Erectile Dysfucntion (ED) is common sexual dysfunction for people with penises. Learn the causes, symptoms and treatment from a sexual health educator.
Having erection trouble from time to time is common for people with penises. But if you or your partner routinely struggle to get and stay hard, it may be erectile dysfunction.
What Is Erectile Dysfunction?
Erectile dysfunction (ED), also known as impotence, is when someone with a penis regularly struggles to get and keep an erection that’s firm enough for intercourse. It’s a common male sexual dysfunction.
Ongoing ED can cause stress, affect your self-confidence, and lead to relationship problems. Plus, it can signal an underlying health condition that needs treatment.
In short: ED isn’t only in your penis. It’s not necessarily all in your head either.
ED is more common among older people with penises but it’s neither a natural part of aging nor relegated only to older people with penises. About 15% of 20-39 year olds with penises report struggling with their erection at least occasionally.
What Causes Erectile Dysfunction?
Sexual arousal, including getting an erection, is a complex process involving your brain, hormones, emotions, nerves, muscles, & blood vessels. Therefore, erectile dysfunction can result from a problem with any of these parts of your body. Stress and/or mental health concerns also can cause or worsen it. Often, it’s a combination of physical and psychological issues.
Physical causes of erectile dysfunction include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High cholesterol
- High blood pressure
- Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Parkinson’s disease
- Multiple sclerosis
- Certain prescription medications
- Tobacco use
- Peyronie’s disease — development of scar tissue inside the penis
- Alcoholism and other forms of substance abuse
- Sleep disorders
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
Psychological causes of erectile dysfunction include anything that interferes with sexual excitement, including:
- Depression, anxiety or other mental health conditions
- Relationship problems due to stress, poor communication or other concerns
In addition to these causes, there are various risk factors that can increase your likelihood of developing ED. These include:
- Tobacco use
- Being overweight
- Certain medical treatments such as prostate surgery or radiation treatment for cancer
- Injuries, particularly spinal ones
- Medications including antidepressants, antihistamines, and those used to treat high blood pressure, pain, or prostate conditions.
- Drug and alcohol use
You might think aging is the biggest risk factor for ED. However, erectile difficulties are not a natural part of aging. What is common is for your erections to take longer and not be as firm as you get older, requiring more direct touch to your or your partner’s penis.
What Are The Symptoms of Erectile Dysfunction?
Symptoms of ED may include persistent:
- Trouble getting an erection
- Trouble keeping an erection
Remember: it’s perfectly normal to experience these symptoms from time to time. It’s only an issue when they’re ongoing.
You also may experience other sexual dysfunction including:
- Lower sexual desire
- Trouble having an orgasm
- Ejaculation problems, such as lack of ejaculation; small volume of ejaculation; or pain with ejaculation
What Should I Do If I Think I Have Erectile Dysfunction?
Because there are so many potential causes of ED, it’s important to check in with a healthcare provider you trust to get a better idea of what’s causing it. This provider can advise you on your next best steps, whether that’s medication, treatment for an underlying health condition, sex therapy, or some combination of the above.
Your healthcare provider will do a physical exam and take your medical history. Often this is all they need to diagnose ED and recommend treatment. If you have other health conditions or if you or your health care provider is worried about an underlying condition, you may need further tests or an appointment with a specialist like a urologist.
Additional tests may include:
- Nerve testing to check the nerves that go to your penis for sensation
- Blood tests to test for underlying heart disease, diabetes, low testosterone, or other conditions
- Urine tests
- Ultrasound to see how the blood flows to your penis
- Psychological exam
What Treatments Can Help With My Erectile Dysfunction?
First, you will treat any underlying physical or mental health conditions.
Then, depending on the cause and severity of your ED, you will have a variety of treatment options to choose from. These include:
- Oral medicines
- Penis injections
- Urethral suppositories
- Testosterone replacement
- Penis pumps
- Penis implants
Choose the treatment that makes the most sense for you, your partner, and your sex life.
