How to Treat Erectile Dysfunction (ED)
Here's what you need to know to improve Erectile Dysfunction (ED) and create a vibrant and magnificent sex life
Don’t Let ED Slow You Down
Whether you are 25, 52 or 76, you can have a fulfilling and fabulous sex life. Just because you get older, doesn’t mean you aren’t interested in sex. That’s right, you younger readers, your parents are still doing it! Thinking about sex, wanting sex, and being sexual are parts of being human that stays with us until the very end. It’s very normal to have sexual issues crap up as we age. For instance, many young men ejaculate much more quickly than they want. Many women struggle with desire when they have young children. Couples have a difficult time being sexual when they are exhausted from raising a young family or they are concerned about teenagers cruising by their room at 11 PM, hearing their parents making love. Women go through menopause and have trouble with dryness and other women struggle with sexual pain with penetration.
Many people feel sexual shame based on the culture or religions in which they were raised. But men suffer incredible shame, disappointment, and frustration when they have erection problems. We define erectile dysfunction (ED) as the inability to maintain a hard enough erection for penetration. And having ED or any type of erection problem or difficulty such as Peyronie’s, which is a curvature of their penis that often makes insertion impossible, can be absolutely devastating to a man’s self-esteem and to the emotional and sexual health of his relationship. If you are reading this, you are probably looking for a cure for ED or ways to treat ED. I wish there was an easy way to fix ED, but ED treatment is often more complex than taking a pill to get an erection. A successful ED treatment plan often involves both medical and non-medical aspects. I want to share a roadmap for navigating ED in a way that enables you to improve erection difficulties and create the vibrant, meaningful, and magnificent sexual intimacy you desire. Let’s dive in.
Understand the Difference Between Facts and Common Myths About Sex and Masculinity
Our society really does us a disservice when it comes to sex. We don’t talk about sex and facts about sex enough and this gives myths and inaccurate beliefs the opportunity to run rampant. Many of the things you have been taught and believe about sex are myths and not based in fact. The birds and the bees talk? Really, who came up with that name? Even calling it the birds and the bees talk furthers the cultural norm that talking about sex is some sort of stigma or secretive or bad thing. My clients often ask me what is “normal” because they want to know if what’s happening to them is normal and if they are normal. Knowing which beliefs are myths and which are facts helps you know what is normal. It’s also important because these myths contribute to sexual performance anxiety and ultimately, pave the way for ED.
Myths about masculinity also form our beliefs about what men are supposed to be. Toxic masculinity is a term often used to describe the negative traits of being male and it perpetuates some people's idea of “manliness.” Toxic masculinity expects men to aspire to be strong, powerful and “macho,”and doesn’t allow boys to have feelings or express emotions. It paints an image of what a “real man” is that is often misogynistic and unhealthy. Thank goodness our society is working hard to change these toxic myths, but they are deeply ingrained in the subconscious of many people and influence our beliefs, our feelings and our actions.
Let’s be myth busters about some of the common myths about sex and masculinity.
- A real man can get hard whenever they want: This is absolutely not true. There are many reasons why someone can’t get hard on demand such as fatigue, stress, not getting enough stimulation, medical causes and many more.
- You are responsible for giving your partner an orgasm through intercourse: This is absolutely not true. Everyone is responsible for their own orgasm and if your partner wants to have an orgasm, they might prefer other avenues to orgasm such as oral sex, a vibrator or you touching them.
- Bigger penises give the best orgasms: This is absolutely not true. And for some people, bigger penises can be more painful. If you are worried that your penis isn’t big enough or hard enough, well guess what, those worrisome thoughts are setting you up for potential ED.
There are many more myths about sex that contribute to ED or cause ED. I bet you can think of a lot more.
Deal With Your Feelings About ED
ED stinks. It’s an awful experience for both the penis owner and their partner. Both of you are impacted by it, and often, in very negative ways. It’s helpful for you and your partner to identify and accept the myriad of feelings you have about ED, about you not being able to get hard when you want, about erection problems impacting intercourse and about how you feel about yourself. ED is a self-esteem killer for men. Feeling bad about yourself is reinforced by all those cultural myths about what a man is supposed to be.
When we bury feelings, we make them worse. When we are alone with a feeling, it usually makes it worse. Unfortunately, the shame people feel about ED keeps them from talking about it. Don’t be afraid of the feelings because they are there, whether you acknowledge them or not. Write them down on a piece of paper. Journal about them. Think about them in the shower, while you are walking the dog, driving your car or catching the subway. Talk about them. Do whatever you need to do to honor just how bad you feel about having ED. And if you are feeling brave, share your feelings with your partner and ask them how they are feeling. Show them kindness and empathy and respond from a place of love, which is what you probably also want from them when you share your feelings.
