Erectile Dysfunction and Jewish Law

Information Sheet: Erectile Dysfunction and Halacha

Definition and Causes

For a normal erection to take place, the blood flow to certain areas of the penis must increase up to four times the regular flow, through relaxation of smooth muscles controlling these areas, while blood flow out of the tissues decreases. As a result of the increase in both the pressure and quantity of blood the penis becomes longer, wider and straighter. Impotence results from a failure in this mechanism.
Previously such a defect in the mechanism was attributed in most cases to psychological causes. It is now known that in over 80% of impotence the primary cause is organic (physical), but this is usually augmented by a secondary psychological cause arising from the man’s anxieties regarding his situation. Factors linked to erectile dysfunction include diabetes, vascular disease, tobacco, drug and alcohol use, and hormonal imbalances.


The Need for a Solution
One of a husband's main obligations is to provide pleasure and satisfaction to his wife. The implication of impotence regarding a good relationship (which the Talmud refers to as ‘domestic peace’) is clear. Impotence can also impede the requirement to procreate1.

The Solutions

There are a number of possible solutions:

  • Implants
  • Pharmacological agents such as Viagra
  • Vacuum Erection System (VES)

Implants
Until about fifteen years ago the only way to treat severe organic impotence was by implanting a prosthesis in the penis to replace the parts that fail to enlarge with increased blood flow.

Are implants Halachic?

The halacha rules out surgery if there is an alternative non invasive method. Furthermore, if the only option to treat his erection problem is a painful procedure, the husband might prefer artificial insemination. If his wife does not accept his decision and demands from her husband that he fulfill his marriage obligations, she may sue for a ‘get’ (halachic divorce) in a Rabbinical court.

Viagra
The past decade has seen the discovery of pharmaceutical medical treatment for organic impotence. Via pills or injections, the blood vessels of the erectile tisue are induced to operate properly for a time. Through Viagra, millions of patients have regained a measure of sexual functionality.

Is taking Viagra Halachic?
Since an impotence patient's life is not in danger and he is not bedridden as a result of his condition, his treatment does not suspend any mitzvot.

However, the basic halachic question that arises in connection with treatment for impotence is whether one can inject into the penis on Shabbat. The area concerned, the corpora cavernosa, is in some ways very similar to the hollows in the veins, because their sinuses too are filled with blood, but there is a difference: the normal procedure with intravenous injections is to first draw a little blood to verify that the needle has penetrated the vein. Such drawing of blood, which would constitute the melacha of chovel, is not necessary when injecting into the corpora cavernosa; therefore there is no need for concern.

Today functional impairment can be overcome in most cases, on condition that the treatment is applied correctly taking care to avoid complications. Some people experience bad side reactions after taking Viagra or similar pills. These pills are not prescribed for people taking nitroglycerine for a heart condition. As long as the pill does not damage his body to the extent that he would need medical treatment to correct it, he may use Viagra. The final result enables normal family life to continue in compliance with halacha.

Vacuum Erection System (VES)
In this technique, the penis is placed in into a vacuum tube and a pump creates a vacuum that causes an erection. To keep the erection stabilized after removing the penis, a narrow stretchable ring is placed on the organ close to the body. The user is given an option to try different size rings. This is a safe procedure and generally does not cause side effects.

Is VES Halachic?
The halachic problem is caused when the diameter of the ring needed is so narrow that it will trap the semen and not allow it to flow into the vagina. When he withdraws his penis and thereafter the ring, the semen will flow out. This is prohibited because it involves ejaculation outside the vagina, unless the semen is saved in a tube for the purpose of artificial insemination and his wife agrees to undergo the procedure. In such a situation Viagra is preferable unless it would harm him. By cutting the ring after ejaculation and allowing the semen to flow into the vagina before withdrawing he can also avoid the aforementioned prohibition. He may use round-tipped scissors to cut it to avoid injury.

What is the order of preference?
In terms of order of preference, the pill or the VES are the favored options. However, if the VES is not an option, and Viagra damages his body, then the injection procedure should be used. If the injection procedure does not work for him, or it is not accessible to him, and the last option is the implant procedure, then he is permitted to receive the implant.

In terms of order of preference, the pill or the VES are the favored options. However, if the VES is not an option, and Viagra damages his body, then the injection procedure should be used. If the injection procedure does not work for him, or it is not accessible to him, and the last option is the implant procedure, then he is permitted to receive the implant.

  1. Viagra or similar pills, assuming they are safe for him;
  2. VES;
  3. Injection;
  4. Implants.

 

 

1. Bereshit 1:28

 

 

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