousing, though what aspect
different people find arousing will vary. Most heterosexual males are
visually stimulated by female nudity or partial nudity, while some
heterosexual females are stimulated by the state of romance with their
partner. According to the marital and sex therapist, David Schnarch,
intimacy, the honest portrayal of the two people joining in the sexual act,
may lead to a heightened state of passion in sex, including sexual arousal.
Such sexual arousal may not lead to an actual sexual activity, beyond a
mental arousal. In a 2004 study at Northwestern University, the female
participants (both heterosexual and homosexual women) became sexually
aroused when they viewed straight as well as lesbian adult content films. Among the
male participants, heterosexual men were turned on by explicit
adult films showing only women; gay males were aroused only by films showing
men. The study's senior researcher said that women's sexual desire is less
rigidly directed toward a particular gender, as compared with men's; and
women's desire is more changeable over time.
The libido or sexual desire
is key to the process leading to erection. The libido is not located in the
groin but in the brain. Physical stimulation of the penis is ineffective in
producing an erection without engaging the brain and more specifically the
area within the brain responsible for sexual desire.
In males the libido is
directly related to the level testosterone produced, which varies from
individual to individual as well as age. Most men will maintain
testosterone levels which are sufficient to desire sex for much of their
the normal erection process
The physiological mechanism
which produces an erection is actually
counterintuitive. To most the swelling of the penis would indicate a
“stiffening of muscle tissue”, when in fact it’s just the opposite.
the penis to become erect its smooth muscle (involuntary) tissue needs to
"relax". At first glance this appears to be entirely illogical.
Yet this is a key part of the process, which begins with
the release of nitric oxide into the corpora cavernosa (spongy tissue
chambers running along the shaft of the penis). The nitric oxide allows this
tissue to relax and fill with blood (up to sixteen times its normal capacity).
This results in pressure being applied to the veins (leading blood
away from the penis), which in effect restricts blood flow out of the penis.
The veins are unable to drain blood out of the penis and so the penis becomes
rigid and erect. This condition normally keeps this erection firm enough for
is erectile dysfunction ("ED")?
Erectile dysfunction, sometimes
called "impotence", is the repeated inability to achieve or to maintain an
erection which is firm enough to allow sexual intercourse. The word
"impotence" may also be used to describe other problems that interfere with
sexual intercourse and reproduction, such as lack of sexual desire and
problems with ejaculation or orgasm.
An occasional problem achieving an
erection is nothing to worry about, but failure to do so more than 50% of the
time at any age may indicate a condition that needs treatment.
tumescence test (NPT)
The NPT test indicates whether a man is having normal
erections during sleep. Most men have 3 to 5 full erections during deep
(rapid eye movement, or REM) sleep. Men who do not have erections because of
psychological problems can still have erections during deep sleep.
Occasionally, some sleep problems or serious depression can prevent these
normal nighttime (nocturnal) erections.
strip of four to six non self-stick postage stamps should be used for each
test. The test needs to be done for three nights. For this purpose he
should wear brief-type under shorts with a fly opening. This garment will
allow the penis to be brought through the fly.
The strip of stamps are wrapped snugly around the
shaft of the penis. The stamps need to overlap so the overlapped stamp can
be moistened to seal the ring. When the stamp has dried, the penis is
carefully replaced inside the shorts. The shorts are worn to sleep and
help protect the stamps from falling off inadvertently.
In the morning, check to see if the stamp ring
has been broken along the perforations. If the tearing of the stamps
awakens the man during the night, check for an erection and how rigid the
The stamps may be felt as an unusual sensation,
but the test should be repeated until three nights of comfortable,
uninterrupted sleep is achieved.
Evaluating the result
During at least one of the nights, the ring of stamps is broken between
any two stamps.
If the stamps are
broken it may suggest that the erection problem is the result of
psychological causes. If the stamps are not broken on any of the 3 nights
it may indicate that the erection problem is related to physical
conditions or medications. A health care provider should be consulted.
The test is not foolproof. It does not indicate
many important factors of sexual dysfunction: such as quality, duration or
number of erections during the night.
"ED" with drugs or mechanical devices
A number of
heavily advertised pills serve as a substitute for nitric oxide and by
boosting its effects. These drugs
slow the breakdown of a specific enzyme, prolonging nitric oxide's actions.
This allows blood vessels in the penis to expand, which in turn produces an
erection as the
corpora cavernosa relaxes and engorges with blood. In the
absence of a "natural" triggering mechanism (releasing nitric oxide),
the ingestion of ED drugs or the artificial vacuum of a penis pump there can be no erection. For some men drugs or
mechanical devices are an unavoidable price to pay for achieving a
satisfactory erection, but for others the issue may lie elsewhere.
"ED" Drugs are only able to affect the
physical causes of erectile dysfunction, not those rooted in the mind. A lack of desire to
engage in sexual activity is not always attributable to a physical limitation
in a man. I may simply be limited by a physical desire for the long term
effects of "ED" drugs
danger and long term harm
Should not be used by men with heart
conditions whose doctors have warned them not to have sex. Also, patients
taking drugs that contain nitrates have been warned not to take ED drugs
because of sudden, unsafe drops in blood pressure.
Federal health officials are currently
investigating reports of blindness in men taking ED drugs. This type of
blindness is called NAION, or non-arteritic anterior ischemic optic
neuropathy. It can occur in men who are diabetic or have heart disease,
the same conditions that can cause impotence and thus lead to ED drug use.
Other common side
Responsibility to satisfy
the partner, particularly in long term relationships (marriage)
Generally men are
sufficiently attracted to a female to produce a potential chain of events leading to an
erection. This is not always the case for
all men under all circumstances, where there might be a gradual loss of
physical interest or passion in the partner.
Most relationships begin
with physical attraction and build to a strong emotional bond (love).
Over the course of time the physical attraction (excitement) may diminish
while the emotional bond actually increases. Love and physical attraction are
not always one and the same.
While a woman is able to
successfully engage intercourse without actual arousal or interest, the same
is impossible for a man. Although it’s possible for a man to satisfy his partner by other means than
intercourse, the lack of an erection will still be evident.
In the case of those men are
not handicapped by a physical debility (such as ED) which inhibits an otherwise desired
erection, is it fair to expect that they ingest potentially harmful drugs for
the purpose of masking the fact that they are no longer
(sufficiently) aroused by their partner?