Figure Out the Causes of Your ED
This may seem obvious, but many people don’t seek treatment from a qualified professional to diagnose their ED and identify the underlying causes of ED. Instead, they search the internet for “How to fix ED” or “How to cure ED” and they try many of the ideas they find, including ordering erection enhancing pills online. Unfortunately, the pills are only successful in 60% of people, and many others stop taking the pills for a variety of reasons. ED is also commonly related to other sexual problems, especially low sexual desire, and premature ejaculation and taking a pill to get hard won’t fix those other issues. Without really knowing the cause for ED, taking a pill is a band aid approach. Additionally, recent research has shown that sudden ED in people, especially younger men, can be an indicator of a potential cardiovascular event.
ED can be caused by a variety of medical or physical factors such as:
- cardiovascular disease
- high blood pressure
- injuries to the pelvic region
- insufficient blood flow to the penis
- low testosterone
- lifestyle choices such as smoking, drinking, not exercising, being overweight, and not getting enough sleep
ED can also be caused by psychological factors, often called psychogenic causes for ED. These are things such as:
- family and financial stress
- major life changes
- relationship stressors
- sexual performance anxiety
- other sexual problems
- previous sexual trauma
- sexual beliefs
- lack of knowledge about sex
- low sexual self-confidence.
The cause for your ED might be more than one thing. Even if you have a medical cause, you likely also have some psychological factors you need to address. For example, if you are one of the over 300 million people worldwide who have experienced ED in the past (which is probably anyone reading this), you likely will worry about whether your penis will get hard the next time you have sex. You also will probably be more focused on whether your penis is hard enough for intercourse of if it’s too soft the next time you have sex. That additionally worry will backfire and cause you to have further ED. The more you focus on your erection, the less you will be in tune with all of the wonderful sexual feelings that help with arousal.
Consequently, you can get or you lose your erection. For more information, watch my free training on the role of performance anxiety on ED.
Get Help From a Doctor or a Certified Sex Therapist
Many people try to fix ED by themselves. They read everything they can on the internet. They try supplements and special smoothies. They buy products that claim to fix ED. They use many of the products incorrectly. They take erection enhancing pills. They jelque (ouch! Please be careful as this practice can cause damaging micro-tears that can injure your penis). The ED market is like the wild, wild west. Many things are unregulated, and you can get your hands on just about anything. But we all know that we wouldn’t try to fix a broken arm or diabetes or a significant health issue ourselves, so why do we think we can fix ED? Why don’t we call in the professionals when we should?
Let me tell you a story about trying to fix something. Our society celebrates rugged, self-sufficient individualism. Look at all the home improvement shows on TV or the YouTube influencers telling you how to do everything yourself from changing your oil to launching a million-dollar business. I fell into this trap once. Well, actually many times, but let me share this one really costly time. I am a handy person and I decided to clean out the p-traps in our upstairs bathroom. I watched tutorials on how to do this. Easy peasy. Well, my hand strength isn’t the strongest and I didn’t tighten the fittings well enough on one of the traps. One day, my partner came home from work to find water leaking from the upstairs bathroom into our living room. It was so bad, we had to hire someone to replace the ceiling drywall, texturize it and repaint the entire first floor ceiling. Ouch! $3,000 later, I wished I had paid a plumber $150 to clean out the p-traps.
So the moral to that story is to call in the professionals when you need to. There’s a reason they are professionals – aka lots of training and experience. Do you really want to experiment on your penis? Double ouch!
Deal with Anxiety
One of the most helpful things to help ED is to understand the role performance anxiety or worrying about your sexual performance and stress in general plays in continuing your ED. For more information, watch my free training on the role of performance anxiety on ED. Once you start having difficulty with erections, it’s common to have lots of worry about whether or not you will be able to get and stay hard the next time you have sex. This sets us a dangerous cycle of performance anxiety which serves to help cause your ED in the future. Even if your ED is due to a medical reason, you’ll likely experience residual performance anxiety.
Your body is designed to allow you to get erections through the mechanics of allowing the smooth muscle tissues in your penis to relax so blood can rush into your penis and fill it up. In simple terms, that means to get and keep an erection, you need to be relaxed. If you are too stressed, the entire system is hijacked and you won’t be able to get a good erection or you won’t be able to keep it.
