Erectile Dysfunction (ED)

Erectile Dysfunction

Erectile dysfunction or Impotence can be caused by ‘Psychological factors’, ‘Physical factors’, or a ‘combination of both’, and can have a major impact on a man’s emotional well-being.  Common effects of ED can include:

–  A man may feel a loss of manhood,

–  Embarrassment, frustration, Anger

–  A loss of confidence and low self-esteem,

–  Difficulties in relationship, or sexual encounters.

Erectile Dysfunction can be extremely difficult for men to discuss even knowing that it can be treatable.  Dave Wells provides a confidential and respectful service, supported by specialised skills in sexual health and relationship issues. Addressing ED can require individual and/or couple’s counselling, dependent on the man’s situation.

Dave Wells recognizes the importance of providing support for partners of men who are suffering from erectile dysfunction, since we understand when in a relationship this often becomes a couple’s issue. When in a relationship, a co-operative couple will benefit more from treatment.

For the independent man, ED can greatly interfere with meeting partners, effect his personal view of himself, and his sexual confidence.  ED and its effects aren't something that men have to live with, however when in the case of ED being a result of a medical condition, e.g. Prostate Cancer, etc, treatment can be made much more complicated.

A Gradual Problem

Men with cardiovascular disease (heart disease, stroke), hypertension (high blood pressure), or atherosclerosis (narrowed arteries) may notice a slow but continuing change in being able to achieve or maintain an erection.  The same process, which can cause cardiovascular disease and linked conditions, also affects the penis.  When arteries in the general circulation become blocked, this restricts blood flow to the heart and can cause heart disease.  When arteries in the penis become blocked, blood flow to the penis is restricted, which is necessary for an erection.

In general, morning and night-time erections, without any form of sexual encouragement, are a sign of everything working normally.  With a ‘gradual’ type of erection problem. It is common for natural morning and night-time erections to become increasingly uncommon.

A Sudden Problem

Men with erection problems of a more emotional cause can often pin-point the very first time it happened.  It may be linked to a particular event (or run of events) in their life – such as being made redundant, a divorce/separation, bereavement, or an operation (such as prostate).

Morning and night-time erections usually still occur, and the problem gaining an erection may only happen sometimes.

An Occasional Problem

Very few men go through life without now and again having a problem with erections.  Drinking too much alcohol, stress, anxiety, and loss of confidence, can be the cause of an occasional problem.

A poor lifestyle including unhealthy eating, smoking, recreational drug use, and a lack of exercise are also common causes of erection problems.

In most cases ED is psychological in nature.

Psychological Causes of ED

Psychological factors are responsible for a high percentage of all cases of ED (Erectile Dysfunction); however it can be a secondary reaction to an underlying physical cause or as the result of medications or drug use. In some cases, the psychological effects of ED may stem from childhood abuse or sexual trauma. However, the most common psychological causes of ED include:

•  Stress: Stress can be job-related, money-related, or the result of marital problems, among other factors.

•  Anxiety: Once a man experiences ED, he may become overly worried that the problem will happen again. This can lead to “performance Anxiety”, or a fear of sexual failure, and consistently lead to ED.

•  Guilt: A man may feel guilty (E.g., not satisfying his partner, or regarding the partner who he is with.

•  Depression: A common cause of ED is depression which can affect a person both physically and psychologically.  Depression can cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED.

•  Indifference: This may come because of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems; in a couple’s relationship, or of a personal nature.

•  Low self-esteem: This can be due to prior episodes of ED (thus a feeling of inadequacy) or can be the result of other issues unrelated to sexual performance.

The information above has been adapted from:

How Can Dave Wells Help?

While many drugs, such as Viagra and Cialis, are available to support be able to attain an erection, they only mask the symptoms, and do not address the underlying causes of ED. For some men, these drugs are not an effective solution and for others who have medical conditions that prohibit the use of performance-enhancing drugs, there can still be help available. Also, there are some men out there who want to fix ED, but simply do not want to be reliant on a drug. Whilst I am not against the use of ED drugs as one possible pathway to greater confidence, I believe that addressing the underlying cause should be first process, especially when the root of erectile dysfunction is psychological as opposed to physiological.

