What’s up Doc? Or rather, what isn’t up? Impotence, simply put, is the inability to get or maintain an erection adequate for intercourse. But, it is important to distinguish between an inability to get an erection and a loss of desire for intercourse. Lack of desire may be a testosterone deficiency and this can be determined by a simple blood test. It is also treatable by taking testosterone in a number of different ways. Impotence on the other hand is treated not with testosterone as much as it is with medicines that we have all come to know such as Viagra, Cialis or Levitra to name a few. One of the key questions I ask as a physician is whether the patient ever wakes up with an erection. If he does, then at least all the plumbing is working and that is a good sign.
Stress, fatigue, guilt, alcohol and other reasons can contribute to impotence. It can also be fleeting so don’t panic. Ask your physician for samples of one of the above medicines and give them a try. If they fail to work, then I would see a Urologist (a physician who specializes in this field). And, if you get an erection lasting for four hours, don’t call me. Call your wife.