Erectile Dysfunction - Erection Problems (Part 1)

Every penis in the world sometimes fails to perform.

That's a natural fact of life, yet many men still believe they should be able to "get it up" whenever they are being sexual, and their first experience of "failure" leaves them worried and expecting it to droop again.

But men often experience some erectile difficulties, especially with a partner who is either very inexperienced or very experienced, maybe somewhat critical perhaps, or putting high expectations on him.

For any man who is unsure of his sexuality, doubtful about his sexual identity, or not certain of his masculinity, the fear of impotence can be a renewed source of self-doubt with every sexual encounter.

And of course some drugs - both medical and recreational - as well as stress, alcohol, tiredness, and a host of other things can cause erectile problems.

But whatever the original event that caused the loss of erection, if a man is not relaxed about it, or fears it may happen again - well, it probably will.

Anything else bothering you?

Men often have sexual secrets which are not shared with anyone, and these secrets can cause stress and sexual problems. Examples:

• when a man finds he is more attracted to another woman than he is to his wife or partner
• when a man has fantasies about which he is ashamed
• when a man fears his penis is too small
• when a man is ashamed of some sexual secret (such as using porn or visiting prostitutes)
• when a man finds that he is sexually attracted to other men

For most men who have such difficulties that are causing them erectile problems, the cure begins with gradually uncovering and working through the issues that may be bothering them.

Some facts about men, sex and erection problems!

There are lots of things that men come to believe about sex that are untrue. Here are some statements that I believe represent the real truth:

• It is not the responsibility of a man to satisfy a woman - at best, sex confers a joint responsibility to seek out pleasure for both partners.
• A big, erect penis is not essential to a woman's sexual pleasure. A soft or semi-hard penis is not a disaster, no matter how often it happens..
• A woman may or may not prefer penetrative sex to everything else. Often she just enjoys being close emotionally and physically to her partner.
• A man is a not a constant sex machine and he cannot always get an erection, but even so, he and his partner can still enjoy sexual pleasure.

Sexual activity changes with age, but it can be just as enjoyable. It may take longer for one's penis to become erect and it may require physical stimulation to get it there, but a man's orgasms can be just as intense, and a woman is likely to be more satisfied with the gentler pace and sensitivity of a more mature man.

Erections may be softer than before, yet they provide all the physical pleasure of the rock hard penis of youth.

Losing Your Erection When Making Love or Using A Condom

I have many emails from younger men who say that everything is fine until they try to put on a condom - then their erection disappears, and that, so to speak, is that.

And many young men have written to me saying that their erection is fine until they are about to penetrate their partner, and then their penis collapses.

In reality, most loss of erection is due to

• performance anxiety - "will I measure up?"
• fear of rejection by the woman or
• fear of not being able to perform because you lost your erection once before or
• over-concern with, or taking too much responsibility for, the woman's pleasure.

In dealing with such situations, start from where you know you are confident.

So if kissing and cuddling arouses you and produces a hard erection while you are fully clothed, that is a starting point for you. You can begin your self-help treatment by playing around with your partner while you have your clothes on.

Later she can stimulate your penis while you still have your clothes on. Next, she can play with you while you have your trousers off but your underwear on.

This is a kind of gradual desensitization process, gradually working out from sexual situations where you can keep an erection until you are more confident.

You might move on to oral sex before you try full penetration. A good method of stimulating an erection is oral sex. As your partner stimulates you with her mouth, enjoy a fantasy to help reduce your own anxiety.

Once you are confident that you can get and keep an erection like this, you can then move on to an orgasm achieved by means of manual or oral stimulation. Let me also remind you that lack of an erection does not say anything about your degree of manliness or masculinity.

Now, let us suppose that you have an erection waiting to do what it naturally wants to - enter a willing and receptive vagina.

The first step is to enter the vagina for just a little while - not with the expectation of sexual intercourse, but with the simple objective of being in there and remaining erect. You can thrust for a little while, but do not ejaculate inside your partner.

Enjoy your orgasm after you withdraw. You may want to enter and withdraw a few times, with a few thrusts each time, and reinforce your erection with hand or mouth stimulation from your partner if yoru cock begins to soften.

And it may be easier for you if you have your female partner on top, and she guides your penis in and out of her vagina, thrusting herself a few times while you are inside her.

You now simply move on to ejaculate inside your partner if you feel you want to. This is not about satisfying the needs of your partner through intercourse but about helping you get rid of your erectile problems. If she doesn't come as you thrust till you reach your own orgasm, then she can have an orgasm through clitoral stimulation after you have finished.

Putting on a condom - losing your erection

This is a very common issue for men. Here is an explanation of why guys lose their erection when the condom goes on. The simplest explanation is that fiddling with the condom is off-putting and seems like an embarrassment if a man isn't sexually experienced.

The best way to deal with his is to have your partner put it on for you as part of your sexual play - this can then become a very sexy signal that you are about to penetrate her! In these situations a condom becomes sexually stimulating rather than interrupting your sex.

Video - Dealing With Erection Problems

How to get your erection back - whatever the reason it's gone away!

