Erectile dysfunction or just not sexually aroused

This article was last updated on April 16, 2022

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According to the Minnesota Men's Health Center, one in ten men in the world suffers from ED (Erectile Dysfunction) and the likelihood of ED goes up with age: 39% at age 40, 65% over the age of 65. It is estimated that up to 30 million American men frequently suffer from ED and that it strikes up to half of all men between the ages of 40 and 70.

However those same stats point out that every man at one time or another has had a bout of ED and the causes of this condition are not just physical but also psychological. Sometimes it's all in your head and sometimes it's all in the head of your penis.

In examining the physical causes of ED, we find a number of conditions which are related to either the nerves or the circulatory system however it seems that with the importance of blood flow being at the heart of any erection, the factors which affect one's blood vessels are probably the most significant. Arterial narrowing brought on by ageing may be one of the biggest concerns as statistics state that men in their 60s are four times more likely to suffer from ED than men in the 40s. However other physical problems may be at fault: heart disease, clogged blood vessels (atherosclerosis), high blood pressure, diabetes, obesity, Parkinson's disease, Multiple sclerosis, low testosterone, Peyronie's disease (development of scar tissue inside the penis), certain prescription medications, tobacco use, alcoholism and other forms of substance abuse, and treatments for prostate cancer or enlarged prostate and surgeries or injuries that affect the pelvic area or spinal cord. Whew, that's quite a list.

The psychological causes of ED may be considered at times to be more subtle and more difficult to recognise as men are well known for being tough and not admitting to anybody, including themselves, that they may be having a problem. Stress or anxiety, low self-esteem, marital or relationship problems, performance anxiety and even an unsatisfactory sex life can all play a part in the likelihood a man may have a bout of ED. However, in saying a "bout of ED" there is the idea that this ED is temporary and can be remedied. It is this last point the current article will explore.

Who hasn't heard of Viagra or Levitra or Cialis? Anybody who's had to deal with spam has probably had more than their fair share of emails advertising these magic pills which portend to give any man a raging hard-on the likes of which haven't been seen since, well, one was 16 years old. There is, however, a curiosity to be found buried in the directions. On the official web site of Levitra (Why Levitra: Forget the Rumors), the manufacturer Bayer states:

* Levitra is not a magic pill or an aphrodisiac (a substance such as a food or drug that arouses or is believed to arouse sexual desire); it will not increase sexual desire.
* It should not give you an instant erection; you'll need to be sexually stimulated for it to work.

On the same site, in the upper right hand corner of the page, is a link to the Patient Information of the drug. You will find the following points:

ED is a condition where the penis does not harden and expand when a man is sexually excited.

When a man is sexually stimulated, his body's normal physical response is to increase blood flow to his penis. This results in an erection.

In the above snippets of text taken directly from official documentation for the drug Levitra, you will see when a man is sexually stimulated or [a man needs] to be sexually excited. In other words, the drug will not give a man an erection. The desire for sex, the excitement of sex or sexual stimulation will give a man an erection. The drug will only facilitate the flow of blood to the penis; it has absolutely nothing to do with making the blood actually flow into the penis. Only sexual arousal does that.

Marty Klein: How to not get an erection
Dr. Marty Klein (b 1950) is an American sex therapist, educator and public policy analyst. He publishes a monthly magazine called Sexual Intelligence and in issue #137, July 2011 he tells the story of Sam who starts dating a year after his wife left him.

Sam arrives at a point in one relationship where he is going to have sex but Sam encounters a problem: he's not getting an erection when he wants one. Sam thinks he is suffering from erectile dysfunction but questioning by Dr. Klein leads to a few discoveries.

Sam describes how he and his girlfriend Yolanda were kissing and it seemed they were going to have sex. Sam was excited by this but didn't have an erection. When Klein asks Sam to describe what they were doing, Sam explains they were making out and rubbing against each other but nothing else. Klein goes on to talk about physical stimulation.

I told Sam that he needed to have direct stimulation on his penis in order to get an erection. He disagreed; shouldn't it be enough that he was "excited"? "It's important that you're emotionally aroused," I partially agreed. "But you need to be physically aroused as well."

The gist of it is that Sam expects to have an erection with little or no direct physical stimulation either by his girlfriend or by himself. Sam is also very, very reluctant to talk about this with his girlfriend.

This conveniently illustrates the three rules for not getting an erection when you want one:
* Don't get the physical stimulation you need
* Envision "sex" as something that requires an erection
* Don't discuss this dilemma with your partner

All of the documentation associated with these so-called wonder drugs for supposedly giving a man an erection state over and over again that a man must be sexually aroused to have an erection. In other words, the drug itself is only a physical aid to assisting in blood flow. If a man isn't sexually aroused, the drug ain't gunna do squat.

