Penis Problems: I can't get an erection

An email: "I've been losing interest in sex for some time now. I find I want it less, my desire for and interest in other women is much reduced, and I rarely initiate sex anymore. My partner is very upset - she thinks she's not attractive to me any more. To be honest, she isn't, at least not sexually. And even if we do get down to it, my penis just doesn't respond."

Erectile dysfunction - impotence - loss of erection: whatever you call it, it's a blow to your sense of male pride, and it can shake your confidence to the roots the first time it happens.

Sometimes the cause is just circumstantial: you have a bad experience while making love and your penis goes soft; too many sexual demands are put on you by your partner and you can't meet them; you are tired, try to make love, fail and lose confidence; you're with a girl and it's your first time, but you don't really want to be having sex with her; you're putting on a condom and find it's such a turn-off that your penis goes limp. Whatever the original cause, what it comes down to is this: you lose your erection unexpectedly one day and then find the next time you try to have sex your penis remains resolutely soft. These are the circumstantial causes of erectile dysfunction, and they can be cured with a boost to your confidence, a bit of support from your partner, and maybe some Viagra to get over the shock.

But that's not what the guy who sent in the email at the top of this page meant. No, he meant that he'd lost the ability to get erect over a period of time, and now he was impotent.

The first question to ask anyone in this position is whether or not their relationship is going well. One sex therapist of my acquaintance says "the penis never lies" - by which she means that a soft penis can say more about a relationship than you'd ever guess on the surface. Anger, hostility, fear, boredom and many more emotions can all be brushed over in day-to-day communication, but a soft penis may tell the true story of what's going on between two people. Even when a man has a normal level of testosterone, depression can be an erection killer. And when a man has a low level of testosterone, he may be both depressed and impotent.

A good website on impotence is this one.

Another website with a forum to discuss all matters relating to your penis is here.

This is not to say that all erection problems are caused by low testosterone, but many are. Indeed, one clinic for men says that a combination of Viagra and testosterone replacement therapy can cure 95% of all cases of erectile dysfunction. (The moral of this fact is that the days of injecting chemicals into the penis to make it erect have long since gone, and the days of implanting prostheses into the penis - after first removing the erectile tissue - should never have been here in the first place.)

But how do you know if you have a normal level of testosterone? There are warning signs: you're approaching 40 or 50, you're losing your motivation, drive, energy, and enthusiasm for life, you find your libido is diminished, and perhaps you're experiencing a sense of futility, tiredness, exhaustion, and maybe even having hot flashes and night sweats. In addition, and worst of all, your penis may not only be refusing to get erect, but it may appear to be shrinking.

Naturally, as you may have guessed by now, I recommend testosterone replacement therapy to men in this position. And I recommend it because I have been on it for some time myself, and it has transformed my life.

Life is dismal as a man if you have no libido, aren't able to get an erection or have small, insignificant erections in place of large, powerful ones, aren't sexually interested in your partner, and feel depressed and tired all the time. But here's the thing - to deal with male mid-life hormonal issues, you need a good doctor: one who understands testosterone and how it works in the male body, one who can diagnose accurately your levels of free and total testosterone (these terms are explained at http://www.the-penis.com/andropause.html ), one who can knowledgeably prescribe the best testosterone replacement regime for you.

A great place to start is by reading about male hormone replacement therapy on The-penis.com - that's the URL shown in the paragraph above. Finally, women have objected, it seems to me, to men appropriating the term "menopause", as in the male menopause. So let's call it the andropause. That sounds much more masculine.

Another good way to research this subject is to buy Dr Malcolm Carruthers' books, Androgen Deficiency In The Adult Male, which is a textbook, or Maximizing Manhood, which is more of a mass-market book. They are both available from Amazon.com and Amazon.co.uk. Search for them by title.

Penis Problems: I can't get an erection

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