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The four most common symptoms of men seeing their doctor with erectile dysfunction are:
- difficulty getting an erection
- difficulty sustaining or maintaining an erection
- premature ejaculation
- low sex drive (libido).
Most patients have a combination of two or more of these problems. They are usually first given a thorough medical history and examination to determine the extent of the problem and to hopefully pinpoint a cause. I want to briefly outline the nature of these four symptoms so that your problem will make more sense to you as a patient if you are experiencing any of them.
Difficulty getting an erection
One of my patients described his dilemma as 'trying to stuff a marshmallow into the coin slot of a vending machine'. Another explained proudly to me how 'I used to be able to hang a wet towel on the end of it'. The nostalgic ones say, 'What I used to be able to do all night now takes me all night to do.'
Most people remember what they were doing when they found out Kennedy was shot. More recently, most would remember where they were when they heard about Princess Diana's accident and subsequent death. Similarly, a man will always remember the first time his penis failed him, what he was doing, and with whom. When erection problems start to set in, a man will always remember the period in his life, however brief, when he was able to have intercourse several times in one day. He will compare his current performance to this period for the rest of his life, believing that 'anything less than this is inadequate'.
I define adequacy in intercourse as 'the ability to obtain an erection sufficiently strong enough to penetrate your partner during sexual intercourse and which remains erect for an "adequate" period of time'. I will discuss the term 'adequate' in the section titled, 'Difficulty in sustaining an erection'. For the meantime this 'adequate period of time' refers to a period long enough to attain personal satisfaction, often related to the point of ejaculation.
The cause of poor erectile strength is either physical or psychological, or both. Medical practitioners previously thought that the majority of symptoms had a purely psychological cause. As specialists in the field of erectile dysfunction, we have now been able to prove that the majority of causes of this condition are a combination of both physical and psychological factors. The physical problem is most commonly only the initial problem—the psychological consequences are usually more debilitating.
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WONEN WHO SHOULD NOT TAKE THE COMBINED ORAL CONTRACEPTIVE PILL
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How severe is the condition
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