When a man becomes unable to attain an erection, either some of the time or all of the time, he is suffering from erectile dysfunction, or impotence. This condition plagues nearly half of all men today, and in the last thirty years the quest to overcome this devastating problem has yielded some interesting results.

Although there are many possible causes for a man to become impotent, a very common one is the loss of sexual drive, or libido. At first glance the it seems like simple common sense-if a man is not aroused he will not be able to develop an erection. But it turns out there is hard science behind the chemical connection between testosterone levels in the body and a man’s libido. This connection has been known since the mid nineteenth century, when scientists observed the sexual behavior of roosters compared to their castrated counterparts. While the former was often disposed to chase the female roosters about, the latter showed little interest.

In humans, science has fairly recently concluded that similar processes are at work. The strength of a man’s libido is directly connected to the level of testosterone flowing through his blood stream. Testosterone is the hormone associated with sexual drive, and is also responsible for the typically male secondary sex characteristics involving body hair and change in voice. It is also responsible for the thoughts and fantasies a man has regarding sex. Now it is known that men with decreased testosterone levels have diminished libidos, and are also chemically inhibited from attaining an erection.

There are various ways in which a man can be subject to decreased testosterone levels. In a normally functioning body’s self-regulatory system, there is a back-and-forth between the sexual organs and the brain; if the testes don’t produce enough testosterone, the brain releases a chemical signaling the testes to speed up the process. But if there is are obstacles at the level of the brain, which prevent the chemicals from being released, a drop in the man’s testosterone levels will be experienced. An obstacle such as this could actually be the presence of pituitary brain tumors. When a doctor checks your testosterone levels, it is sometimes an indirect way of finding out if there is possibly a tumor present. This type of benign tumor is treatable, and rooting it out will likely also bring testosterone levels back up to par. As with any surgery, it is important to consult one’s personal physician and interview many different surgeons before going through with an operation.

Dysfunctions in the testes themselves can also create a drop in testosterone levels. If a man has had undescended testicles in the past, or infection of the testicles or testicular torsion, there is an increased probability that he will be subject to lower testosterone levels. Also, of course, the surgical removal of the testicles in order to treat prostate cancer will dramatically reduce a man’s testosterone levels and his sexual drive.

Testosterone therapy offers a solution to those who suffer from diminished levels of this hormone. It is important, however, to remember that very few men are actually afflicted by low levels of testosterone. Those who did undergo therapy for actually having low levels of testosterone experienced significant changes and improvements, not only in libido but in the health of their muscles, bones and the skin as well as the development of body hair and, for some who received the therapy during puberty, an enlargement of their genitals.

There are a variety of ways testosterone can be administered to the body, including pills, shots, patches, pellets and placing the delivering mechanism below the tongue. Unfortunately, testosterone pills often come hand in hand with severe liver problems. Placing a patch upon the scrotum is a much safer way to go, but requires the regular and inconvenient shaving of the area. The most widely accepted way of dosing testosterone is through injection. While this method achieves its aims well enough, some doctors are worried about the long term effects of putting the body through a roller coaster ride of artificially high testosterone levels right after the injection that sink to below normal after a few days.

For a man with normal testosterone levels who experiences impotence, there are many options to combat erectile dysfunction. One direction men turn, hopefully after having exhausted all other options, is prosthetic surgery. This procedure, which involves implanting material into the penis, is quite risky and can have bad results. One type of surgery provides the patient with a permanent erection, while a more advanced procedure allows the patient to bend it into shape at will. Another type of prosthesis is the inflatable penis. A downside of the inflation devices is an eventual deterioration in the penis’ flexing joints. With any penile prosthesis there is a high risk of complications including infection, unstoppable bleeding, scarring and perforation.

Another option for countering impotence is the penis vacuum pump. It is a medically legitimate method of temporarily being able to attain an erection, accepted by major insurance enterprises and recommended by some doctors. Yet even this has its drawbacks. Men who use the vacuum pump often complain about the loss of heated, spur-of-the-moment sex. There is a certain level of inconvenience in having to attach a ring around there penis, then place a vacuum on it, pump it, release the pump and finally engage in intercourse that is then limited to half an hour. It should be remembered that us of this device for longer than half an hour could result in serious injury.

Penis rings use a similar technique to the vacuum pump routine. They work by fixing a ring tightly around the base of the penis in order to trap blood flow. Once this is done, an erection can be sustained for a brief period of time, not to exceed half an hour lest, as mentioned above, serious injury occur. Used as an exotic enhancement device and sold in sex shops, these so-called “cock rings” have been known to cause heavy penile swelling. There are more medically sound rings available from doctors who can prescribe them, usually only to men whose impotence is caused by veins that do not function so well in trapping the blood during an erection. The side effects can include redness and erections that cease to go away over a protracted period of time.

Viagra® and Cialis® are drugs known to treat impotence, but what is not so commonly known is that they have absolutely no effect on the libido. Consider them the drug equivalents to the vacuum pump; their function is to increase blood flow to the penis. They work to break down the chemical substances that hinder the blood flow response during an erection. When taken some time before sexual intercourse, these drugs have been known to be effective. But it is important to discover the root cause of one’s impotence before beginning a costly drug therapy. It should be remembered that in terms of enhancing the level of testosterone or increasing a man’s libido, these drugs are powerless.