For some men the use of ED medication can result in a psychological addiction where the fear of not being able to gain an erection or premature ejaculation will lead to anxiety and the belief that they cannot have satisfying sex without taking a pill before-hand.

ED can also have negative consequences for the partners of the men who experience the condition, and where partners are of a concern, therapy may include a combination of working with the individual, as well as combined sessions.

Physical Causes of ED

In many cases, erectile dysfunction (ED) is psychological in nature however it can also be an early symptom of heart disease and other vascular diseases. Although ED can be caused by various conditions, it can be caused by the narrowing of the small arteries in the penis, therefore causing a reduced blood flow to the areas of the penis responsible for gaining an erection. This is the same problem that can occur in other blood vessels.

‘Impotence’ is a condition that consistently affects a person’s ability to achieve or maintain an erection, or ability to achieve ejaculation. It’s a form of erectile dysfunction (ED).  There can be several contributing factors for impotence. These include both emotional and physical disorders. According to ‘The Merck Manual of Diagnosis and Therapy’, an estimated 50 percent of men ages 40 to 70 experience some ED at one time or another. The risk of impotence increases with age.

How Can Dave Wells Therapies Help?

Impotence often has a negative effect on sex life, and can cause additional stress, depression, and low self-esteem.   Dave Wells can support men through the processes of elimination utilising psychological exploration and medical referral to achieve the understanding necessary towards attaining control over gaining an erection.  Although ED or Impotence is often related to psychological reasons, it can be caused by a number of physical effects.  Understanding the most common potential physical and psychological causes can help a person identify why they may be experiencing the condition. Examples include:

– Endocrine Diseases: The body’s endocrine system produces hormones that regulate metabolism, sexual function, reproduction, mood, and much more. Diabetes is an example of andocrine disease that can cause a person to experience impotence. Diabetes affects the body’s ability to utilize the hormone insulin. One of the side effects associated with chronic diabetes is nerve damage. This affects penis sensations. Other complications associated with diabetes are impaired blood flow and hormone levels. Both of these factors can contribute to impotence.

– Neurological and Nerve Disorders: Several neurological conditions can increase the risk for impotence. Nerve conditions affect the brain’s ability to communicate with there productive system. This can prevent a person from achieving an erection. Neurological disorders associated with impotence include:

•Alzheimer’s disease

•Parkinson’s disease

•Brain or spinal tumors

•Multiple sclerosis


•Temporal lobe epilepsy.

People who have had prostate gland surgery can also experience nerve damage that causes impotence. Long distance bicycle riders can also experience temporary impotence. This is because repeated pressure on the buttocks and genitals can affect the function of the nerves.

– Taking Medications: Taking certain medications can affect blood flow, which can lead to ED. A person should never stop taking a medicine without their doctor’s permission, even if it’s known to cause impotence. Examples of medications known to cause impotence include:

• alpha-adrenergic blockers, including tamsulosin (Flomax)•beta-blockers, such as carvedilol (Coreg) and metoprolol (Lopressor).

• cancer chemotherapy medications, such as cimetidine (Tagamet).

• central nervous system depressants, such as alprazolam (Xanax),diazepam(Valium), and codeine (found in various brand name drugs).

• central nervous system stimulants, such as cocaine or amphetamines.

• diuretics, such as furosemide (Lasix) and spironolactone (Aldactone).

• selective serotonin reuptake inhibitors or SSRIs (Prozac, Paxil).

• synthetic hormones, such as leuprolide (Eligard).

– Cardiac-Related Conditions:

Conditions that affect the heart and its ability to pump blood well can cause impotence. Without enough blood flow to the penis, a person can’t achieve an erection. ‘Atherosclerosis’, a condition that causes the blood vessels to become clogged, can cause impotence. High cholesterol and high blood pressure (hypertension) are also associated with increased risks for impotence.

– Lifestyle Factors and Emotional Disorders:

To achieve an erection, a person must first go through what’s known as an excitement phase. This phase can be an emotional response. If a person has an emotional disorder, this affects their ability to become sexually excited.

Depression and anxiety are associated with increased risk for impotence. Depression is a feeling of sadness, loss of hope, or helplessness. Fatigue related to depression can also cause impotence.

