They say penis size doesn't matter; that it's not how big the package is but how one uses it that counts. But what of cases where the man is well-endowed but it wouldn't stand in attention?

Sexual impotence, more commonly known as erectile dysfunction to health professionals, it can be a total inability to develop an erection or a tendency to maintain it only for a brief period. 1 out of 10 men experience it. It affects most men around the age of 60-70 years old. It rare cases, it hits as early as age 20. An erection is similar to a hydraulic system in the sense that blood rushes to and fills the penile shaft to make it rise up. Symptoms of impotence may include an inability to get an erection, the inability to sustain an erection, an inconsistency in the ability to do so, a tendency to sustain an erection for a short period of time, and the inability to ejaculate after intercourse.

Erection begins through either mental or sensory stimulation of the male organ. The brain will then send impulses to the muscles surrounding the corpora cavernosa, a chamber located at the top of the base of the penis, to loosen up and let blood rush in. This will make the penis expand. Another muscle, the tunica albuginea, will then trap the blood within the corpora cavernosa, thereby sustaining the erection.

Reasons for impotence may be classified as either physiological or psychological. Physiological impotence occurs when the erection is impeded at the beginning, middle, or end of the process. It fails to initiate when the systems necessary to get and/or maintain an erection malfunction. The brain fails to send specific chemical messages to the necessary muscles to initiate the erection. This may be an after effect of previous illnesses or accidents. Hormonal insufficiency, spinal cord injuries, radical pelvic surgery, multiple sclerosis and Parkinson's disease are only some physical conditions that may cause impotence. Failure for blood to fill the penis disables the it from sustaining an erection hard enough for intercourse. This is most commonly caused by artery blockages. Impotence can also be caused by the penis' inability to contain the blood in the corpora cavernosa within chamber, causing it to escape too quickly from the penis back into the body. Psychological impotence happens when erection fails due to too much thoughts and feelings occupying a man's mind during intercourse. Pressure from work, financial worries, frustrations; or feelings of anger and depression often contribute to psychological impotence.

Medications, penile implants or prosthesis, and sex therapy are the most commonly used treatment for impotence. Testosterone supplements are used for impotence caused by hormonal deficiency. Medications can either be taken orally or injected directly into the penis. Medicinal herbs can also be used as treatment. Prostheses such as internal penile pumps and penile sheaths are used in worst cases wherein medications or therapy no longer work. For cases of psychological impotency, constant counseling and therapy helps a lot to help let a man let go of anger issues and relax his mind.

In a society where the size of the penis and the erection is equated to one's virility and masculinity, sexual impotence is an embarrassment. No man would dare to announce that he can't get his member up for fear of ridicule. It isn't the penis size nor his expertise that defines a man, but rather how he treats women that will count in the long run.