Is Your Erectile Dysfunction Due to Mental or Physical Reasons

Many men experience erectile dysfunction sometime in their life. In fact, anywhere between 5-20% of men experience it (that they've admitted to) in their lifetime. Yet, for some reason, it seems to be considered a mark of shame on one's manhood. That's nuts (no pun intended). There is nothing wrong with having ED, and we've discussed many ways to combat the problem itself. According to Dr. Joel Block, our resident erectile dysfunction expert (with over 2 decades medical training), the first step is to identify the problem. Where does this problem come from, anyway? Is it a mental or physical issue. Curious? Read on!

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If you have concerns about your erections, ask yourself the following questions. Before you seek help it is important to determine the origin of your condition:

1. Do you have an erection at least once a week when you wake up in the morning?

The answer to this question is important because it indicates whether your problem is psychological or physical. In an investigation conducted at the University of Chicago's Sexual Dysfunction Clinic, 32 men who said they were suffering with ED were asked about morning erections. They were also given a thorough urologic examination. Of the men whose exams indicated psychogenic (psychologically based) ED, 86% reported having morning erections.

In contrast, 100% of men who were found to have an organic (physical) basis for ED did not have morning erections. If you frequently have morning erections, or nocturnal erections—it is often incorrectly assumed that these are related to a need to urinate-your problem is most likely psychogenic in nature.

2. Are you able to get an erection firm enough for intercourse under some circumstances—for example, during masturbation or with a different partner?

Your answer to this question distinguishes between situational and global erection disorders. A man with a situational disorder can get an erection in some circumstances but not in others. For example, if you are able to stimulate yourself to erection, you are capable of having an erection with your partner and your problem is situational. If you are unable to get an erection under any circumstances your problem is global.

3. Did something in particular happen in your life that seems to have triggered your erection difficulties?

If your erection difficulties started at the same time you began a new job, moved, retired, or lost a loved one, your problem is likely to be caused by stress. Sometimes when ED persists for several months after the triggering event, you can be caught in a self-perpetuating cycle of erectile failure: Stress leads to erection failure, the episode of ED creates anxiety, and this leads to another failure. Anxiety and the anticipation of failure interfere with sexual responsiveness.

4. Do you get a firm erection but usually lose it when you attempt to penetrate for intercourse?

If you are getting sufficient stimulation, that loss of firmness may signal a slowly developing physical problem. Poor diet, sedentary lifestyle, heavy smoking or drinking, and other behaviors may be catching up with you. But the abrupt loss of a firm erection on penetration may also indicate a psychological conflict. If this happens frequently, have a urological examination to eliminate any physical cause before you begin looking at personal and relationship issues. Gradually losing your erection after several minutes of intercourse is not a cause for concern. You may be tired, or you may need to vary your sexual routine.

5. Can you feel mentally aroused even if you have trouble with erections?

Almost every man has had some period in his life when he didn't feel his normal desire for sex. In most cases, this is temporary, and desire soon returns. When loss of desire persists, look for an underlying psychological cause. Stress, fatigue, boredom, fatigue are all possibilities.

These questions can help you evaluate your situation and determine if the erectile dysfunction problem is more physical or psychological. They can also be used as talking points to open a discussion with your partner. Your erection problems affect her too. So keep those lines of communication open, and try not to assume the worst.

Joel D. Block, Ph.D., is an award-winning psychologist-excellence in couple therapy-practicing couple and sex therapy on Long Island, New York. Board Certified in Couple therapy by the American Board of Professional Psychology, Dr. Block is a senior psychologist on the staff of the North Shore-Long Island Jewish Medical Center and an Assistant Clinical Professor (Psychology/Psychiatry) at the Hofstra North Shore-LIJ Medical School.

For 20 years he was the training supervisor of the Sexuality Center at Long Island-Jewish Medical Center. Dr. Block is the author of over 20 books on Love and Sex, his specialty. Check out DrBlock.com for more information.

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Gents! 4 Steps to Restoring Sexual Function

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What Erectile Dysfunction Is - And Isn't

Don't panic GetLusty men, there's nothing wrong with you, or your penis. A failure to perform is not a permanent illness you will suffer from for the rest of your life. For some, it's just a sign that your body and mind are changing, and that you might just need to make some adjustments in your sex life. Take a deep breath, and let Dr. Joel Block ease your worries with his expertise on this delicate matter.

