Did Erectile Dysfunction Bring Valentine's Day to a Premature End?

Valentine's Day has come and gone for another year, and perhaps a day that started with high hopes ended poorly because you were only able to do one of those things—and it wasn't the former. If you're still recovering emotionally from a body blow delivered by a bout of erectile dysfunction (ED), take some solace from the fact that you are far from alone. More than 30 million men in the United States suffer from ED.

The reasons for ED are nuanced and obvious, surface level and bone deep, physical and emotional. Your primary care physician and/or a urologist can make sense of it all.

Date-night downers

Chances are at some point during your Valentine's evening, if it included dinner, you consumed salt. Maybe you even loaded up on it. Perhaps that's a habit of yours. Well, you'd be wise to get that under control.

A high-salt diet can lead to ED even without the development of high blood pressure, according to a 2019 lab rat study published in the American Journal of Hypertension. A 2020 study in the Journal of Sexual Medicine found high salt intake had a direct effect on impairing erectile function in lab rats, meaning that even before hypertension occurs, high salt intake changes how the blood vessels react to cellular signals.

In that case, ED drugs such as Viagra and Cialis may not work well for men who consume a lot of salt, because they rely on signals and pathways that may be hindered by salt intake.

And that steakhouse you took your partner to as part of the festivities? That could be behind your lack of Valentine's Day vigor, too. A handful of different studies suggest a correlation between red meat and erection trouble. A 2010 study published in the Journal of Sexual Medicine, a 2020 study in the Journal of the American Medical Association Network Open and a 2006 study in the International Journal of Impotence Research all found a diet rich in vegetables, fruits, whole grains and fish but low in red and processed meats was associated with better erectile performance. You've likely heard this called the Mediterranean diet.

But it's not quite enough to conclude that excessive red meat alone kills your erections. The problem might be the rest of your dinner intake. Ignore those greens and other vegetables at your penis's risk.

Was the clinking of glasses part of the buildup to a lovely ending to a lovely time? Perhaps the clinking of too many glasses? About that: Alcohol, as most people know, can cause erectile issues. Luckily, ED caused by alcohol consumption is a temporary condition that happens for several reasons, which, of course, is little consolation in the moment.

ED has so many causes

While you may have done something on Valentine's Day that ultimately affected your performance—it could have been a one-time occurrence—it's more likely the problem has been building. ED can be temporary or chronic, and the causes are myriad, some controllable and others not so much.

You may not realize your overall health, lifestyle choices and some prescribed medications can impact your ability to get and keep an erection. Despite these possible factors, however, ongoing erectile dysfunction may be a sign you have one or more of these serious health conditions that needs to be addressed:

• Heart disease
• Hypertension
• Atherosclerosis, or gradual clogging of the arteries
• Chronic obstructive pulmonary disease (COPD)
• Cirrhosis of the liver
• Kidney disease
• Peyronie's disease, or scar tissue that causes penile curvature
• Psychiatric disorders, such as depression, schizophrenia, anxiety and bipolar disorder
• Neurological disorders, such as stroke, amyotrophic lateral sclerosis (ALS), dementia, Parkinson’s disease and multiple sclerosis
• Prostatitis, or swelling and inflammation of the prostate; and benign prostatic hyperplasia (BPH), or an enlarged prostate
• Endocrine disorders, including hypothyroidism, hyperthyroidism, diabetes and Cushing syndrome
• Trauma affecting the penis, such as prostate surgery, vascular surgery and spinal cord injury
• Pelvic cancer treatment, including radiation or surgery for bladder cancer, colorectal cancer or prostate cancer

Some lifestyle factors may also cause ED, such as:

• Alcohol abuse
• Tobacco use, including smoking, dipping, chewing and vaping
• Poor sleep habits
• Opioids, including oxycodone, hydrocodone, fentanyl, heroin and morphine
• Cocaine
• Marijuana
• Anabolic steroids, or performance-enhancing drugs
• Obesity

Erectile dysfunction could be caused by the medications you are taking for health issues you already know you have. These medications include:

• Antidepressants
• Psychotropics
• Ketoconazole, an oral or topical fungal medication
• Beta blockers, used to lower high blood pressure
• H2 blockers, such as Tagamet, Pepcid AC and Zantac
• Tranquilizers, such as Valium, Ativan, Xanax and Klonopin
• Antihistamines

Treatments for ED

Given all of the various potential causes of erectile dysfunction, treatment is as individual as the sufferer. Knowing the heart and the penis are closely tied together, your doctor will likely begin his investigation by addressing your heart and vascular health. If your heart is healthy enough, lifestyle modifications, including diet, could be a starting point for treating ED.

Some evidence suggests exercise works for some guys whose ED might be lifestyle-driven. Walking, jogging, weightlifting, yoga and Pilates can help get the blood moving and the muscles relaxed.

If there's a psychological component to a man's erectile dysfunction, various therapies can help as part of an overall program. Everything from mindfulness and meditation to couples counseling and sex therapy have been implemented by therapists to help men and their partners get past erectile issues.

If your heart is healthy enough, lifestyle modifications, including diet, could be a starting point for treating ED.

Oral medications, including tadalafil (Cialis), sildenafil (Viagra), vardenafil (Levitra) and avanafil (Stendra), are available for many men. They have side effects and require some planning, but they do work for a lot of men.

Wearable, medical-grade devices are another solution. Constriction devices and vacuum pumps can effectively help men address the issue noninvasively. These devices—Eddie by Giddy^Ⓡ, is an FDA-registered Class II example—are placed around the base of the penis to constrict blood flow during sex and help maintain an erection. They are available without a prescription and come without the side effects of ED medications or the risks of injections or surgery.

Beyond that, surgical options are available for men who don't find relief from drugs or devices. Microsurgical penile revascularization—basically a similar procedure to a cardiac bypass—is used in men younger than age 50 whose ED may be caused by an injury with a localized arterial lesion. Penile implants are also available. They're invasive, to be sure, and are usually the last resort, but they can provide a lasting fix.

OK, so you have just less than a year to figure out what went wrong this Valentine's Day. We've given you a head start. Let's make sure next time, the violets are the only things that are blue.