Sexual Enhancement

In addition to the approximately 80 percent of ED cases that have physical origins, there is an estimated 20 percent with psychological causes. These figures are only estimates and in reality, depend on other factors, such as age. In men over the age of fifty, for example, ED is about 90 percent physical and 10 percent psychological. In men under the age of fifty, psychological ED is more common.

But the causes of erectile problems cannot be so neatly categorized, and a large number of men who have ED because of physical conditions suffer psychological problems, as well. That is why many men with ED, and their partners, seek the help of both a urologist and a therapist.

There are several different psychological problems that can contribute to erectile dysfunction. Here are some of the more common ones:

Depression

People who suffer from depression often lack physical energy, and this often includes their sexual drive, as well. They may feel sad, experience feelings of low self esteem and basically lose interest in life and its activities.

It is only natural that sexual relations will be affected when a man has these feelings. if the depression goes untreated, erectile problems can become chronic

Today's society is full of opportunities to become overly stressed, whether due to a demanding job, financial burdens, a troubled relationship, or family difficulties.

It is important for men who feel overly stressed to get professional help. If they continue to live with stress over a period of time, it will often affect their sexual performance, and they may end up with erectile dysfunction.

Some men have deep psychological problems, often from childhood, that can have an adverse effect on their sexual performance. They may be afraid that their erections won't be hard enough or last long enough for satisfactory intercourse; they may have feelings of guilt about sexual activity in and of itself; or they may have an unhappy relationship and be afraid of the criticism of their partner.

Performance anxiety can easily turn into a vicious cycle, where a man experiences one erectile failure, becomes fearful that it will happen again, is unable to have successful intercourse a second time, becomes even more fearful, fails a third time, and so on. The initial incident can be caused by anything, including too much alcohol, drug use, overwork, or an argument with his mate. But after it has happened more than once, he doesn't know how to get himself out of the cycle.

Without treatment, this problem will only get worse. When a man with such fears has problems getting an erection on a regular basis, he has developed ED.

If a relationship is not going well and there are feelings of unresolved anger, a man may sometimes be unable to get an erection with his partner. He may be experiencing mixed feelings and feels unable to express his love or desire fully. Or he may want to withhold sex, consciously or unconsciously, as a form of punishment. Whatever the scenario, unresolved anger can lead to erectile dysfunction if it is not successfully resolved.

Low Self Esteem

Some men who lack self confidence may experience erectile problems as a result. They may be convinced that their penis is too small, that they are not good lovers, that their partner will laugh at them or become angry or leave them. In some cases, a man may be with someone who is more sexually experienced than he and he fears comparison to previous lovers.

Such feelings about sexual abilities are often echoed in a man's feelings about himself in other areas. He may be having problems at work or may be disappointed in the way his career is progressing. He may have financial difficulties and think he is a failure as a man and as a husband or father. In other cases, a man may lack self confidence be cause of his appearance or because of health problems.

He may think his partner will find him unattractive or unworthy because he has gained weight, is getting bald, or is now on medication for high blood pressure. These feelings can be even more serious if a man keeps his fears to himself and refuses to discuss them with his partner. But With treatments such men can usually rebuild their confidence and their sexual potency can return.

Unrealistic Expectalions

Erectile dysfunction can even result when a man is too confident confident beyond reality. He may forget that sex is not a sport but is a way of communicating love and caring between two people. When he sees it solely as a performances he can easily sabotage himself.

If a man decides that he is going to give the sexual performance of all time, that he is going to be harder and last longer than any man in history, he is asking for trouble.

By focusing solely on his physical actions and forgetting about his partner, her feelings, and their relationship, a man can disappoint both of them and experience erectile failure.

Many older men who have survived one heart attack afraid develop a fear of sexual activity because they are they will have a second, and possibly fatall attack. Others, Who have never had a heart attack, nevertheless believe that the exertion needed for sexual intercourse could be dangerous to their hearts.

What is the truth? If a man is engaging in sex with his long¬term partner and is not attempting any gymnastics, he is not at significant risk for a heart attack, whether or not he has had a previous heart attack, provided he is in good physical condition. How does he know? First, he should ask his doctor directly. Second, he should take a stress test if his doctor advises it.

The amount of energy expended in a normal sexual encounter with a regular partner is about the same as that needed to climb two flights of stairs. If he can climb the stairs without exhaustion, he can usually engage safely in sex.

Why do we specify that he be with a long term regular partner? Because the stress of being with a new partner can be dangerous to a man with a heart condition. Whether he is concerned about his performance or whether he is involved in an illicit relationship, the pressure of such an encounter is much greater than that of sex with someone he knows well.

Strong feelings of guilt can also interfere with a man's sexual function. This can be seen in some widowers who feel that having sex with a new partner will mean they are being "unfaithful" to their deceased mate. Or they may simply feel it is unfair that their mate had to die and wrong that they should continue to enjoy life, and sex, without her. In fact, this type of situation is so common that Masters & Johnson termed it the "widower's syndrome."

In other cases, a divorced man may have the same types of feelings when he is with a new partner. And, of course, if a man is married or in a long term relationship and is secretly seeing another woman, his guilt feelings may prevent a successful sexual encounter from taking place.

There are also men who were raised in very strict, sometimes religious, households and were taught that sex is "dirty" or something you do only in order to have children. Men from these backgrounds sometimes have trouble overcoming such early teachings and may need therapy in order to learn how to enjoy sex for its own sake and for the closeness it provides with one's partner.

This psychological problem was raised by Freud in 1912, when he wrote that some men are sexually aroused only or primarily by women below their social class. The reason is that these women do not resemble their mothers or sisters.

In such men, their mothers or sisters are seen as "Madonnas," pure, chaste, and unsuitable for sex. Lower class women are viewed as "whores," and it is acceptable to have sex with them.

Men with this problem may have erectile problems with any woman in their social class whom they find attractive, and they may be potent only with women of lower social classes. In other men, everything is fine until they are married or until their wife has a child. At that point, their mate becomes a "Madonna," and they are no longer psychologically able to have sex with her. This type of problem is usually very deep seated, and overcoming it requires intensive therapy.