By Herbert Mugarura
The worst slap in the face men can ever experience is the failure to rise up for the occasion in sex.
It is agonising for a man who knows he is fully functioning to find, one night, that his manhood cannot stand! After doing everything that usually stimulated him and failing, the effects spread to psychological torture, continued performance anxiety, social maladjustments, several phobias and damage of oneâ€™s general quality of life.
Erectile dysfunction is the inability to achieve or maintain an erection or have an erection of the penis not satisfactory for sexual intercourse.
It may strike once in a while, become consecutive or permanent.
In men, erection is associated with an enormous increase in blood pressure in the penis as a result of increased blood flow therein.
The degree of erection is proportional to the degree of stimulation, whether be it psychological sensory stimulation of sight, smell, sound and fantasy or physical stimulation of touch.
Anything can go wrong in the stimulation - erection process. Experts say about 10% of impotent cases are due to physical problems such as generalised illness or nerve disorder. The other 90% are psychological.
Sometimes these two may interact. A minor physical problem may slow down sexual response, getting a man worried about attaining an erection (performance anxiety), which may fail the erection alltogether.
Usually, psychological factors are self-perpetuating. They arise from fear, anxiety, or guilt.
Other causes include depression, low self-esteem, unresolved sexual orientation, a partnerâ€™s lack of interest in sex, relationship problems, and estrangement from a partner such as unresolved conflicts, to mention but a few.
Previous traumatic sexual experience or abuse, like in defilement, can cause erection dysfunction.
Anxiety about performance or fear of humiliation at the first sexual encounter can make a man fail to attain or maintain an erection.
Stress from work or at home can result in erection failure.
These include the side effects of certain drugs, like those used to treat depression, psychiatric conditions (haldol) and hypertension (inderal, atenolol, lasix at high doses and prolonged use).
The drugs used in the treatment of prostate cancer can result in erection failure because they work by decreasing the production of the male hormone (testosterone) in the testes and adrenal glands, which is necessary for male sexual function and development.
However, it is recommended not to alter any dosage or discontinue any medication without the advise of your doctor.
Erectile dysfunction can also arise from diseases. Diabetes mellitus (sugar disease) causes damage to the nerves, blood vessels and fibrous tissue of the penis, leading to impotence. (30%-50% of diabetic men suffer some degree of erectile dysfunction.)
The hardening of blood arteries (arteriosclerosis) as in old age, among smokers, people with high fat levels in blood and alcoholics can lead to too little blood flowing into the penis.
Other diseases include Parkinsonâ€™s disease, chronic kidney disease and liver failure.
Any surgery in the pelvic area, like an operation on the prostate, may damage nerves and blood vessels supplying the penis and lead to impotence. The same can happen with accidents that result in spinal cord injury, which disrupts nerve impulse flow in the brain-penis circuit.
Age is another factor. Risk factors increase as we grow older.
Erections tend to take longer to develop or may not be as rigid or require more direct stimulation to be achieved.
You may notice in older men that orgasms are less intense, the volume of ejaculations is reduced and recovery time increases between erections.
A man experiencing a degree of impotence may try to hide it from his sexual partner by creating situations of avoiding sex like staying up late, watching TV or reading to ensure that his partner is asleep. Others go to bed early and sleep (or pretend to) before the partner. Others invite friends at home to reduce on the amount of time alone with their wives. Some men may return home â€œtoo tired for sexâ€ or claim a headache or backache at bed time.
And when a man attains an erection and fears he cannot maintain it, he avoids romancing and penetrates straight. In most such cases he quickly ejaculates before losing the erection completely.
Of course the female partner suffers greatly in the relationship. They donâ€™t reach orgasm, are sexually starved and feel lonely and abandoned.
Men with sexual problems are encouraged to see a doctor. The doctor will carry out tests to identify the cause.
The wives should be supportive. The impotent men can, in the meantime, maintain other sexual interactions like kissing, caressing, manual or oral genital stimulation to cater for the wifeâ€™s sexual needs. It is wrong for men to think that penetrative sex is the only satisfactory way.
Discussing your partnerâ€™s sexual needs can help. Once a man feels that he is under no pressure to perform, his erection ability may improve.
If it is medication side effects, the doctor may change the dose. He may also prescribe side therapy to correct your hormonal levels in the blood.
Recovery from anxiety, alcoholism and drug dependency is also important.
The majority of long-term cases of psychological impotence can be improved or even cured by sexual counselling and education.
The good news is that up to 95% of men who experience erectile dysfunction can be treated.
Author is a medical doctor