Sensate focus allows couples to concentrate on touching the person, not the body or the sex act, and it is inherently rewarding to give and receive.

It concentrates on sensual rather than sexual pleasure, it fulfills a deep need to be touched - present from birth in all of us, but very often neglected or ignored, especially by men - and it communicates very effectively that someone cares deeply about us.

Further, delicate touch reduces emotional and physical tension, and when it is made clear that the goal of the touching is not to be sexual, but just to be touched and enjoy the feelings, any level of performance anxiety is lessened.

The man does not need to have an erect penis, and the woman is not expected to be so sexily alluring that he gets one; orgasm is forbidden, so to speak, which means the pressure is off.

It's simple. First, sex is not allowed. However arousing the process may be, forget touching the penis or vulva, and put off the idea of orgasms and intercourse for the moment. Then decide who is going to receive the pleasurable touch first.

Remember, this needs some time set aside without fear of interruption or distraction.

Let's assume that you, the man, is receiving first. Lie down, on your belly, naked, warm, and comfortable. Think in terms of giving yourself up to the experience.

Your partner will caress you gently, stroking along your body from top to toe.

She starts with the back of your head, ears and neck. Her caresses should be gentle and tender, delivered with care and love or affection. She can use her lips, tongue or fingers, the palms of her hands or the balls of her thumbs. Since this experience is about your pleasure, don't worry about her feelings.

Rather, concentrate on what it's like to receive this gentle touch, focusing on the experience, and what sensations you feel in your skin wherever she is touching you.

If your mind wanders, just bring it back, and let her know how she is doing - for example, if you would like her to move more slowly, or more gently, or more firmly, or use her lips instead of her fingers, or whatever, tell her.

If it feels good or very pleasant, ask her to repeat it - you are very likely to find some areas seem much more exquisitely sensitive than others as she moves her hands or lips over your body. There should be no touch to your penis at this stage!

She will work her way down your body slowly, down your sides, back, buttocks, the inside of your thighs, sides of your legs, and the backs of your legs. And you may like her to pay special attention to your feet, which are very sensitive areas for most of us.

The same process applies all the way down - gentle, delicate caresses. Some men and women find that the very lightest of touches - just the brush of the finger tips with so little pressure that it only moves the hairs on the body - is very stimulating and sensuous.

At some point, you will be turn over so that she can follow the same process on the front of your body. Again being delicate and sensitive, she starts with gentle touches and caresses to the top of your head and works her way down your face, neck, arms, chest and stomach.

She does not, however, touch your penis or balls.

She then moves down your legs and on to your feet. She will be using as much sensitivity as she can find during this process, and it is possible that you may get an erection - that is neither good nor bad, it just is, but leave it alone. Once again, the object of the exercise is not to be sexual.

After you are happy with what you have received, it's your turn to give to her. The process is exactly the same, except that you are going to avoid her nipples, clitoris and vulva.

Just concentrate on caressing the rest of her body in a delicate, gentle and sensuous manner.

You don't need an instruction book to do this, just follow your instincts and do whatever feels natural or whatever she indicates is nice for her.

With anything as intimate as this it helps if you can talk to each other about what you were feeling and experiencing.

The end point of this exercise is to be able as a couple to do this comfortably and regularly - it may take about two weeks of practice to be happy about it.

The next stage of the process is the addition of a similar sort of gentle touching of breasts, nipples, clitoris, vulva, penis, the vaginal opening, and the testicles.

Once again, the way to do it is to be sensitive and accepting, not to expect or hope for sexual arousal, just to experience the sensations and accept what it feels like, and to go with whatever the process brings up in terms of emotions or feelings.

Most couples find the absence of the man's erection or the woman's lubrication is not a barrier to the giving and receiving of pleasure.

And really, when you think about it, what a great thing to know: that the lips and fingers can provide sensuous pleasure. If you do get carried away, and find you have extremely erotic feelings and go on to have sex, try to go back to the process next time.

Video - sensate focus

Sensate Focus 2 - Genital Pleasure

Again, this process of giving and receiving pleasure is meant to be independent of orgasm, so avoid anything that is likely to make either partner reach orgasm.

And if you do not get an erection, it doesn't matter. Neither of you is out to sexually satisfy the other, and the objective is just to enjoy the experience.

Your female partner will tease and caress your penis, scrotum, pubic area and your inner thighs with her fingers, lips, tongue and whatever else she thinks of while you lie back and enjoy the sensations.

After you have had enough, whether your penis is hard or not - and, by the way, don't ask your partner to masturbate you to orgasm if you get hard - it is the woman's turn to receive the pleasure. Start by gently going over her whole body.

But this time spend only a few minutes doing this, then turn to her breasts, kissing and teasing her nipples, playing with her pubic hair, teasing the lips of her vagina, stroking her clitoris lightly, and just playing with the outer parts of her vulva.

After a few minutes of this, or when she indicates she is ready, stroke the skin on ether side of her clitoris lightly, not touching the bud of her clitoris unless she indicates she is ready and willing - it is often too sensitive for women to take a direct manipulation.

