It’s important to remember that you’re not alone if you’re facing challenges in this area.
In the U.S., between 30 million and 50 million men deal with erectile dysfunction (ED), and around 70% of men over 70 experience it, which involves trouble with achieving or maintaining an erection.
Two medical professionals shared insights with the Post about what contributes to this widespread issue and how to navigate it.
Factors Contributing to Erectile Dysfunction
Often, relaxation issues arise from poor blood circulation linked to arterial hardening, high blood pressure, elevated cholesterol, and smoking habits.
Nerve damage that interferes with brain and spinal cord signals to the muscles is a critical contributor as well.
“Achieving normal erections requires a delicate balance among the brain, hormones, nerves, blood vessels, and smooth muscles. Any disruption in these pathways can lead to ED,” explained Dr. Justin Homan, a urology expert at Cedars-Sinai.
Various disorders—metabolic, hormonal, and neurological—can impact these vital nerve signals.
For instance, diabetes can harm the nerves and vessels essential for erections due to high sugar levels.
Drugs such as those for hypertension, depression, and even chemotherapy can also result in ED, Homan noted. Moreover, factors like pelvic surgery, obesity, sleep apnea, chronic kidney or liver issues, and smoking can heighten the risk. Psychological elements—such as depression, anxiety, and stress in relationships—can either trigger or amplify ED symptoms.
Can You Have ED Even If You’re Attracted to Your Partner?
This scenario is actually quite common, according to urologist Dr. Jay Amin. He pointed out that it’s crucial to first rule out any medical or hormonal issues and work on reversible causes like blood flow disturbances.
Homan emphasized that desire and arousal don’t always align. “Men might still struggle with getting an erection despite finding their partner attractive if there are vascular, nerve, or hormonal problems,” he said.
Partners might mistakenly think the issue stems from a lack of attraction, which is typically not true.
Concerns about performance can create a cycle of avoidance that resembles apathy. However, Homan suggests that clear communication and medical checks can clarify that ED is often a health issue and not indicative of relationship problems.
Both doctors advise couples to talk openly about their concerns regarding ED. “Talking with your partner can relieve pressure and show them you care about their needs while actively seeking solutions,” Amin said.
Research indicates that men with strong emotional ties to their partners usually encounter fewer erectile issues and recover more quickly.
What Should You Do If You’re Experiencing ED?
Amin and Homan both recommend that men facing ED should reach out to their primary care doctor initially.
Your doctor can evaluate for underlying conditions such as heart disease and diabetes, and they can handle straightforward cases. If the ED continues or requires specialized attention, a referral to a urologist may be necessary, Homan explained.
It’s essential not to overlook ED, as it may signal more serious health concerns, particularly heart-related ones.
Fortunately, various treatments for ED are available.
Amin noted that options like direct-to-patient services, such as HIMS and Ro, have made access to medications much more convenient, even allowing patients to avoid in-person visits.
How Is Erectile Dysfunction Treated?
ED treatments depend on the root causes and patient preferences, but lifestyle alterations should typically be the first step, according to Dr. Homan.
“Adopting healthier habits is key—managing blood pressure, cholesterol, and blood sugar levels, losing weight, exercising, cutting down on alcohol, and quitting smoking can all enhance erectile function,” he said.
Addressing issues like sleep apnea and depression can further alleviate ED symptoms, and oral medications can help promote blood flow to the penis.
Psychological counseling may also assist in dealing with performance anxiety, stress, and depressive feelings related to relationships.
For more severe cases, vacuum erection devices can intake blood into the penis with the help of a pump. Some may find that tightening bands help maintain an erection.
Additionally, Homan mentioned intracavernosal injections and intraurethral medications that successfully yield erections in about 70% of patients.
In cases where other treatments fall short, inflatable or semi-rigid penile implants can offer reliable erections with high satisfaction levels.
Some newer treatments, like low-intensity shock wave therapy, platelet-rich plasma injections, and melanocortin activators appear promising, but further research is still needed.
