Maybe you and the wife just got home from a romantic evening. Or you’ve successfully convinced that beautiful blonde you met at the bar to come back to your place. Regardless, you know where this is headed.
You playfully touched each other on the cab ride home, in between short but intense make out sessions. Not even in the house 15 seconds you’re on the couch, various articles of clothing being thrown through the air.
After a few minutes of some of the most passionate kissing you’ve ever experienced, you pick her up and carry her to the bedroom. Once there, you remove the rest of her clothes, and yours.
You work your way from her lips, to her neck, her breasts, and finally find yourself between her legs. After a few minutes of some of the loudest moans you’ve ever heard (good job!) you realize something is wrong…you’re not hard.
Not wanting her to know, you continue on, while you try all you can to get yourself ready for action. But still nothing.
“It’s your turn!” she exclaims, pulling herself up and pushing you back onto the bed, as she starts going down on you.
Still not hard, you’re starting to freak out. “Just relax.” you tell yourself. But as she continues, you can barely make half-mast.
After a couple more minutes, she looks up at you, disappointed, and asks, “Is something wrong?’
And then you mutter the words that all men fear…
“I don’t know. This has never happened before…”
Does this situation sound familiar? Has it ever happened to you, or “a friend”? If so, you might be suffering from erectile dysfunction (ED), also known as impotence.
Now, for most men, this may sound scary. And while the situation can certainly feel embarrassing, know that ED is much more common than most men like to admit. In fact, it’s quite normal. And, thankfully for us guys, ED is often easily treatable, and rarely, if ever, a permanent thing.
- 1 Erectile Dysfunction And Its Causes
- 1.1 Physiological Causes
- 1.2 Psychological And Lifestyle Issues
- 2 Dealing With Erectile Dysfunction
- 3 Treating Erectile Dysfunction
- 4 Erectile Dysfunction Misconceptions
1. Erectile Dysfunction And Its Causes
Erectile dysfunction is actually much more common than people think, affecting over 50% of men, according to the Cleveland Clinic.
The condition is more present in older men, with 40% of men age 40 suffering from the condition, while that number climbs the older you get, jumping to around 70% of men around age 70 or older.
However, more and more younger men are starting to experience impotence as well. In a study published in the Journal of Sexual Medicine, they found that nearly one in four men may suffer from some sort of erectile dysfunction, with almost half of those cases being severe.
ED is mainly defined as the inability to get or keep an erection firm enough to have sexual intercourse, and can cause stress, strain on relationships, and self-confidence issues.
There are two forms of ED or impotence: primary and secondary. Men with primary impotence have never had sufficient erections for satisfactory intercourse. This form of impotence is rare and often caused by extreme psychological conditions, such as intense fear or intimacy, extreme feelings of guilt and severe anxiety.
Secondary impotence, defined as the loss of erectile function after a period of normal function, is more common. Men with secondary impotence are typically able to engage in intercourse only 25% of the time. This form typically comes on gradually and is usually more easily treatable than primary impotence.
All men will suffer from ED at one point or another. That’s normal. If it becomes a persistent issue however, medical attention may be needed. Because, while not being able to get hard may seem like a big issue, erectile dysfunction is often a sign of a deeper physical or psychological problem.
Erections are mysterious beings, and are part of a very complex system involving the brain, nervous system, hormones, muscles, and blood vessels. A problem in just one of these areas can be responsive for erectile issues.
RELATED: How Erections Work, Explained
The number of physical conditions that can lead to ED are many. According to the Mayo Clinic, erectile dysfunction can be caused by:
- Heart disease
- Clogged or restricted blood vessels
- High cholesterol
- High blood pressure
- Too little exercise
- Metabolic syndrome
- Parkinson's disease
- Multiple sclerosis
- Scar tissue in the penis
- Some prescription medications, especially those that affect nerves or blood vessels
- Tobacco or drug use
- Sleep disorders
- Prostate cancer or an enlarged prostate
- Surgery or injuries to the pelvic area or spinal cord
- Hormonal issues, such as low testosterone
Let’s take a look at some of the most common causes of ED…
The endocrine system is responsible for regulating the hormones that control metabolism, sexual function, libido, and much more.
One common condition that affects the endocrine system is diabetes, because of its effect on the body’s ability to produce insulin.
A side effect of diabetes is nerve damage, which can affection sensation; as well as reduction in blood flow, and hormone levels.
These are conditions that affect the nervous system, and the brain’s ability to communicate with the reproductive system, and prevent a man from getting an erection.
Some of the most common neurological conditions include: Alzheimer’s or Parkinson’s disease, brain tumors, Multiple Sclerosis, and stroke.
Medications that affect blood flow can lead to the inability to get an erection, and cause ED.
Such medications include: alpha and beta-blockers, certain chemotherapy medications, depressants like Xanax or Valium, stimulants like cocaine or amphetamines, Prozac or Paxil, and synthetic hormones, among others.
Despite the fact that you may be experiencing ED as a result of one of these, you should never stop taking any medications without consulting your doctor.
