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What Is Causing Your Erectile Dysfunction?

erectile dysfunction


What Is Causing Your Erectile Dysfunction?

There are several possible causes of erectile dysfunction and several possible fixes

Back in junior high school (middle school these days) we thought the worst thing that could befall a girl was a menstrual bloodstain on the back of her skirt for all to see. For the boys it was an unwanted erection when called upon to stand up or go to the blackboard. Friends used to debate which was worse. I think both were excruciatingly embarrassing to those to whom it happened and a source of great glee for the rest of us.

Granted, I can only write about erections from a woman’s standpoint but I am a sexologist who has heard from hundreds of men on this subject. Having erections when one doesn’t want them and not having them when one does can be a lifelong worry.

Unwanted erections can be hidden by holding something in front of one’s lap, wearing baggy trousers, or tighter underwear or an athletic supporter if they happen frequently. Some men have reported success in making an erection subside by thinking franticly of something unsexy like the cat’s litter box. Usually, when a male is past the first flush of youth having an erection when the occasion does not call for one is a sometime thing rather than an everyday occurrence. If you think you might be embarrassed on the dance floor, say, or when going in for a good night kiss, prepare for it by one or more of the solutions I mentioned. (I personally am of the school of preparing for an eventuality rather than spoiling the moment for yourself by not being wholly present and worrying about your crotch!)

For the reader of my essays, as far as I know, a more likely concern is not having an erection when one is wanted. Let me say first that an erection is caused by increased blood flow to the genitals. That increased blood flow comes about through sexual arousal. If on several occasions you do not get an erection when you are aroused or a full one as you know it to be I urge you to consult a urologist. Many diseases and conditions manifest themselves by restricted blood flow. Diabetes is one of them, so best to be aware of any physical problems early.

Another important thing to remember is that fear and nervousness (first time sex, doubts about your ability to please a partner, worry about an erection, etc.) is antithetical to sexual arousal. You may think you’re hot and ready to go but if you are also extremely nervous and thinking about a failure which feeling is going to win out? The answer is sometimes one, sometimes the other.

I remember reading a play years ago written from the standpoint of a penis on the occasion of sex for the first time with a new partner. The monologue went something like: “I don’t want to go in there. It’s dark and scary and I don’t even know that person! Can’t we just wait awhile, take it slow, talk a little bit first?”

If medical issues have been ruled out and a man does not get an erection when one is wanted think if your penis might be saying that to you. Both women and men have a conditions which must be met for ideal sex – physical comfort, privacy, familiarity, a sense of welcome, whatever it might be for the individual. If your basic conditions are not being met why force the issue? Do your best to meet them first or perhaps help things along with erection aids such as Viagra, Levitra or Cialis.

A word or two more on erection drugs: Most doctors will happily offer a prescription. They are not only “for old men”. One does not become addicted to them. Often, after a man becomes more comfortable with his partner or some of his other conditions have been met he will no longer need to rely on them and their use can be abandoned.

If a man loses his erection in the middle of intercourse or other sexual play it is often because he has turned himself off with non-sexy thoughts such as “It will be a disaster if I don’t please my partner!” Often cognitive behavioral therapy, CBT, is helpful in order to learn how to speak to oneself in a more productive manner and avoid self-sabotage. Sometimes he simply needs more stimulation or a different kind. If he is reluctant to ask for what he wants in sex and his erection wilts because he is not receiving it, both people are the worse for his failure to speak up.

Not all cases of erection failure have been covered here. Sex therapy need not be a long term or expensive process and, of course, I recommend it. I have found that often one or two sessions of exploring what isn’t working and educating about what might be done differently is all that’s needed to put things to right. This can be for the man alone or with his regular partner if there is one.

The other participant in creating a better sexual experience can be his/your penis so don’t ignore that in the process!

[Isadora Alman]

Isadora Alman, M.F.T., is a California licensed marriage and relationship therapist, a Board-certified sexologist, author and lecturer. Her syndicated sex and relationship column "Ask Isadora" ran in alternative weekly papers worldwide for 25+ years. Web surfers can find her columns on her online free interactive Sexuality Forum (link is external). She is the author of two collections of Q & A's from columns: Let's Talk Sex and Ask Isadora, as well as Sex Information, May I Help You?, a peek behind the scenes of a sex help phone line which still flourishes in San Francisco today. Doing It: Real People Having Really Good Sex is a collection of helpful hints and titillating tidbits culled from column readers and Forum web site users. Her novel Bluebirds of Impossible Paradises: A Sexual Odyssey of the 70's is out in paperback on She has also contributed chapters to several books including Herotica (Down There Press), Dick For A Day (Villard NY), The Moment Of Truth (Seal Press) and Single Woman Of A Certain Age (Inner Ocean Publishing, Inc.) Isadora has been a talk show host and frequent TV and radio talk show guest, and a lecturer and workshop leader on a variety of communications topics. She conducts her private psychotherapy practice in the San Francisco Bay Area.

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