Don't put a finger into her vagina at this stage - just gently arouse the external parts of her feminine areas.

When you do this to your female partner, be gentle and imaginative.

Stop stroking her clitoris, or the skin either side of it, to go to another part of her genitals, then come back - be teasing, and stimulate her.

Be sure to ask her what she would like, and what she wants, and get feedback - also, tell her how the experience is for you, and how you feel, seeing her respond to your stimulation: does it excite you to tease her in this way?

Does it make you feel sexually aroused, seeing her respond to your touch? Don't bring her off, just let her take pleasure in being touched gently.

The reason this can be sexually arousing is that the pressure associated with sexual intercourse is removed, and so is the fear and tension that goes with such pressure. In such a relaxed situation, the man's sexual responses are not put to the test.

For the woman, lubrication and desire for penetration are very common reactions - often accompanied by a level of arousal that she had forgotten she was capable of or had never known was possible for her.

Sensate Focus 3 - orgasm outside the vagina

This means you are now going to enjoy orgasm without intercourse. Actually, the process is just the same as Sensate Focus 2, but this time you and your partner will be having an orgasm.

You caress each other gently all over the body and finish by stroking the penis and clitoris until you reach orgasm, one after the other.

The next step is to put your erect penis inside your partner's vagina as she sits astride you. At first, the objective is just to enjoy the sensations with no pressure for intercourse, no thrusting, and no expectation of orgasm.

As you realize that your erection is firm and see that it remains so, the woman can begin gentle movements of her hips - not vigorous pelvic thrusting, just gentle rocking and swaying of her hips.

This movement is a natural one for a woman in a high state of arousal, but even if she isn't aroused, she can easily rock gently to provide you and her with sensations of movement, pressure and warmth. It can actually be a highly erotic and sensuous experience for both partners, and often leads to a very rapid increase in sexual confidence.

If it makes you feel easier, let her direct the process of entry and withdrawal, and hip rocking and gentle movement.

Or if you feel more confident being in charge, then you direct events. Do whatever makes it most relaxed for you both.

As confidence increases, you can begin to thrust gently a few times. However, you are not to ejaculate inside her at this stage! At this stage of the process, you ejaculate outside her vagina. Do this until you are happy and confident about your ability to keep a full erection.

Sensate Focus 4 - Moving on to full sexual intercourse

Make sure that your partner has an orgasm if she wants one, but remember you are involved in a process that is designed to get you back to sexual fitness.

So, for the moment, be selfish. As you penetrate her vagina, and begin to thrust with your penis, do whatever you need to feel confident that your erection is here to stay. Indulge yourself with sexual fantasy.

Use whatever position, speed or force of thrusting you want, abandon yourself to your emotions and ejaculate inside or outside her vagina as you wish.

The period during which you move back towards full vaginal intercourse is one in which you put no pressure on yourself and your erection - and if you have any doubts about your ability to come inside her, then withdraw and have an orgasm outside her vagina.

Sooner or later you will be secure in your ability to have full intercourse. And if you have any doubts, you can always go back to these techniques, and re-establish your confidence in your ability to stay hard.

2 Vacuum Erection Devices

These represent one method of dealing with erectile dysfunction, and despite the problems listed below can give good results in generating an erection suitable for intercourse..

The vacuum erection device (recently renamed the vacuum constriction device) consists of a plastic cylinder that fits over the penis. This cylinder is connected either directly or by tubing to a vacuum generating source (a manual or a battery-operated pump).

Once the penis is engorged with blood due to the negative pressure, a constricting ring is then applied to the base of the penis to maintain the erection. To minimize injury to the penis, the ring should not be left in place for longer than 30 minutes.

The erection resulting from a vacuum device is different from a natural spontaneous erection or one produced by Viagra.

First of all, that portion of the penis between the ring and the abdominal wall is not rigid. Sometimes this causes a lack of good base support and can result in a rotating, pivoting effect.

After a few minutes the penile skin becomes cold and sometimes dusky. Also, ejaculation is different in that the semen usually goes retrograde as it is trapped by the constricting ring. Sometimes the ring can be uncomfortable or even painful.

Some patients have additional numbness in the penis and develop bruising and bleeding below the skin. And men taking aspirin or Cournadin should exercise extreme caution when using these devices.

The majority of men, on the other hand, did report satisfaction in terms of penile rigidity, length, and circumference. Read more here. They also reported good partner satisfaction. However, these vacuum devices are contraindicated in patients with any history of priapism (prolonged erection) or bleeding disorders.

In patients with severe venous leakage or arterial insufficiency, fibrosis caused by priapism, or an infection from a prosthetic device, the vacuum device may not produce adequate erections.

In those men, combining Viagra with the vacuum erection device may enhance the erection. The device may also be used successfully with men who have a malfunctioning penile implant in place.

The vacuum constriction device is much more acceptable to older men in a steady relationship than the young single man. He will find it much more difficult to explain to his partner why he has to use the mechanical device to enjoy intercourse or fellatio!