Any condition that affects the heart, and the ability to pump blood, can lead to ED.
Clogged arteries, high blood pressure or cholesterol can all affect blood flow. Treatment can include prescription medications or certain natural remedies. However, if you suffer from any of these conditions you should consult your doctor first.
Smoking can be a big cause of erectile dysfunction, especially in younger, otherwise healthy men. In addition to all the other issues smoking can cause, the chemicals in cigarette smoke can cause damage to the blood vessels.
So even if you are aroused, if your blood vessels are damaged as a result of smoking, getting or maintaining an erection can be very difficult. Depending on the severity of the damage, quitting smoking will often reverse this.
Just like smoking, recreational drug use, including marijuana, cocaine, and heroin, can all damage blood vessels, and cause erectile dysfunction.
Lastly, as I’m sure any man who has gone to college can attest, alcohol can increase the likelihood of experience ED.
While chronic alcohol consumption can lead to a whole host of health issues associated with ED, even short-term overconsumption, or binge-drinking, can lead to erection issues.
Alcohol is considered a depressant, which means it can dampen the mood and decrease sexual desire. It can also decrease blood flow to the penis, which means maintaining or even achieving an erection can be difficult.
Psychological And Lifestyle Issues
While physical conditions are often the main culprit, psychological issues can also affect your ability to get an erection.
The brain's role in the erection process cannot be understated, as this is it starts. The desire for sex, and subsequently erections, begins in the brain, and the brain then sends signals to send blood to the penis.
Psychological issues like stress, depression, anxiety, or other mental health conditions can interrupt this process. Relationship issues and stress can also contribute.
While issues like stress can be attributed to a large number of things, like your job, money, or relationship problems, persistent erectile dysfunction with no physical issues can often be traced back to a prior instance of ED.
A single case of erectile dysfunction can lead to performance anxiety, or the fear that it will happen again. Fear of not being able to satisfy one's partner also contributes. All of this can lead to self-esteem and confidence issues, further exacerbating the issue.
Psychological issues are often the cause of ED in younger men.
Mental health issues, like chronic stress or depression, are things that don’t often get the attention they deserve. While we know the affects things like cardiovascular disease or diabetes can have on our physical health, we often bury our heads in the sand to the affect mental health issues can have on our bodies too.
While these things primarily affect the brain, their effect on the brain affects our bodies too. Stress and depression can cause aches and pains, chronic fatigue, loss of appetite, and insomnia, in addition to a decreased interest in sex.
It doesn’t stop there, though. These symptoms can further damage our bodies in other ways. For instance, a lack of sleep can lead to a number of problems.
When we sleep, our bodies go into recovery-mode. If you exercise or strength train, this is when your body goes to work building and repairing muscle, and the damage caused by exercise. A lack of sleep can lead to constant soreness and fatigue.
When we sleep is also prime time for hormone production within our bodies. Testosterone, growth hormone, and countless others are mostly produced while we sleep. If you’re chronically under-slept your production of these key hormones is going to be lacking.
Lastly, a lack of sleep increases the body’s production of cortisol, the stress hormone. Chronically elevated levels of cortisol can lead to fat storage, increased hunger, and difficulties losing weight.
And, all of this can contribute to ED. As you can see, it’s a vicious cycle.
RELATED: Can Porn Cause Erectile Dysfunction?
2. Dealing With Erectile Dysfunction
As we talked about earlier, erectile dysfunction is an issue that will affect almost all men at some point. As much as we’d like to think we can, we can’t always bat a thousand in the bedroom.
A once, or occasional bout of ED is nothing to worry about. If it’s a persistent problem though, there likely is something more going on.
The important thing for both you and your partner to remember is there’s nothing wrong with you, and no reason to freak out. Your sex life is not over. Being overly concerned about it is a catch-22. The more stress and anxiety you have about it, the more likely it is to continue to happen.
It’s also very important it stay open about it with your partner, because they may see your issue as a sign of diminished sexual interest in them, which can put further stress on your relationship. Communication is important because when your partner is involved, treating the issue becomes much more effective.
Lastly, don’t ignore it, hoping it will go away. Doing so will only make things worse.
Let’s go back to the scenario we introduced in the beginning of the article. What happens, if in the heat of the moment, you have trouble achieving an erection? What do you do?
Again, the first thing to remember, for both you and your partner, is not to freak out. That will only make the situation worse; with both of you ultimately blaming yourselves.
Second, it doesn’t have to ruin the mood. I’m of the belief that a woman should always come first anyway, so this is perfect time to switch the focus to her, and make things about her pleasure.
Lastly, understand that this could very well be an isolated incident. It may “have never happened before”. But that doesn’t mean you should ignore it. If it happens again, it may be time to have a talk with your partner about it, to see if there is something deeper at play, or see a medical professional.
3. Treating Erectile Dysfunction
The first step in treating erectile dysfunction is to determine if in fact it is a real issue through a simple exam by a doctor. This may include a physical exam, as well as blood and urine tests to check for signs of heart disease, diabetes, testosterone levels, and other physical conditions.