How Can I Enjoy Sex With Erectile Dysfunction?
Despite what you’ve likely been taught, sex is so much more than penis-in-vagina (or mouth or anus). Sex includes all of the things that bring you sensual pleasure. You don’t need an erect penis in order to have amazing sex!
You can enjoy all sorts of sex without an erect penis including hand job, oral sex, and anal play. Plus there are lots of premium sex toys and products to help you have better sex if you suffer from ED.
Best Sex Toys For Erectile Dysfunction:
The Pulse SOLO and DUO Male Vibrator, can be used while flaccid or erect. Pulse focuses vibration on the frenulum, which is a very sensitive part of the penis. The Pulse SOLO can be used alone during masturbation. Meanwhile, the Pulse DUO can be used as a couples toy with your partner thanks to the vibration on the underside of the stimulator and the remote control.
We-Vibe Pivot Vibrating Ring
If you have trouble staying erect, try a penis ring. The We-Vibe Pivot Vibrating Penis Ring helps you have stronger and longer lasting erections. Rumbly vibrations provide hands-free clitoral stimulation when used during penis-vagina sex as well as vibrations to the penis. Connect the Pivot vibrating ring to your smartphone with the free We-Connect app for the remote control. Soft and stretchy, the Pivot fits penises of different sizes.
Laid P3 Penis Ring
If you are not interested in vibration, the Laid P3 Penis Ring is an excellent alternative. Designed to be worn around the penis and testicles, the Laid P3 penis ring helps to achieve a fuller erection and may delay orgasm by slowing the flow of blood from the penis. The Laid P3 also stimulates the testicles and the perineum when worn facing down.This premium penis ring is available in two versions. The regular version is firm yet elastic enough to stretch for comfortable wear. The stretch version can be worn around everything.
ON Power Glide
ON Power Glide for Him is a fast-acting gel that heightens sensation and increases blood flow for firmer, thicker and longer lasting erections. Power Glide is more powerful than other arousal gels because it is absorbed directly into the skin. It’s botanical formula with natural compounds, nutrients and L-arginine helps to dilate blood vessels and increase blood flow in the penis. You will feel tingling, buzzing, warmth, increased blood flow or a slight increase in girth.
Please keep in mind that every man is different.
Sliquid Ride Bodyworx Rise Stimulating Gel
Sliquid Ride Bodyworx Rise Stimulating Gel is a sexual stimulant that enhances the sensitivity of your penis. SRise Stimulating Gel gently promotes blood flow to the surface with peppermint oil and menthol, known to be natural vasodilators. This special formula is free of L-arginine, a common irritant found in other stimulation gels, and instead uses plant-based and organic botanicals that help soothe and excite delicate skin.
Aneros Helix Syn
An excellent prostate massager for beginners, the Aneros Helix Syn Prostate Massager has a thick layer of the finest silicone over a rigid frame for comfort and maximum pleasure. A tapered tip allows for easier insertion. The Helix Syn also features a narrowed neck for increased mobility. Also, the Helix Syn features a perineum tab that stimulates the perineum during the prostate massage as well.
LELO Hugo Prostate Massager
Meant for more advanced users, the LELO Hugo Prostate Massager is a remote-controlled premium prostate massager with 2 powerful motors for powerful orgasms. Two motors are located in the tip to stimulate the prostate and in the base to stimulate the perineum for dual stimulation. Hugo’s shape has been designed to perfectly stimulate the prostate for hands-free pleasure. Due to its shape, LELO Hugo also allows insertion and stays perfectly in place once inserted.
Erectile dysfunction is really only a problem if you think it is! While you sort out treatment, work on exploring what else brings you pleasure. Introduce new high-quality sex toys, try sensation play, explore BDSM, master giving sensual massage, or try anything else that’s been on your sexual bucket list.
Not sure where to start? Click here to schedule a call with Kait Scalisi, MPH, our Director of Education & Training.