The story of Sam underlines a myth held by probably every man and woman: a guy is ready, willing and able twenty-four by seven. Associated with this is the idea that a guy must get a woman "in the mood" for sex. As the initiator of sex probably about 100% of time in our culture, the man comes to the table already "in the mood" so he has the job of warming up his partner. This amusing metaphor for men and women succinctly sums up the traditional view of the two sexes and their different relationship to sex. Men are like microwaves; you push a button and they're on. Women are like crock pots; they take time to warm up. (see Sex: Men are always ready, willing, and able)

But what if the man isn't in the mood? Is it erectile dysfunction or is it that he's just not "in the mood"? And if it's that he's just not "in the mood", what does anybody do about it? First of all, in Sam's story, he's embarrassed to talk with his partner. Why this reticence on the part of Sam? He points out that having sex is one thing but talking about it is much more difficult and then Dr. Klein makes the most telling of statements: Talking about sex is much more intimate than doing it. That strikes me as a powerful assertion. Is sex more than just sex? Is sex talking? Is sex the intimacy of communicating with your partner? Klein goes on: "Sex would be a lot easier on the nerves if you didn't feel pressured to get erect for it. If you just counted everything as sex, and you two decided to enjoy each others' bodies in whatever ways were available, getting an erection wouldn't matter."

Secondly, since Sam's story makes no mention of the woman's participation, the question begs to be asked: does the woman know how to sexually arouse a man? Can she get Sam "in the mood"? Is Sam truly suffering from the physical ailment of erectile dysfunction or is he just not sexually aroused or not aroused enough?

In the article "How Sex Changes for Men After 50" by Michael Castleman (AARP: Association for the Advancement of Retired Persons – Oct 12/2010), the author writes:

Some things change. Take, for example, erections. After 40 and certainly by 50, they rise more slowly, and become less firm and frequent. Sexual fantasies are no longer enough. Men need fondling, often for quite a while. It's disconcerting to lose firmness and suffer wilting from minor distractions, such as a phone ringing, but these changes are perfectly normal. Unfortunately, many men mistake them for erectile dysfunction (ED) and become distraught — only exacerbating the problem. Anxiety constricts the arteries that carry blood into the penis, making erections even less likely.

Mr. Castleman is discussing men after 50 but is the idea of a man not being "in the mood" and needing to be warmed up applicable to any age?

Final Word
Boy, do I end up talking about the weirdest subjects or what? The point I found so curious in looking at the above materials is that while erectile dysfunction can be a physical condition, is it always? Stress or anxiety, low self-esteem, marital or relationship problems, performance anxiety and even an unsatisfactory sex life can have an impact on a man's performance, that is, can leave a man not "in the mood". Not being in the mood is not erectile dysfunction; it's just not being "in the mood". Gee, where have I heard this before? (hint: women not being "in the mood") – If you'll get it up, I'll get it out.

Talking about sex is much more intimate than doing it. Wow. Powerful stuff. I've always heard that the body's biggest sex organ is our brain. Are we all missing out on something? Is there more to this thing called sex than just an erection? Is there more to this thing called sex than just sex? This reminds me of an odd question about the brain and sexual arousal. This is applicable to all readers in whatever your partnered circumstances may be, but the wording, if you'll excuse me, is as if I'm asking this of a woman:

Can you give a man a hard-on without touching him?

Obviously we're back talking not about a man's genitals but about his biggest sexual organ his brain. If that's stimulated, will everything fall into place? And if you think you could successfully answer the above question, I would add a second question:

Could you make a man cum without touching him?

References

Wikipedia: Erectile dysfunction
Erectile dysfunction (ED, "male impotence") is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.

Wikipedia: Vardenafil
Vardenafil (INN) is a PDE5 inhibitor used for treating impotence (erectile dysfunction) that is sold under the trade name Levitra (Bayer AG, GSK, and SP).

official web site: Levitra
About ED
* The inability of the penis to harden and expand when the man is sexually excited.
Why Levitra: Forget the Rumors
* Levitra is not a magic pill or an aphrodisiac (a substance such as a food or drug that arouses or is believed to arouse sexual desire); it will not increase sexual desire.
* It should not give you an instant erection; you'll need to be sexually stimulated for it to work.

Levitra: Patient Information
What is Levitra?
Levitra is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men. ED is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection.
Levitra does not:
* cure ED
* increase a man's sexual desire
How does Levitra work?
When a man is sexually stimulated, his body's normal physical response is to increase blood flow to his penis. This results in an erection. Levitra helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity.

The Free Dictionary: Erectile dysfunction
Description
Under normal circumstances, when a man is sexually stimulated, his brain sends a message down the spinal cord and into the nerves of the penis. The nerve endings in the penis release chemical messengers, called neurotransmitters, that signal the arteries that supply blood to the corpora cavernosa (the two spongy rods of tissue that span the length of the penis) to relax and fill with blood. As they expand, the corpora cavernosa close off other veins that would normally drain blood from the penis. As the penis becomes engorged with blood, it enlarges and stiffens, causing an erection. Problems with blood vessels, nerves, or tissues of the penis can interfere with an erection.

