I have a question about ED. I think this is fairly rare around my age (20), and I was wondering if it's generally a physical cause or a psychological one? It's happened 3 times in my life, but even so it tends to bother me. The last time I had a stomach problem at the same time, could this be related? Also, do you recommend the use of anti depressants to solve this problem?

Dear Ed,

To help others who don't know what "ED" means, it is short for Erectile Dysfunction, which means your penis doesn't get hard when you want it to, or your erection won't hold and it gets soft sooner than it should. Another factor here is how often the ED happens--if it's the majority of the time, then you're courting ED, if it's only once in a while, then your penis is simply reminding you that you are a normal guy.

Of the kinds of ED, some are strictly physical (from plumbing or neurological causes), some are strictly psychological, and some might be a combination of both. A really simple way to tell if your plumbing is working is if you get erections when you wake up in the morning, if you get unwanted ones during the day, or if you can get them when you are jerking off. If you do and they can last for at least a couple of minutes, then it's about 99% sure that your plumbing is OK.

If the erection failures were happening on a regular basis, I would want you to tell your healthcare provider about it and have a physical exam, as it could be an indicator of another problem. However, what you are describing is not reason for concern. As for your question about ED and a "stomach problem," I don't know what you mean by a stomach problem. If you were taking drugs for your stomach problem, they might cause an erection failure. However, it's more likely that you just weren't feeling well, and your erection had a perfectly good reason for being a no-show.

You might find it telling to know that on a large sex survey that I have done, only a few of the males said they ever had an erection problem, while many of the females said their male partners do occasionally had erection problems. I leave it to you to decide who's telling the truth.

The worst part of a misbehaving erection is not that it won't get hard or stay hard, but what the couple makes of it. A healthy response is to say, "No big deal--there are lots of other ways we can have fun sexually." Instead, a woman sometimes try to read a hidden meaning into it, e.g. "Maybe it's because he doesn't think I'm sexy," or the guy gets all stressed out and responds in strange ways instead of just saying, "Oh well!" and works to please his partner in other ways.

As for your question about anti-depressants, an occasional lost erection is not an indication that you are depressed. Maybe you are depressed, maybe not, but I can't speak to that based on what you say. Anti-depressants are not prescribed for ED and I would wonder about someone who prescribed them for that. (Note from the editor: Especially since most anti-depressants have unpleasant sexual side effects which often inhibit arousal in the first place.)

If you feel you are depressed, please speak to a licensed counselor or therapist. See if you can make progress that way instead of simply asking a healthcare provider to write you a script for anti-depressants. A number of us who are mental health professionals believe that anti-depressants are way over-prescribed. The exception is if you have an inherited and/or serious depressive disorder. If you do have a serious depressive disorder--which most of us don't--the therapist will probably know a psychiatrist who can evaluate you for meds in addition to your ongoing counseling or therapy.

Best wishes,

Paul
author of "Guide To Getting It On!"

if you are interested in Paul's book:
http://www.amazon.com/exec/obidos/ASIN/1885535694/goofyfootpres