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Some 150 million men worldwide and nearly 50 million men in India, alone suffer from it. Less than 10 % of men seek treatment due to fear of being branded as ‘sissy’, ‘namard’ (unmanly) etc and a whopping 90 percent struggle with their ‘curse’. Yes, indeed I am referring to every man’s nightmare, impotence, medically known as Erectile Dysfunction or simply ED. In the social and cultural constructs of sexuality, where male sexuality is defined mainly in terms of their sexual prowess, the inability to penetrate is seen as a ‘failure’ of manhood. It is therefore not a coincidence that the word impotence comes from a Latin word meaning ‘loss of power’.
In its most simple definition, impotence or ED can be defined as the inability to achieve and maintain a full erection during sexual arousal or sexual intercourse. Various physical and medical causes have been cited for ED- diabetes, high blood pressure, surgery, injury, medications, aging etc. All these cases in one way or the other restrict or weaken the flow of blood into the arteries in the penis and hence disable erection. In 1998 relief came to men suffering from this sexual dysfunction with the introduction of the ‘magic’ pill Viagra. Viagra was initially designed to be a heart drug until scientists found a useful spin off effect on the blood vessels of the penis. And voila, rest is history. Doctors started prescribing this drug to their male patients; men stormed pharmacies to buy this wonder pill which if taken an hour before sexual intercourse would help in the erection of the penis and lead to successful penetration.
But the joy was not to last for long. Soon men started finding out that the ‘magic’ pill did not work wonders for all of them or failed to cause erection when used a second time; those using it on a regular basis over time started showing side-effects such as- effect on vision, headaches, heart attacks, painful long lasting erections. While scientific explanations could be found for the side-effects people using the drug were baffled as to why the drug had such varied and inconsistent results. What was going wrong?
It is amazing, how evolution has created the wonderful biological system that we call the human body. One of the strongest responses in the body is the reaction to fear, called the fight-or- flight response. In the times of our ancestors physical challenges included facing dangerous animals. In such a situation they had two choices: to battle it out (“fight”) or to run away (“flight”). When faced with this anxiety/fear adrenaline is released throughout the body to help in this situation by increasing the heart rate and blood pressure, which helps to pump more oxygen to the brain and the large muscles of the arms, legs, and torso to help in the process of running or fighting. Part of the fight-or-flight response is thus to make sure that the penis stays soft (because a stiff penis would only get in the way with either running or fighting!).
These physical challenges have gone but our bodies have retained the biological reaction to fear and anxiety. It has been found that anxiety and depression are the main psychological causes for ED in men. In one study, 82% of men who reported moderate to severe erectile dysfunction also suffered symptoms of depression. Origins of anxiety and depression can be many. Among men the most common cause is excessive concern about sexual performance often referred to as ‘performance’ or "honeymoon" anxiety perpetuated through myths such as size matters, through comparisons of penis erection duration with images shown on porn films, through peer pressures of scoring and proving manhood by loosing virginity. The need to ‘perform’ makes sex a goal oriented process where erection and penetrating the woman is the ultimate product. The inability to do this provokes an intense fear of failure and self-doubt. Stress at work, financial worries, discordant family situations etc can cause mild to severe depression in men. Since for most sex is in the ‘mind’, a less than peaceful mind will make sexual ‘performance’ anxiety-ridden. The victim unarguably is the penis which fails to achieve full mast.
In a study on 191 patients in andrology clinics in Cairo it was found that psychogenic factors were the cause of erectile dysfunction in 74.4% of the investigated patients, of which, performance anxiety was the cause in 52.9%, and in 21.5% other psychological distresses were responsible.
Experiences of sexual abuse are also found to be causes of ED in men. In a survey conducted by The National Health and Social Life Survey (NHSLS) it was found that men who were sexually ‘touched’ before puberty had three-fold increase in erectile dysfunction and low sexual desire compared to men without this history. Since most men/women rely on the ‘mind’ to stimulate sexuale desire, memeory naturally plays a critical role. Sexual abuse, violence and even sexually humiliating comments/experiences create an emotional trigger of fear, or low self-esteem which instantly affects ED.
Performance anxiety, past experiences of erectile dysfunction, sexual abuse trigger off fear, anxiety during sexual intercourse which in turn activates the involuntary "fight or flight" response in the human body. Stressed relationships due to emotional incompatibility, lack of communication regarding sexual anxieties lower sexual desire and do not cause any sexual stimulations for the body to react with its chemical secretions. Worst of all patients who may have occasionally experienced some form of ED during intercourse now carry a rabid fear. The fear fuels further anxiety and literally prophesizes increased ED unless the individual addresses and resolves the fear in the mind.