People who are really worried about their erections focus lots of energy during sex analyzing the hardness or softness of their erections and consequently, they become disconnected from all of the pleasurable oohs and aahs of having sex and they don’t notice or respond to the usual sexual feelings that cause arousal. And it’s the feelings of arousal and being turned on that get the party started with an erection and keep it going. Many people “Spectate” their sex. They are like fans on the sideline of a sporting event and the team they are cheering on or yelling at is their penis. Unfortunately, they become very focused on the play by play of their penis and become frustrated fans berating their team. All of their energy and focus is on spectating, leaving them without the erection they want.
It’s important to learn relaxation and mindfulness techniques to manage your anxiety both prior to and during a sexual encounter so you can stop spectating and worrying about your sexual performance. Then, you can be present and enjoy all of the good sensations that lead to the arousal that gets you hard.
Include your partner in your ED treatment
Work together to implement whatever non-medical or medical solution is best for you. All of the scientific research suggests you will be much more successful if you include your partner. What does including your partner in ED treatment mean? It means have them come to doctor’s appointments with you, jointly discuss treatment options and include them in implementing the treatments. You can discuss which pills is best for the two of you based on your joint desires because some pills allow for spontaneity and others require you to plan when to have sex. Including them sends your partner the message that you value them and your sex life. It helps both of you to support one another through this difficult ED journey.
Strengthen Your Relationship Outside of the Bedroom
That doesn’t mean figure out how to have sex in lots of other places outside of the bedroom, although that would be an added bonus. It means strengthening the closeness and connection in your relationship. We call this emotional intimacy. This is the feeling of closeness with your partner, like you can trust them and share yourself with them. It’s the feeling of deep connectedness and understanding in your relationship. An emotionally connected couple can share their thoughts and feelings freely and vulnerably with another, knowing that their partner will support them.
It’s knowing what’s going on inside of your partner – what they think, feel, want, hope, and fear, and it’s them knowing what’s going inside of you. It fosters a profound sense of security, trust, tenderness, and commitment within your relationship. You can let your guard down and be yourself. For many people, this can be one of the most rewarding parts of their relationship.
Emotional intimacy is not the same as sexual intimacy but both go hand-in-hand. A good sexual relationship is built on emotional intimacy and closeness. In other words, if you’re hoping to improve your sexual relationship, you need to first work on your emotional connection.
Research shows that emotional closeness heightens sexual satisfaction. Emotional intimacy creates a bond that fosters healthy sexuality because it helps you to play, express sexual desires and needs, tune in to your partner and it makes it safer to deal with any sexual challenges like low desire or erectile dysfunction.
In my clinical practice, many of the women I treat say they need to feel emotionally close and loved to be interested in sex, whereas for many men, sex is the thing that makes them feel close and loved, and for men, sex is often a prime path to feel emotional intimacy with their partner.
There are many simple things that you and your partner can do to grow emotional intimacy that don’t require huge amounts of time or money. It’s better to fully connect for 5 minutes every day than to wait until date night or a vacation. Anything that increases connection, caring and trust in your relationship will make it stronger and more resilient. Here are 3 things you and your partner can do to strengthen your relationship by building emotional intimacy:
- Do an unexpected act of kindness for your partner. This could be sending them a card at work, texting them “I love you” or “I was thinking about you right now” during the day, buying them flowers or their favorite snack, making them their favorite meal, taping a sticky note to say hello and I love you on their car dashboard or the bathroom mirror. The choices are endless. But the message is really clear. These acts communicate how much you care about them and make them feel special and loved.
- Give them a lingering kiss. John and Julie Gottman, celebrated authors and researchers in the area of relationships, recommend a 6-second kiss. I tell my clients to shoot for 6 seconds, knowing it may likely end up being a little shorter. This is different than a quick peck on the cheek. A longer kiss communicates “I love you.” I recommend doing this as a good morning kiss when you wake up or are headed out the door, or in the evening when you come home or right before bed.
- Ask your partner about their day and really listen to their response. You can ask them if they have a big or stressful day ahead of them and then ask them that night how it went. Or, you can ask if there’s anything thing you can do to help them out that day. The most important thing you can do as you talk is give them your full attention, so that means no phones, not technology and if possible, no interruptions by kids. The goal is to communicate how sincerely you care about their day. That makes anyone feel special.
And isn’t making your partner feel special a great way of showing them how much you love them?
Talk with Your Partner About the Elephant in the Room
Are you thinking “No way!?” Don’t be like many people and seek treatment or take pills in secret. Even more so, don’t stick your head in the sand and avoid intimacy, thus ignoring your ED. Your partner has likely already figured out you are experiencing ED. It’s impossible to hide it when you don’t have an erection.
