Just Can't Get It Up?

Zachary Levin

My old friend Jake told me recently that he's under constant pressure "to keep things up." I assumed he was referring to his law school grades, but he lowered his voice and confessed he was suffering from what he called "the limp noodle syndrome." The poor guy sounded so defeated, you'd think he'd just failed the bar exam for the fourth time.

At 27, Jake's had a healthy, problem-free sex life for the past ten years -- maintaining an erection has never been an issue. In fact, if memory serves, he was the priapic jock in tenth grade algebra who was always embarrassed to stand up when the teacher called on him to solve an equation on the blackboard. Trust me, it wasn't because he didn't know the answer.

Just Can't Get It Up
Impotence, also known as erectile dysfunction, occurs when the penis does not become firm enough for vaginal penetration or loses firmness following penetration. It affects the sex lives of up to 30 million American men and their partners and may happen at any age, although it's more common in older men. In men of middle age and beyond, common causes of impotence are removal of the prostate and chronic disease of the lungs, kidney, heart, nerves, arteries, or veins. But a host of other causes that are not age-related can also cause the dreaded limp noodle, including the following:

  • Some prescription medications
  • Diabetes
  • Low testosterone levels
  • Long-distance bicycle riding
  • Injury to the pelvic region and spine

Alcohol and marijuana use can also be the culprit. Their use dulls the senses, diminishing the sensation a man feels during sex. Take it from Shakespeare, who said, "Drink provokes the desire but takes away the performance." Cigarettes are no aphrodisiacs, either. They contain nicotine, which causes the narrowing of blood vessels and thus prevents maximal blood flow to the penis.

What About Jake?
But what about Jake, who doesn't fall into any of the above risk categories and just got a clean bill of health from his general practitioner? Most likely, it's in his mind. "In the young age group, under 35, the most common cause is psychologic," says Jed Kaminetsky, M.D., clinical assistant professor of urology at NYU School of Medicine. And while the Mayo Clinic reports that psychological factors account for 10 to 15 percent of impotence cases in all age groups, this may be a conservative estimate.

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