Confused About Erectile Dysfunction? What It Is and How to Treat It

Erectile dysfunction (ED) refers to a man’s recurrent inability to maintain an erection that is adequate for successful penetrative sex.

An erection is influenced by physiological, hormonal, and cognitive factors. Your brain and your blood vessels work together to achieve an erection. When your brain, body, and penis aren’t on the same page, that’s erectile dysfunction.

Though ED can result from any of a wide number of causes, the condition itself isn’t rare and can be a sign of major health issues, including cardiovascular disease, anxiety, depression, prostate issues or a hormonal imbalance.

How common is ED?

Researchers have found records of erectile dysfunction and its treatments dating as far back as 1550 BCE. Today, erectile dysfunction is the most common male sexual disorder, with more than 52 percent of men older than age 40 experiencing it, according to the years-long Massachusetts Male Aging Study.

According to Tracy B. Gapin, M.D., F.A.C.S., a urologist who founded the Gapin Institute in Sarasota, Florida, ED becomes "more common as men age." It isn’t impossible for younger men to experience it, though; the age at which you may experience erectile dysfunction isn’t set in stone, and it isn’t the same for everyone.

Is ED preventable?

Yes, ED is preventable, and sometimes even reversible with the adoption of lifestyle changes. Dr. Gapin recommends that for a highly effective treatment option, patients adopt healthy eating, sleeping and exercise habits.

"It’s always better to fix the underlying etiology or cause of the disease rather than to just use short-term treatments," Dr. Gapin said.

This entails making your health a priority by scheduling regular exercise and rest, eating a balanced diet and reducing stress in your life. Also, make sure other medical problems such as cardiovascular disease and diabetes are fully addressed.

Removing erectile dysfunction from the picture permanently depends on the underlying cause, so you’ll want to work with your doctor to determine that.

How does ED affect my relationship?

Inability to perform during sex can strain a relationship, but let’s get one thing straight: ED and libido are two very separate concepts. Your ability to maintain an erection doesn’t necessarily signify how attracted you are to your partner. It’s important to communicate this, to eliminate any insecurities or doubts they may have.

ED can affect a relationship in a few ways:

• Anxiety. Not knowing how to handle having ED can leave you anxious about when it will happen again and may make your partner question your sexual attraction to them.
• Frustration. Not effectively communicating about ED will leave everyone involved frustrated and emotionally exhausted.
• Stress. Not being able to perform during sex can be emotionally challenging. On the other side of the experience, it can also be difficult to cope with not being able to help your partner as they struggle with ED.

Various studies have shown that most people who experience ED look for support from an online community before talking to their partners or doctors. Online forums present the risk of getting misinformation. It may be uncomfortable, but it’s important to be able to talk directly with whomever you’re having sex with. The more you communicate within your relationship, the easier it will be to find a solution, and the easier it will be to talk with a doctor.

Relationships can be strained by ED, but it’s a challenge that can definitely be worked through, for an even stronger relationship afterward. Giddy psychologist Dr. Susan Ansorge talks about creating normalcy in a relationship despite the occurrence of erectile dysfunction. Watch the video here to learn more.

Which ED treatment is right for me?

Before you dive into ED treatments, you should reference the International Index of Erectile Function (IIEF) to gain some insight about your specific erectile dysfunction. A shortened version of the index, the IIEF-5, is a list of five questions that is often used as a first step in evaluating ED. This will help you determine your next steps, as far as treatment options go, when speaking with your doctor.

Besides lifestyle changes, a wide range of effective and affordable treatments are currently available including the following:

• Wearable, medical-grade constriction devices, such as Eddie by Giddy^®
• Vacuum erection devices, or penis pumps
• Oral medications, such as sildenafil (Viagra), tadalafil (Cialis) and others
• Penile injection therapy

When conservative management with oral medications and optimizing other treatment modalities fails, then invasive surgery such as penile implant surgery can be considered.

The treatment plan you and your doctor ultimately decide upon may depend on the underlying cause of your erectile dysfunction, since heart disease, diabetes, obesity, depression and other conditions can directly affect your ability to get an erection. Some, but not all, treatments are covered by insurance.