Impotence 

If the reason that men don't go to their doctor is anything to do with that troublesome old macho image, then this problem will be one of the most unreported conditions around. Even then we know about the one in ten men it affects and that the true figure is likely to be quite a bit higher. If you read one of the many American books (and one or two trendy British ones) about this condition you might be told that it is mostly due to psychological problems such as stress or depression. Although this may be the case for some, it is fairly widely accepted in Britain that there is more often than not a physical reason why your penis may appear to go on strike just when you need it most. But don't disregard the stress factor, as this can still be devastating.

Many of us have experienced a temporary problem of this nature at some time in our lives. Mostly we put it down to overdoing the booze, (brewer's droop) or just simply overdoing things generally (too knackered). The solution in these cases is self evident, but what about when the cause is not so easy to pin point?

Because of our differing views on the usual causes of malfunctioning tackle, the first option taken by your doctor (for it is he/she you need to tell, second only to your partner) will probably not be sessions with a sexual counsellor, group therapist, or perhaps relationship guidance, although any or all of these may ultimately have a role to play.

Instead, your good old British G.P. will first look carefully at your medical records, to see if you have one of the complaints sometimes associated with erectile dysfunction (as he will no doubt be thinking of it). These include diabetes, heart disease, some men's cancers, Multiple schlerosis (M.S.) and raised blood pressure, and a few others. Unfortunately some drugs including prescribed, social (such as alcohol and tobacco) and downright illegal (list too long to include) can also have the undesired effect. The other thing your doctor will know about you (this is why he is the best choice of confidant) is whether you have recently undergone any surgery or injury which may account for your difficulties. There will always be some for whom there is no physical cause and worry, stress or overwork being the problem. It could be worth you reading the piece about dealing with stress on this site.

 
There are many treatments available for the underlying causes of impotence and some may involve a change in lifestyle, referral to a specialist, or counseling from someone trained in helping men to deal with this disorder, surgery or drug therapy. You will be guided toward what is most appropriate for you.

 
Just to clarify recent press coverage regarding the wonder drug, "Viagra". It is available on NHS prescription at normal prescription cost only to men who fit certain criteria. Your doctor may decide that this would help you even though you are not in the qualifying group, in which case he may be willing to give you a private prescription. This means that you will have to pay the full price of the medicine to obtain it, although you will not be charged for the private prescription as you normally would. Just to dispel one final myth, erectile dysfunction does not prevent you from fathering children so be aware.

- Chris Bradley