Impotence Dr Rob Hicks Erectile dysfunction is a problem for at least one in every ten men in the UK.

In this article

What is impotence? Symptoms

Cause and risk factors Treatment and recovery

Advice and support

Impotence is now more commonly known as erectile dysfunction (ED), or sometimes erection difficulties. Men find they're unable to achieve or sustain an erection adequate for sexual intercourse.

A man may find that he is unable to achieve an erection at all, or that he cannot sustain one that is hard enough or lasts long enough for sexual intercourse. Men with ED may feel angry or guilty, and become depressed. Many lose interest in sex and relationships often suffer.

It's thought that 70 per cent of cases have physical causes and 30 per cent psychological causes. However, often there are both physical and psychological reasons for the condition.

Most men experience occasions at some time in their lives, when they cannot achieve or sustain an erection, as a result of fatigue, stress or excessive alcohol consumption.

Among younger men, ED is often caused by anxiety – just about having sex, pleasing their partner or getting her pregnant. In middle age stress, overwork and tiredness often play a part.

Among older men, physical causes become more common. These include diabetes, thyroid or kidney problems, high blood pressure, damage to nerves or blood vessels, pelvic surgery or trauma, heavy smoking and the side-effects of medication.

However, one of the commonest causes is atherosclerosis – damage to the small blood vessels which control blood supply to the penis. In fact researchers have warned that erectile dysfunction may be an early warning of widespread atherosclerosis which could lead within a couple of years to a heart attack. Psychological problems may also be relevant in ED, and include depression, and sexual or relationship worries.

Treatment depends on the underlying cause. The first step is to talk to someone who understands the problem, such as your GP or a properly qualified specialist. They will help to check for physical causes, advise on treatments and refer you on to a suitable therapist if appropriate. It may also help to talk to your partner about the problem, and sexual counselling may be an option.

In the past decade oral new medicines (tablets) that help a man to achieve an erection have radically improved the treatment of ED. These drugs work for the majority of men affected, whatever the cause.

But they don’t help or suit everyone and can cause important side effects. So other treatments still have a place – these include mechanical aids such as vacuum pumps or penile implants, and medicines such as intra-urethral pellet therapy and injections into the penis. Your doctor should be able to help you find a treatment that will work for you.

To reduce your risk of ED, avoid smoking and excessive alcohol, eat healthily, take regular exercise, and make sure you relax and get plenty of rest.

Sexual Dysfunction Association
Helpline: 0870 774 3571
Email: info@sda.uk.net
Website: www.sda.uk.net

This article was last medically reviewed by Dr Trisha Macnair in March 2009.