Dear DR. Holmes:
What is the difference between impotence and erectile dysfunction? I suffered one or the other or both ten days ago when I won a strip tease dancer at one of the many stag parties I have been attending in honor of my coming marriage next month.
The dancer was 18, very beautiful and the crowd was cheering, so I cannot understand why I failed to perform.
I tried again last night with a 17-year-old prostitute who had never been used, but again nothing happened. I am getting desperate. Will Viagra help?
RAUL
Dear RAUL:Actually, erectile dysfunction and impotence are terms that describe more or less the same thing. One could say erectile dysfunction is merely the politically correct (and thus, scientifically more accurate) term for impotence. Scientists use the former because it is less judgmental, wreaks less emotional havoc on the diagnosee and requires three objective indices to be present before such a term can be used. Emotionallly distraught men like yourselves and occasionally even extremely irate women, especially if they feel betrayed, tend to use the latter to describe the inability to attain or maintain an erection hard enough to achieve coitus. The two other indices required are that this inability should have lasted at least six months and must have occurred at least 50% of the times coitus is attempted.
In other words, so far, you have suffered from neither impotence nor erectile dysfunction. It is too soon to tell. If you want to be scientifically precise, you can only diagnose yourself as such 5 months and 20 days later, if you fail to get an erection often enough to achieve coitus 50% of the times you try for it.
While I don’t know exactly *why* you didn't get an erection the last two times you attempted intercourse (first, with a beautiful 18-year old strip tease dancer and secondly, with a 17-year old prostitute who had never been used), but it was definitely *not* because you were impotent and *not* because you had an erectile dysfunction.
I think it was more because of a whole lot of other reasons--reasons that have affected countless men before and I am sure, countless men after you. The trick is not to be overwhelmed by these reasons, most of which can be analyzed, controlled and thus be temporary. The idea is to understand why these things are hapening to you and see if you can do anything about them.
Such reasons include:
(1) Fatigue--you mentioned going to countless stag parties lately. Late nights and rock hard erections do not exactly go hand in hand.
(2) Alcohol--To paraphrase William Shakespeare in his tragedy Macbeth: Liquor increases desire but decreases performance.
(3) Performance anxiety--Many men find it difficult to achieve an erection when someone in addition to his partner is present in the room. Multiply that some*ONE* to the number of cheering, jeering barkada-mates you have, commenting on your technique, teasing you about the size of your penis, your staying power, etc. etc. and most men would find it well-nigh *impossible* to achieve an erection, let alone make wild and terrific love to anyone, no matter how great a body or how sexy a dancer she is.
(4) Spectatoring--Unlike basketball which can be fun if you are cheering by the sidelines, sex is not a spectator sport. You cannot get a lot out of it if your energies are focused on watching yourself, rather than on enjoying the moment. You cannot make terrific love if, rather than reveling in each other, you worry about whether you will get an erection or not. Whether she is the love of your life or the lust of the night, she will not enjoy your penis inside her unless you focus on her--giving *her* pleasure, responding to the sight, sound and smell of *her*--rather than on your penis.
We sex therapists occasionally define and differentiate anxiety from panic by saying: "Anxiety is the first time you cannot get it up twice in one night; panic the second time you cannot get it up once."
It doesn’t have to be that way. Sometimes, a man cannot get an erection for one, two or three months *not* because he is impotent or has an erectile dysfunction but simply because he has panicked over nothing...simple because he has had a string of bad luck (for lack of a better term). He is under a lot of stress, his mother in law is in town for a visit, he has just been told his business is going under, and, he has had a lot to drink, etc. etc. All these things would make *any* man have difficulty getting an erection. If, added to this, is an over-reaction to this temporary, perfectly-understandable-under-the-particular-situation-he finds-himself-under setback, a man is setting himself up for a permanent panic called impotence.
So, I suggest giving your penis and, more importantly, your angst-ridden reaction to this very possibly merely temporary setback a more relaxed perspective by
(1) being with someone you really enjoy and maybe even care for
(2) not obsessing about whether you will have an erection or not (I know, I know, easier said than done)
(3) but just relaxing with and enjoying each other’s minds and bodies.
If you still have problems, write to me again and/or consult with a urologist and then and only then can you even start *thinking* about Viagra. Hope to hear from you again--whether the news is good or bad. All the best!
MG Holmes
(BodyMind Vol. 2 No. 19 - First posted: 9-9-98)