No wonder Viagra was unable to create the ‘magic’ that it was meant to. Viagra works by blocking an enzyme found mainly in the penis that breaks down chemicals produced during sexual stimulation that normally produce erections. Viagra allows these chemicals of arousal to survive longer and improves erectile function. In their pre-occupation with ‘performing’ manhood and in their rush to ‘prove’ their masculinity what men seemed to have overlooked that even for Viagra to work an appropriate sexual stimuli is a pre-condition.
The magic of sex does not lie in a pill. What is more important is building a healthy relationship where sex is not a means to an end or a power game of ‘scoring’ through penetration and a touchdown involves longer and more ‘magnified’ erections. Masculinity itself is in fact the culprit. The notions, projections and expectations of what defines a powerful man, the singular pre occupation with penis/erection size as a measure of manhood etc are frankly the root culprits. In a world where few men actually express sexual anxiety, or reflect on its roots, do not open themselves to the vulnerability of being different/sensitive, ED is a logical curse. Especially in South Asia, the shrouds around sexuality make the problem more pronounced and it is little wonder that we see cities littered with quacks, hakims et all taking about ‘restoring virility’. Handing out placebos and hideous potions they make huge fortunes on the plight of the terrified and confused millions. Viagra being the ultimate dressed-up quack!
In the absence of emotional well-being, the sexual is reduced to a mental exercise. True both for men and women. However, men’s anatomy gives them away far more easily. Unable to access their own emotional depth and hence the underlying currents they have little else than a pill to turn to for help. Unless of course they find the courage to face their fears, shake off sexual norms and rediscover sexuality as a road of emotional bonding, penetration of intimacy rather than organs and the fun and frolic of sensual exploration.
Posted By Chaitali Dasgupta - 9:20 AM Saturday 04 February 2006
Very informative piece Chaitali. When I was in Sahil, we did a little survey on sex clinics in Islamabad and Rawalpindi. These were mostly run by quacks, claiming to be hakims practicing alternative methods. The majority of men were coming in with complaints of impotence and premature ejaculation. The only way for us to access these clinics was to pretend we were clients. The interesting thing was that our male and female researchers were sexually harassed at these clinics. All kinds of absurd prescriptions were handed over to the men. These included eating bear testicles (where on earth is one supposed to get them anyway, taking medicines from them which they claimed had lion whiskers, animal genitalia etc. Of course when we tested these medicines in the lab we discovered that in fact they had high quantities of testosterone in them.
Truly impotence is 'masculinities' curse to men. And redefining notions of the masculine is where the solution lies. Well said!
Posted by
Chaitali, thanks for a great read, as always. very informative. "rediscover sexuality as a road of emotional bonding"... well said. True for us all...to revisit and redefine our notions on sexuality, so essential to our spirit and well being.
Anusheh, all along the railway tracks, and at all small and big stations, as you travel up north, from the east coast, endless ads from such clinics are plastered for miles.. you don't see that much in the south, or elsewhere in the country.. wonder what kind of phenomenon that is..
Posted by
Dear dear chaitali
What a wonderful piece of writing. I have to tell you that i too am a statistic amongst the one you quoted. Strange admission for a man is it not? You see I was sexually abused as a little boy and it made me quite unable to have sex. Intimacy scared me and therefore there was no chance of ever having intercourse.
My wife was quite upset though she would not say much to me. But you can imagine how miserable I felt. Many many years of going to clinics and counsellors I could not help myself. Finally this year I came across a very sensitive counsellor who actually redefined my sexuality for me....very much like you say...I am now able to live a sexually active life and my wife is pregnant this year:-) I cannot tell you what a relief this is. There were times when I was ready to commit suicide. Its true that if men cant get it up then the social condemnation is so great that it can drive you to experience severe shame and feeling humiliated.
Thank you for this piece. I hope my story is helpful to you people. I have never shared it like this in an open forum before. Its interesting that a woman should write about this and not a man. I wonder if the men are scared.
Posted by
informative share, chaitali.tx.very true, we see so many quacks abound in a demand zone; almost as prolific as beauty/cosmetic surgery parlours...just indicative of the demand -supply aspects in stereo-typed situation manifests.And these aspects have been in vogue for so long in mental conditioning spaces.
redefining and repositioning; i wonder who is qualified to do it, however...everybody looks at things from their perspectives and conditionings and contexts of existence.Which can be equally ignorant of basics and contextual to their assumptions.
That, in my opinion, could hardly be the solution...different people use different levels of access and the levels of consciousness and the frames of reference therein are themselves an eternally evolving dynamic....for me, it is going back to one's roots in individual spaces and exploring them threadbare whenever one encounters any roadblocks in the way in any context...which would qualify as a spiritual quest.
It is like the allopathic treatment methods as against ayurvedic perspectives which delve further and further into the roots of issues.The depth of analysis of any problem and its proferred solution is always a function of the practitioner's personal evolution.
