• Inability to have an erection at any time, either alone or with a sexual partner.
• Inability to maintain an adequate erection until completion of the sexual activity.

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If erectile failure:

• Is only temporary or occasional, the problem is probably not serious; all men go through periods of erection problems.
• Develops gradually and persistently, a physical cause is likely; this is generally the case with chronic impotence.
• Develops abruptly but you still have early-morning erections and are able to have an erection while masturbating, the problem probably has a psychological cause.

Sexual interest and desire may be normal or impaired, as may be your ability to have an orgasm and to ejaculate.

Course
When erection problems become persistent, they can affect your self-image and sexual life. If you have had persistent erection problems, "performance anxiety" can worsen your problem. A man who cannot have satisfactory intercourse may still have a strong sex drive, which can be frustrating. In some cases, for example where the problem is the result of transient factors such as a major life change or relationship difficulty, erection problems may clear up spontaneously once the causes have disappeared. In other cases, particularly where there is more than one cause and the problem has become a source of great distress, spontaneous recovery is less likely. Fortunately, many of the physical and psychological factors that cause erection problems respond to treatment.

Reviewed by Dr Werner Botha Specialist Urologist, Cape Town Medi-clinic.

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