So, talk with your partner about the elephant in the room. Talk with them about what you are going through, about your relationship, about your sex life, and about the impact of ED on your relationship and sex life. Be vulnerable. Gather up the courage to share your feelings. If you have been avoiding any type of intimacy because you’re afraid you won’t be able to get hard, own up to it and work to change. Your partner may be worried that you don’t love them anymore and that’s why you are having trouble getting hard. When people don’t know what’s happening, they sometimes jump to their own conclusions about it and when it comes to ED, they are often wrong. So clear the air and have an honest conversation.
People I’ve worked with are most hurt when they feel their partner shuts down and avoids all forms of intimacy and touch with them. They tell me they want to be hugged and kissed and touched in sexual and non-sexual ways that don’t involve intercourse. ED is a horrible thing to have to contend with and it can make you feel disappointed, frustrated, and angry. But that’s not a reason to ignore your partner’s needs
Try new things
Your ED may be fixable or unfixable, intermittent, or permanent. You probably won’t be able to do the same things you always did sexually. But, let’s look for the silver lining in this. Changing your sexual game can be a very good thing. Many people have sex the same way every time. The stories I hear from most people with ED are that they typically engage in minimal foreplay and head straight to intercourse. That’s not the best long-term plan but don’t let it worry you. Anyone can learn to be better at foreplay and can learn how to pleasure their partner in the ways their partner enjoys. I encourage you to expand your sexual menu beyond intercourse. Take the pressure off your penis by thinking of other wonderful and pleasurable things that you and your partner can do together that don’t require a hard penis. You might find that not having the pressure to have intercourse might be such a relief that you might get an erection.
Plan ahead for ED
Plan ahead for what will happen in those circumstances when no matter what you do, you can’t get the erection you want. It’s normal for all man to have ED off and on throughout their lives. Talk with your partner about what type of support you’ll need from them when you can’t get or stay hard. They may be shy or nervous about what they should say to you and may need guidance from you. They may be afraid to bring it up. Likewise, you can ask them how they want you to handle it. Remember, you both are on the same team and working together when sex doesn’t work out like you want it to is really important. Ideally, the two of you can game plan what other things you could do and have a mental list ready. That way, when ED occurs, you can gracefully pivot into another pleasurable sexual activity that doesn’t require a hard penis.
On a personal note, I’ve shared my personal story on many occasions. I really respect my husband for being open about our experience with ED and his willingness to share our story so that others don’t feel they need to live in shame and be secretive about their ED. We both want it to be acceptable to talk about sex so people can get the support they need.
My partner and I grew even closer despite erectile dysfunction. In fact, we credit erectile dysfunction for catapulting our sexual relationship into new heights. Because of ED, we tried things we may have been too shy or afraid to try and wowza, not only were they fun and pleasurable, but they made us feel even closer to one another. Once we let go of the expectation of having penetration as the goal of every sexual encounter, we started exploring other juicy things that felt really good to both of us. We expanded our repertoire. It was like sex became a diverse charcuterie board of options, not just simple cheese and cracker intercourse. Sex became a special place we went to together, not just a thing we did. Once you start talking, and I mean really talking about sex, about each other’s wants and desires and you free yourself to other ways to make them happen, you naturally grow much, much closer.
And not only did we grow closer despite erectile dysfunction, but our sex became phenomenal.
I wish there was a silver or magic bullet to fix erection problems, but there isn’t. What we did to create magnificent sex included a variety of things I teach in the Erectile Dysfunction Masterclass. We learned to talk about sex, what it means to us and what we wanted and needed sexually. We tried new positions and toys and other yummy things. We supported one another and were vulnerable. We learned and we grew. We pushed ourselves out of our comfort zone. We figured out what turned us on and off and how to set up the right environment for great sex.
I’ve read so many posts on social media groups and heard so many people distressed by erection problems. I’ve witnessed partners blame one another and want to end relationships because of it. Partners avoid sex and all forms of intimacy and couples become roommates, not lovers. All of this is heart-breaking because it doesn’t have to be this way. I’m not saying the journey to great sex with ED is always easy, but nothing that’s really worth it in life is usually easy. The reason I created the Erectile Dysfunction Masterclass for people and their partners is because I don’t want your sexual relationship or worse, your relationship to end because of ED or erection problems. I want you to use it as a tool to grow closer and create even better emotional and sexual intimacy. I want you to have that. Don’t you want that too?