Understanding the Difference between Low Libido and Impotence
I recently heard a story from a doctor friend of mind. He had a patient come in complaining of impotence. This patient was healthy and, when my doctor friend couldn't find a specific physical cause for the impotence, prescribed him Viagra. The man came back the next week saying that the Viagra didn't work. After some questioning, my friend found out why: the guy took the Viagra pill while his wife waited in the next room. The guy sat watching the evening news, waiting for his erection to come. By the time that the late-night infomercials were on, it was clear to him that the Viagra wasn't working.
Surprisingly, these sorts of stories are very common. Even though the websites and ads all say "you must be sexually stimulated to get an erection with Viagra", most men don't understand what sexual stimulation really means.
Sexual stimulation is the product of our libido: a complex system of chemicals and hormones. When our libido is going, it triggers a series of physical reactions. In men, penis cells dilate and blood starts pumping into the penis. In women, the libido causes vaginal lubrication and makes blood flow to the vagina so it becomes engorged and more sensitive. Without sexual stimulation (i.e. a healthy libido), erection is not possible.
Not surprisingly, a lot of men with erectile dysfunction are suffering from low libido. For these men, ED drugs like Viagra are not going to be much help. Viagra isn't going to work unless you are first sexually stimulated. Also not surprising is the fact that many men taking ED drugs probably don't need them at all. For example, the guy from my friend's story could have probably gotten an erection on his own if he'd just spent some time with his wife - even if it took some creativity or romance to get the libido going.
When I discussed this paradox with my friend, he said that ED drugs were interesting because they have a placebo effect on libido. Because men (and their partners) anticipate sex after taking the magic blue pill, they start thinking about sex and their libidos gets going. This alone can help improve erection quality.
On the other hand though, low libido and erectile dysfunction are often comorbid conditions and may share the same cause. For example, stress can devastate the nervous system and disrupt the natural hormones which are necessary for a healthy libido. Stress can also take its toll on blood pressure, which can lead to ED. A drug like Viagra won't help libido but it can help treat ED by getting more blood to the penis. Since libido is still low, then the erection may not be of the best quality though. That is why doctors will recommend that you work on your libido at the same time as you start taking ED drugs.