Performance anxiety can be another cause of impotence. If a person wasn’t able to achieve an erection in the past, he may fear he won’t be able to achieve an erection in the future. A person may also find he can’t achieve an erection with a certain partner. Someone with ED related to performance anxiety may be able to have full erections when masturbating or when sleeping, yet he isn’t able to maintain an erection during intercourse.

Abuse of drugs (like cocaine and amphetamines) can also cause impotence. Alcohol abuse and alcoholism can affect a person’s ability to achieve or maintain an erection as well.

– Treatment:  Treatments are available for impotence, including prescription medications, natural remedies, and lifestyle changes.  Effective treatments are often used to mask erectile problems rather than address the underlying causes.  For many men with more serious conditions effecting ED, medications may not be effective.

Prescription Medications: There are a variety of medical treatments that can be used to treat impotence.

Prescription treatments and other medical interventions to help treat impotence include:

• Sidenafil (Viagra)

• Tadalafil (Cialis)

• Vardenafil (Staxyn, Levitra)

• Alprostadil (Caverject Penile injection)

• Testosterone replacement

• Blood vessel surgery

• Psychological counselling

Natural Remedies: For those who want to avoid prescription medication, there are a variety of natural remedies known to help treat impotence. Some natural or alternative remedies for impotence include:

• Acupuncture
• Ginseng
• Pomegranate juice

Before you use any natural remedies, make sure that you consult your doctor first.

– Lifestyle Changes:

Whether a person’s impotence has a physical or an emotional cause, there are many cases where lifestyle changes can reduce their struggle with ED. These lifestyle and behaviour changes include:

• Smoking and drinking less
• Strengthening communication in a romantic relationship
• Reducing anxiety
• Exercising more and following a healthy diet.

– Prevention: Impotence has a large number of causes, but there are still measures you can take to help prevent it. Methods of possible prevention include:

• Taking part in physical exercise, which decreases the risk of impotence
• Avoiding smoking, drugs, or alcohol abuse
• Getting enough sleep
• Following a healthy diet
• Reducing stress, anxiety, and depression

Though erectile dysfunction can have a negative impact on sex life, it’s a treatable condition. Many interventions exist that can help a person regain their sexual function.

The information above has been adapted from

Ed Treatments

There are a variety of medical treatments that can be used to treat erectile dysfunction (impotence). Prescription treatments to help treat impotence include:

–  Sidenafil (Viagra)

–  Tadalafil (Cialis)

–  Vardenafil (Staxyn, Levitra)

–  Alprostadil (Caverject Penile injection)

–  Testosterone replacement

Treatments can work very well for men with ED; however, they can also be a ‘Band-Aid solution’ as they do not address the larger problem that underlies ED. Usually ED will lead to other problematic areas of the person’s sexual confidence and therefore performance will be affected.  It is important to be aware that the use of ED treatments can also become psychologically addictive, where a man will believe that they cannot perform without them. Also, the use of amyl-nitrate (poppers, etc.) and ED medication together is extremely dangerous and can lead to the onset of severe cardiovascular conditions.

Natural Remedies: For those who want to avoid prescription medication, there are a variety of natural remedies known to help treat ED. Some natural or alternative remedies for ED include:

–  Acupuncture

–  Ginseng

–  Pomegranate juice

Before you use any natural remedies, make sure that you consult your doctor first.

Other more environmental-type conditions can also be causes where treatment requires a change of behaviour.  Environmental causes include:

–  Alcohol

–  Smoking,

–  Other substance abuse

Non-medication type treatments include:

–  Blood vessel surgery

–  Psychological counselling

A majority of causes of ED can be Psychological and through the use of counselling, and/or the use of the treatments mentioned above, Ed can be managed.  However, treatment can become more complicated when ED is related to Physical conditions such as:

–  General aging

–  Diabetes

–  Multiple sclerosis (MS)

–  Prostate disease

–  High blood pressure

–  Under-active thyroid gland (hypothyroidism)

–  Cardiovascular disease

–  Obesity

–  Parkinson’s disease

–  Peyronie’s disease (scar tissue inside the penis)

–  Spinal cord injuries

–  Surgery that affects the pelvic area or spinal cord

–  Sleep disorders

–  Medications (E.g., Anti-depressants)

In the cases where ED is related to more serious medical conditions, Dave Wells can support the work of General Practitioners and specialists by providing referral options and supporting the person with the psychological journey of the sexual impacts of their condition.