Other tests may include an ultrasound of the penis to check blood flow levels, an overnight erection test where a device is attached to the penis to measure erection strength while you sleep, and a psychological exam to determine whether depression or other issues may be an issue.
The most common and successful treatment for erectile dysfunction is medication, including prescribing Viagra, Cialis, Levitra, and Stendra. These medications work by enhancing the effects of nitric oxide in your body. Nitric oxide works by relaxing the muscles in the penis, thus allowing for more blood flow, and making it easier to get an erection once sexually stimulated.
While these drugs are the most common and effective forms of ED treatment, they may not work, or might be dangerous for those who take other nitrate drugs for chest pain, have low or high blood pressure, or suffer from severe liver or kidney disease.
For those, treatments may include:
- Injections — These are medications injected into the base of the penis that are designed to produce an erection in 20 to 40 minutes. Side effects include bleeding, prolonged erection (which usually requires an injection of a different medication to reduce), and formation of scar tissue at the injection site.
- Alprostadil urethral suppository — This treatment involves placing a tiny suppository into the penile urethra using a special device. Erection usually occurs within 10 minutes, and lasts 30 to 60 minutes. Side effects include minor bleeding and scar tissue formation within the penis.
- Testosterone replacement — Low testosterone can sometimes lead to erectile issues, and in these cases testosterone replacement therapy can help correct the issue. (Read more about testosterone and TRT)
- Penis pumps — Penis pumps are hollow hand or battery powered tubes that you place over your penis, creating a vacuum that pulls blood into the penis. Once erect, you place a band over the base of the penis to help maintain the erection. The erection usually lasts long enough for a couple to have sex. Side effects include possible bruising around the site of the band.
- Implants — This treatment involves implanting inflatable or semi-rigid rods into the penis that let you control when and how long you get an erection. This method is usually not recommended until all other methods have been tried, because of the risk of complications.
- Blood vessel surgery — This method is only used in a small percentage of men, and involves surgically bypassing obstructed blood vessels in the penis.
- Counseling — For erectile dysfunction caused by psychological issues, therapy or counseling is often recommended for both men, and their partners.
Natural & Lifestyle Treatments
Often times, doctors will recommend lifestyle alterations as a first step in treating erectile dysfunction because of the effect poor habits can have on erection quality.
Losing weight and becoming more physically active go hand in hand when treating ED. Being overweight can make erectile dysfunction worse, while being more physically active can not only help you lose weight, but can also help reverse some of the causes of ED by reducing stress and increasing blood flow.
- Balanced diet
- Sleep schedule
- Quit smoking and limit alcohol consumption
Smoking causes restriction of blood vessels, so quitting will help reverse the effects of ED, as will reducing alcohol intake. Substance use, and abuse, worsens erectile dysfunction.
- Monitor your medication
- Herbal remedies and supplements
And, if relationship issues are determined to be at the root of the problem, open communication with your partner, either together or with a professional, can help.
4. Erectile Dysfunction Misconceptions
It's A Normal Part Of Aging
Even though older men more commonly experience ED, that doesn’t mean it’s natural or normal. While it’s not uncommon, the older you get, for you to need more stimulation to become sexually aroused, complete sexual dysfunction is not normal. Hence, you do not have to “accept” ED as a natural part of the aging process.
It's Not Dangerous
While it’s correct, erectile dysfunction is not dangerous in and of itself, as we’ve learned, ED can often be the sign of a much bigger health issue. If you suffer from persistent ED, it’s best to get yourself to a doctor and get a full medical exam.
It Indicates A Lack Of Sexual Attraction
Yes, it’s true erectile dysfunction could stem from a lack of sexual attraction to your partner, it’s much more likely the cause is one of the many other factors we’ve discussed. Attraction does not begin and end with achieving an erection.
It Can Be Cured With Herbs And/Or Supplements
While there might be some supplements that can aid in treating ED, none of these will address the actual cause of your erectile dysfunction. Not only that, but supplement companies are not regulated by the FDA, meaning that they are under no obligation to disclose what is actually in their products.
It Means You're Less Of A Man
As men, it’s only natural that we tie our definition of manhood to our sexual capabilities. It’s part of our evolution. However, as you’ve read, ED is actually a fairly common issue, affecting over 50% of men (and those are just the ones who seek help).
It’s important to remember that sex is only a small fraction of what makes us men. And the best part? The only person allowed to define you as a man, is you.
Yes, ED may be an embarrassing issue that you don’t want anyone to know about. But you know what makes you much more of a man than just an erection? The ability to talk openly about your problems, with your significant other, your doctor, and ultimately, getting the help you need.
The important thing to remember about erectile dysfunction is that it’s rarely, if ever, permanent. However, effective treatment first and foremost requires action on your part. That means if something is going on, or you’re continuously having to deal with erection problems, don’t ignore it. A trip to the doctor is only going to help.
And, probably more importantly, make sure you communicate with your partner. Sex is one of the biggest causes of relationship problems, so an open line of communication is vitally important, not only for treatment, but for your relationship as well.