Dinner was appetizing, kissing was luscious, her scent was inviting, and the foreplay was stimulating. But when it came to showing her just who the man is, the little soldier remains in hiding.

Well there comes a time in every man's life where he must come to grip with the fact that little johnny is sometimes shy. This is the time where a man's self-esteem is most vulnerable.

Erection problems are vastly common among adult men. In truth, nearly all men experience occasional difficulty getting it hard or maintaining it. In several cases, it is a temporary condition that will go away with little or no treatment at all. While in others, it may be an ongoing problem that may eventually damage a man's self esteem and harm his relationship with his partner. Thus immediate treatment is required.

So just how would you know if you have a problem? Well if you have difficulty either having or keeping an erection for over 25% of the time, then it is a problem. At one time, erection problems were thought to be "all in the man's mind," just like women's PMS. Oftentimes, they receive unhelpful advice such as "don't worry" or "just relax and it will take care of itself." Doctors nowadays believed that when the problem is not temporary or do not go away on its own, physical factors are often the cause.

Erection problems, commonly known as erectile dysfunction or impotence refers to a man's inability to achieve satisfactory erections suitable for sexual intercourse. This is common to about 25% of the male population. Men who are experiencing repeated impotence tend to be middle aged men, mostly common at the age of 60. The problem may derive from a variety of causes, but aging is the most remarkable factor in erectile dysfunction associated to the decrease in male hormones. For about 20% of sufferers the problem is psychological. While one third is due to physically related diseases and the remainder is the combination of both causes.

In the past few years, the medical community had been committed to enhancing treatments for erectile dysfunction through a wide range of alternatives. But how should a man with erectile dysfunction is treated in this age of vacuum pumps, penile injection, medication and prostheses?

Just like in any other ailment, when a person begins having this problem continually, physical examinations is the first step in the treatment process. This is done to rule out injury, side effects from medicine or diseases and disorders such as diabetes, high blood pressure, high cholesterol, kidney disease, alcoholism, or multiple sclerosis.

A considerable part of the evaluation includes a detailed patient history that can give the doctor virtual clues regarding the patient's condition and the severity of the condition. Treatments should be tailored to the individual, with the severity and cause taken into consideration. Common treatments include medications, vacuum devices and surgery. Prescription medications such as Viagra, Levitra, and Cialis are commonly prescribed, as well as other options such as vacuum devices and surgery.

Vacuum are non-drug options. This is a device which creates a vacuum around the penis that draws blood into the penis and allows it to engorge, thus causing an erection.

Surgery can be performed in order to restore blood flow to the penile area if the vasculature (blood vessels) to the area is compromised. However surgeries have fallen out of favor in recent years because of the possible risk of infection due to such invasive procedures.

There are also instances when patients are advised to receive some form of psychotherapy to help alleviate their condition. Psychological therapy and behavior alterations are other options to treat erectile dysfunction. This process targets to alleviate the psychological factors that may have caused the disorder.