Causes and symptoms
It is estimated that up to 30 million American men frequently suffer from ED and that it strikes up to half of all men between the ages of 40 and 70. Doctors used to think that most cases of ED were psychological in origin, but they now recognize that, at least in older men, physical causes may play a primary role in 60% or more of all cases. In men over the age of 60, the leading cause is atherosclerosis, or narrowing of the arteries, which can restrict the flow of blood to the penis. Injury or disease of the connective tissue, such as Peyronie's disease, may prevent the corpora cavernosa from completely expanding. Damage to the nerves of the penis from certain types of surgery or neurological conditions, such as Parkinson's disease or multiple sclerosis, may also cause ED. Men with diabetes are especially at risk for erectile dysfunction because of their high risk of both atherosclerosis and a nerve disease called diabetic neuropathy.

Some drugs, including certain types of blood pressure medications, antihistamines, tranquilizers (especially before intercourse), and antidepressants known as selective serotonin reuptake inhibitors (SSRIs, including Prozac and Paxil) can interfere with erections. Smoking, excessive alcohol consumption, and illicit drug use may also contribute. In some cases, low levels of the male hormone testosterone may contribute to erectile failure. Finally, psychological factors, such as stress, guilt, or anxiety, may also play a role, even when the ED is primarily due to organic causes.

BJU International – Oct 13/2005
How (not) to communicate new scientific information: a memoir of the famous brindley lecture
by Laurence Klotz
In 1983, at the Urodynamics Society meeting in Las Vegas, Professor G.S. Brindley gives his lecture ‘Vaso-active therapy for erectile dysfunction’ and demonstrates the effectiveness of self-injection with papaverine to induce penile erection by dropping his trousers and showing off his own erect penis.
[I laughed out load when I read Mr. Klotz's personal account of this lecture as he was there and witness to the proceedings. OMG!]

About.Com – Aug 6/2006
Sexual Difficulties: Loss of interest in sex
Loss of interest in sex, or sexual problems such as under-arousal or premature ejaculation, can occur at any age and for any number of reasons. A general state of under arousal is often accompanied by other issues in life such as overwork, stress and/or relationship problems. Men are often fairly poor at recognizing or acknowledging psychological issues or they see it as a sign of weakness. Stress is often viewed as something that affects other people but many men simply aren't tuned in to reading the signs in themselves.

About.Com – May 29/2006
Inability to reach orgasm-Anorgasmia
The inability to reach orgasm during sexual intercourse is better documented for women than men. Whilst anorgasmia, also known as orgasmic disorder, orgasmic dysfunction or orgasmic inhibition, is less common in men there are similarities in both sexes in terms of the possible causes and therapeutic outcomes.

AARP: Association for the Advancement of Retired Persons:
How Sex Changes for Men After 50
It's not the same as it used to be — and that can be a good thing.
by: Michael Castleman – October 12, 2010
Some things change. Take, for example, erections. After 40 and certainly by 50, they rise more slowly, and become less firm and frequent. Sexual fantasies are no longer enough. Men need fondling, often for quite a while. It's disconcerting to lose firmness and suffer wilting from minor distractions, such as a phone ringing, but these changes are perfectly normal. Unfortunately, many men mistake them for erectile dysfunction (ED) and become distraught — only exacerbating the problem. Anxiety constricts the arteries that carry blood into the penis, making erections even less likely.

Mayo Clinic
Erectile Dysfunction: Risk Factors
As you get older, erections may take longer to develop and may not be as firm. You may need more direct touch to your penis to get and keep an erection. This isn't a direct consequence of getting older. Usually it's a result of underlying health problems or taking medications, which is more common as men age.

Minnesota Men's Health Center
Facts About Erectile Dysfunction
* One in 10 men in the world have erectile dysfunction.
* 30 million men in the United States have erectile dysfunction.
* 50% of men with diabetes have erectile dysfunction, frequently within 10 years of diagnosis.
* The likelihood of erectile dysfunction increases with age: 39% at age 40, 65% over the age of 65.
* Men experiencing erectile dysfunction often report increasing anxiety, loss of self-esteem, lack of self-confidence, tension and difficulty in the relationship with their partner.

WebMD
Erectile Dysfunction
According to the National Institutes of Health, approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis.

A much more common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired.

Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.

WebMD
Sex-Drive Killers (Slideshow)
Is Your Sex Drive in Park?
Are you or your partner losing interest in sex? A variety of physiological and psychological factors can impact your libido. Check out these common sex-drive killers.

WebMD
Erections: Use It or Lose It?
Men who have trouble getting erections have sex less often than men with normal sexual function, several studies have shown.

But can a long sexual dry spell actually cause erectile dysfunction (ED)? And can men cut their risk for ED by having sex (or masturbating) on a regular basis?

my blog: Sex: Men are always ready, willing, and able
A woman only has to give a guy the green light and she can sleep with him. Twenty-four by seven, a man is willing to have sex and can be made to have an erection with little or no stimulation. It's a sure thing. No effort on the part of his partner, the woman, is necessary.

Click HERE to read more from William Belle

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5 Comments

  1. Really do appreciate taking your time to spell the difference between erectile dysfunction vs. lack of arousal. Indeed there exists confusion between the two. Thank you for sharing this informative post.

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