National Impotence Day – 14 February 2006

Some people might not be able to resist a smile when they hear that St Valentine's Day has been chosen as National Impotence Day, but for the estimated two million UK men with erection problems – and their partners – impotence is no joke.

© Getty

It's generally reckoned that one in ten of all men experience what doctors call 'erectile dysfunction'. But this can only be a rough estimate as just a small proportion, around 10%, come forward for professional help. Many men are too embarrassed even to talk to their partner about the problem. That adds up to a lot of people suffering in silence.

Over the past year and a half, the 'just ask' advisors have answered well over 100 questions about erection problems. Only a small proportion were from people suffering from the kind of impotence that requires a medical solution.

now you see it, now you don't

The majority of questions posted were from young men experiencing what we might call temporary impotence – they had no erection problems generally but in certain situations their penis refused to rise to the occasion, or went limp just at the crucial moment. For these people the most likely underlying issue seemed to be anxiety connected with penetration – the pressure to 'perform'.

John's question is typical of this kind of thing. He's 16 and has a steady girlfriend. They've had sex quite a few times but now he can only maintain his erection for masturbation and oral sex.
read more

Sarah's question gives a sense of how impotence can affect relationships. Like John, her boyfriend is losing his erection when it comes to intercourse. She's concerned that she doesn't turn him on enough and regrets that she made a joke about him being impotent.
read more

Tom, too, is having trouble with his erection when he tries to enter his girlfriend. Like John he thinks the problem is psychological and he's worried about letting his girlfriend down.
read more

drink and drugs

Another common reason for erectile dysfunction is the effect of alcohol, recreational drugs, and medication. Alcohol is well known to encourage 'brewer's droop' but other drugs like marijuana and cocaine can do the same. Some medicines – particularly antidepressants and blood pressure treatments – can have unwanted sexual side-effects too.

Peter is getting embarrassed because he hasn't managed to have full sex with his girlfriend at all. He does mention that he's always been quite drunk. Could this be the problem?
read more

Kamal hasn't been able to make love for some time. Could it be something to do with his depression medication?
read more

long-term loss

Where men are suffering from permanent impotence the cause is usually – in over two-thirds of cases – physical. Erectile dysfunction is quite common in men with diabetes, and abdominal surgery, particularly prostate surgery, often results in erection failure. Problems with the blood vessels supplying the penis are another common cause – this is why smoking, which affects blood flow, can be a factor.

Perhaps it's not surprising that the incidence of erectile dysfunction rises sharply with age. Many of these conditions are themselves more common in older men.

The good news is that in the vast majority of cases men who take the problem to their doctor can be treated successfully. There can't be many people who haven't heard of Viagra, but it isn't the only solution out there. There are new drugs being developed all the time and many men are helped by other methods such as vacuum pumps, injections and, sometimes, surgery. The feature new treatments for impotence has more information about the new medical treatments.

But so often men prefer to keep the problem to themselves rather than ask for help. At the same time, doctors don't routinely discuss the sexual implications when they are treating male patients for those conditions linked to impotence. It's not just the men themselves that suffer. Partners are affected too and erectile dysfunction can be a huge pressure on relationships. Psychosexual therapy and couple counselling can help, either on its own or alongside other treatments.

Andi wrote to 'just ask' saying that her husband's impotence was destroying their marriage. He is one of the nine in ten men who don't feel they can talk to their doctor.
read more

Another man became impotent after cancer treatment. His partner wrote to 'just ask', explaining the strain on their relationship. Again, he doesn't seem to be getting treatment for his problem.
read more

condom-phobia?

This is one cause of temporary erection problems that deserves a special mention, particularly as National Impotence Day falls right at the beginning of Contraceptive Awareness Week (14-20 February). Quite a lot of men, it seems, have no trouble getting and maintaining an erection, until it's time for them to put that condom on.

Findley, aged 16, lost his erection the first time he and his girlfriend tried to have sex – it was the condom that seemed to be the problem.
read more

Campbell, 19, had the same problem, this time with more than one partner. He felt he was coming too soon as well, but seemed to already know that it could be because he was thinking too much instead of relaxing and having fun.
read more

It's great that neither of these men thought the solution to their problem was to forget about the rubbers altogether. Remember, condoms protect against sexually transmitted infections as well as unwanted pregnancy.

help and info

Channel 4 is not responsible for the content of third party sites.

organisations

Relate
Herbert Gray College
Little Church Street
Rugby CV21 3AP
Relateline: 0845 130 4010 (Mon-Fri, 9.30am-4.30pm) Relate Direct booking line: 0845 130 4016 (Mon-Fri 8.30am-4.30pm)
E-mail: enquiries@relate.org.uk
Website: www.relate.org.uk
The largest relationship counselling organisation in the UK. Offers counselling, psychosexual therapy, and other services to help those experiencing difficulties in any adult couple relationship. Some branches of Relate offer individual counselling to young people. Relateline is for couples experiencing emotional crisis who wish to talk things through with an experienced Relate counsellor. Relate Direct is a telephone counselling service (see website for more details, including costs).

Sexual Dysfunction Association
Windmill Place Business Centre
2-4 Windmill Lane
Southall UB2 4NJ
Helpline: 0870 7743571
E-mail: info@sda.uk.net
Website: www.sda.uk.net
Set up to help sufferers of impotence (erectile dysfunction) and their partners and to raise awareness of the condition amongst both the public and the medical profession.

websites

Embarrassing Problems: Impotence
www.embarrassingproblems.co.uk/pages2/impotence.htm
Dispels myths surrounding impotence and discusses factors that may cause impotence, how to approach your doctor, different types of treatments available and further contacts.

Erectile Dysfunction
http://hcd2.bupa.co.uk/fact_sheets/Mosby_factsheets/impotence.html
BUPA Factsheet outlining what ED is, who is at risk, psychological and physical causes, common symptoms and complications, diagnosis and treatments.

Impotence (erectile dysfunction)
www.netdoctor.co.uk/diseases/facts/impotence.htm
This NetDoctor article discusses impotence, what causes it and how to treat it.

Impotence – Your Questions Answered
www.impotence-help.co.uk/index2.htm
Produced by Schwarz Pharma, this site describes what impotence is, the causes and treatments available. Discusses what may happen when you visit the doctor and what you might be asked. Features personal experiences and frequently asked questions.

Impotence Resource Center
www.impotence.org
American based website, sponsored by the Sexual Function Health Council of the American Foundation for Urologic Disease. Contains extensive information on impotence – causes, common myths, diagnosis, how to talk to your doctor, treatments, and advice for partners.

Sorted in 10
www.sortedin10.co.uk
Offers information about erectile dysfunction and gives advice on how to approach your doctor, treatments available and dealing with impotence for partners. Aims to help men and their partners understand that they are not alone and there is help available.

reading

Coping with Erectile Dysfunction: How to Regain Confidence and Enjoy Great Sex by Michael Metz and Barry McCarthy (New Harbinger Publications, 2004)
This book helps men develop a set of realistic sexual expectations for each phase of their lives and explores the role of their partners in resolving ED problems.
Get this book

Erectile Dysfunction: Best Medicine for Erectile Dysfunction edited by George Kassianos (CSF Medical Communications Ltd, 2004)
Bestmedicine is a series of practical and authoritative guides providing detailed information for patients, carers and the general public that until now has only been available to the medical profession.
Get this book

(February 2002, resources updated January 2005)