Posted by on February 4, 2006 02:42 PM
thats a very integral sharing gaurav and possibly as rare as they come...glad, authentic interventional services helped you.wish you and your wife all the very best in your parenting role.
Posted by on February 4, 2006 03:18 PM
My God Anusheh!!!! thats really unbelievable!!! how can they pass off like that so easily? so did u guys do anything about it? shouldnt these people be debunked??
Posted by
Here you go Radhika :)
Chaitali great post. I'm shocked to hear that 90% won't seek help. I wonder, in a world where men are getting more slick at looking good, using charm, language and many more frills at wooing why are they still so petrified of that little organ. And you know under the covers they probably all are. Do they really think the woman will write them off over a little misfire?
I think this is a great piece and if I was a man I would read it carefully & really think.
Posted by
Thanks guys! When I was researching on the issue even I was fascinated by the facts.
In any intimate relationship the primary thing is communicating and sharing your anxieties and fears. There is a tendency among men to keep their emotions to themselves, an outcome of the socialization of male sexuality.
Achieving erection is not the final climax of sex. Its a myth that sex equals erection. The climax of sex is reached when the partners are able to reach a height where all fear and all anxieties disappear. Sex is not a target oriented act, its a whole process which involves love, affection and above all comfort. Its only then that the magic can happen.
Gaurav and Anusheh thanks for sharing your experience.
Posted by
a very beautiful line , chaitali....about climax being reched when fear and anxieties disappear and absolute comfort manifests in shared space.thanx.
Posted by on February 6, 2006 11:50 AM
Well Gaurav yeah as I guy I'm a bit scared. I don't want my Penis to go limp when I'm with my girl. Its just kinda difficult to accept that sex does not equal erection or penetration. Most of the time when I put the search term sex on google I get definitionS which tell me that it is the process where the erect penis penetrates the vagina and that only when this happens does the woman get orgasm. So according to them without the erect penis I can't give the woman orgasm. All those articles in the women's and men's magazine talking about orgasm and how women feel unsatisfied when they don't get it. All this really puts pressure on us guys.
As guys we really don't get to know much about women's say on stuff like this. If we have more information on how women deal with ED in their men then perhaps we can get some relief fro this anxiety.
Thanks for the breather guys.
Posted by
How fascinating! I hope this will help some men to reconsider using Viagra blindly!
Posted by
Good topic. For many men it is good to know the research and also information to stay away from viagra. As you mention, men generally are in fear that they will not keep wife and lover happy and that fear is to do as you rightly say with member, its size etc. But I also want to share that women contribute to such fears. i have a friend whose girlfriend i think destroyed his complete self confidence in sexuality. He started drinking and avoiding women company for many years. After much pressure from me he said that she had made fun of him calling him bad lover and unable to make her happy. That is all he said and i am not sure what happened. But i saw so much anger in him with women and when i pushed him to see doctor he laughed it off.
i have not met him for many years now because he moved to another city. i hear he got married and i hope he is happy but i feel unless wife was very kind he must still have anger in him. So you see i am sure there are many reasons for men to feel scared of sexual act and women can also destroy their confidence.
Posted by
Dear Riaz,
In any intimate relationship respect for and an understanding of the partner's emotions, feelings is the most important. Why do you think having sex is also called as 'making' love. Because sex is one of the processes through which we get to explore and understand the emotional needs of our partners.
Emotional needs are not constant, they keep changing as we grow. If sex is an exploration of these emotions then we should not expect the nature of sex to remain constant either. Both partners need to keep this in mind.
Posted by
Chaitali,
what a lovely piece you have written. Your analysis of the problem and the solutions you have put forward must surely help people who are illinformed about this.
that boys who are abused before puberty develop ED is a thing I did not know.
in a normal man as age progresses, the sexual drive also decreases. this has to do with a lot of complex scenarios , both of the outer and the inner world. For such a man, mental health plays a better role than any pill I feel. Also like Anusheh's wonderful post a few weeks back, fantasies with the partner shou;d also help.
it is more fun and less problematic than a pill.
thanks.
Posted by
"Emotional needs are not constant, they keep changing as we grow. If sex is an exploration of these emotions then we should not expect the nature of sex to remain constant either. Both partners need to keep this in mind."
That is so well said Chaitali! men usually dont put in so much thought into the sexual activities. for them it is just about penetration and thats it. and it stays that way always. they need to learn to bring in some emotions, love, care, affection into it. and as you have rightly pointed out, one has to be very alert about the changing desires of ways of 'making love' as well.
i dont know why is it so difficult for men to understand this simple thing!
Posted by
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Very informative piece Chaitali, as always!
Some really interesting discoveries - A pill that was going to be used as a heart drug causing heart attacks!! Sexual stimulation is a precondition for Viagra to work!
The kind of pressure that hangs over guys for having an active sexual life is quite scary. Must say girls are better off that way!!