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What is Erectile Dysfunction (ED)?

Erectile dysfunction (ED) is the chronic or ongoing failure to get or sustain an erection. A man at any age can fail to achieve a desired erection or lose an erection during lovemaking. In youth, the situation is embarrassing and sometimes confusing. Most men, however, know that the occasional erectile problem is typically linked to fatigue, overconsumption of food or drink, or a relationship issue. At mid-life, a man may read a lot more anpit ED. He may see his future in a single failed erection. How, he, and his partner handle this situation can determine how frequent they will be. As men get older they experience natural and common changes in their sexual response.

5 things ED isn't?

#1 You need direct penile stimulation to have an erection, and no longer get an erection just from thinking about sex or seeing your partner in an alluring pose.

#2 It takes you longer to achieve an erection.

#3 You require more time to achieve ejaculation. After a period of intercourse, your erection subsides, and after ejaculation, your erection subsides more quickly than when you were younger.

#4 Your erection isn't as hard as it was when you were a teenager.

#5 You need more time to recover between ejaculations.

Now, why does ED happen?

#1 Natural occurrences

Such changes are gradual, and you shouldn't be frightened by them. Changing response patterns enable a man to be a better lover than he was because he is now responding at a pace more similar to his partner's.

Lack of knowledge and refusal to accept the aging process as an erotic opportunity can prevent men from seizing the sexual moment. Anxiety also plays a major role in creating an ED dynamic. If a man misinterprets his responses and becomes anxious about his potency, he will be tense and fearful about lovemaking and may end up making an erectile dysfunction out of a normal occurrence.

#2 Physical problems 

Some men do experience erection difficulties that are more serious than the normal changes associated with aging. Psychological factors, ranging from performance and stress issues to intimacy conflicts, can contribute to erection disorders. Physical problems, such as diabetes, vascular disease, and urological and neurological conditions, can also cause ED. Heavy smokers and drinkers may suffer extensive damage to the small blood vessels—including those in the penis—which leads to ED.

#3 Psychological problems

For most men, ED stems from a combination of psychological factors that need to be addressed. The best approach is a comprehensive psych-based program like the one found at www.MindoverEd.com. A simple prescription drug isn't likely to solve the problem.

When ED is rooted in psychological issues, the cause is likely to be:

Anger. Unacknowledged and unexpressed anger can sit on the end of a penis and hold it down. As noted in previous chapters, repressed anger, whether at the partner or not, has a devastating effect on sexuality.

Intimacy conflicts. Maybe your penis is trying to tell you something about the relationship. Conflicts that have been ignored or papered over for years can cause sexual functioning problems now.

Depression. Libido is often a casualty of depression, even low-level depression, especially if prolonged. Bouts of ED can increase a man’s feelings of discouragement. While antidepressants such as Prozac may lift the depression, they may fail to lift the penis.

Stress. At midlife a man has to learn stress management or face increasing bouts of ED. When he was young, he could get and maintain an erection in spite of stress. That’s less likely now.

Worry. Concerns about job security, personal finances, and family issues such as problems with teenage children and aging parents can also create a psychological climate for ED. If a man is feeling powerless in the world, he may convey that message to his penis. Generally, worry and stress are short-term situations. They may result in brief periods of ED that can be overcome in a good relationship.

Performance anxiety. One occurrence of ED can set up the cycle of failure, anxiety, failure. In fact, performance anxiety is probably the most common contributing, or secondary, psychological cause of ED.

Joel D. Block, Ph.D., is an award-winning psychologist-excellence in couple therapy-practicing couple and sex therapy on Long Island, New York. Board Certified in Couple therapy by the American Board of Professional Psychology. Dr. Block is a senior psychologist on the staff of the North Shore-Long Island Jewish Medical Center and an Assistant Clinical Professor (Psychology/Psychiatry) at the Hofstra North Shore-LIJ Medical School. For twenty years he was the training supervisor of the Sexuality Center at Long Island-Jewish Medical Center. Dr. Block is the author of over 20 books on Love and Sex, his specialty. Check out DrBlock.com for more information.

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