erectile dysfunction   Most common cause of erectile dysfunction

I thought I was becoming impotent two years into my second marriage, says Alan, 42. I panicked. Four years after my divorce, I married Dee. In the early days of our relationship, I had erections and enjoyed the lovemaking tremendously. Then sometimes I wouldn't be able to get an erection or sustain it through intercourse. Dee was very understanding. She said I was pressuring myself to be a great lover for her and I should relax. Nice, but it didn't reassure me. It's like going to the doctor and your blood pressure is a little high. Relax, he says. Easy to say but much harder to do. Actually I was freaking out about not getting it up. I didn't tell her how frightened I was about becoming impotent, but I made an appointment with a therapist.

The first therapist suggested medication after just a few minutes. Not for me. I don't want to be dependent on pills! Besides, those pills are expensive and when you read about possible side effects, I'm the kind of guy that ends up with them all! With the next therapist we talked through my performance problems. He said I was applying very strict standards to measuring my erections. True, I wasn't getting many spontaneous erections, but that, he said, was not the real problem, the problem he said was the pressure I was putting on myself and obsessing about getting erections. He said worrying about sex was not exactly arousing. I was throwing off adrenaline with my anxiety and re-routing blood from my penis. When pressure and pleasure compete, he said, pressure wins!

It took me a while but once I understood what was happening, I stopped worrying. I ask Dee to get me hard; and she's very enthusiastic about doing that. If I hadn't picked up some tips and received some reassurance, I might have worried myself into becoming permanently impotent.

By the time they are 40 years old, the majority of men have experienced at least one erectile failure. It may be caused by fatigue, stress, not being in the mood (yes, that happens!) or too much to drink. This is a normal occurrence, but many men panic at the first sign of erectile problems. Now they are likely to run to a urologist and ask for one of the highly publicized erectile dysfunction (ED) pills, which they probably don't need and may not find effective. Being in a new marriage might have intensified Alan's responses to his perceived erotic failures. For other men it may be a new partner, stress, fatigue or a distraction that throws them off their game. Most men are sensitive to performance pressure and once they experience a failure they perpetuate it by worrying about another failure. They also try too hard and the harder they try the worse it gets.

These circumstances and a strong desire to please his partner, combined with his lack of knowledge about how to deal with performance pressure set Alan up for failure. It is a classic example of what happens with most men who struggle with erectile failure. And once it happens most men obsess about failing, which makes failure more likely. In Alan's case, his erectile difficulty might have led his wife to blame herself for his lack of interest in making love and caused her to withdraw from attempts to initiate sex. If he hadn't received good advice from a therapist he trusted and who directed him to a wellness program he could use on his own to regain his erectile capacity, Alan might have indeed worried himself into long- term erectile dysfunction