I Just Found Out My New Boyfriend Has ED. What Should I Do?
Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection firm enough for sex. This condition impacts more than 30 million men in the United States.
However, erectile dysfunction doesn't just affect men. It can have a major effect on their partners.
How do I deal with ED in a new relationship?
If your partner has erectile dysfunction, it can interfere with intimacy inside and outside the bedroom. You may be confused, feel hurt and wonder, "Why can't my boyfriend stay hard?"
It's important to remember, you aren't to blame for your partner's erection issues.
"Don't take it personally," said Stephen Snyder, M.D., a New York City sex therapist. "Most often, it has nothing to do with whether he's attracted to you or not."
Don't let a manageable disorder that you're not responsible for derail a relationship you want to pursue.
"There are numerous factors that may be leading to ED symptoms," said Elizabeth Perri, Psy.D., a clinical psychologist and sex therapist in Chicago. "While boredom or lack of physical attraction are possible reasons, they are far less likely than the more common causes of ED, such as medication use, psychological factors, relationship stress and medical problems."
Why can't my boyfriend stay hard?
The causes of erectile dysfunction can be divided into five categories, according to Katherine Roker, M.D., a urologist at Yale University:
- Hormonal reasons. Low levels of testosterone, the primary male sex hormone, can lead to erectile dysfunction. Hormonal imbalances can result from conditions such as hypogonadism or as a side effect of certain medications.
- Iatrogenic issues. These are problems induced unintentionally by medical treatments. "[Iatrogenic issues] could be medications, surgeries or radiation treatments that are affecting the ability to get and keep an erection," Roker said.
- Neurogenic problems. Trauma, injury or surgical procedures that affect the nerves in the pelvic region can lead to neurogenic ED. For example, spinal cord injuries, pelvic surgery or injuries to the perineum (the area between the scrotum and anus) can damage the nerves and disrupt erectile function.
- Psychogenic problems. Stress, anxiety, depression and other mental health issues can also contribute to erectile dysfunction. Sometimes, psychogenic issues are referred to as "performance anxiety."
- Vascular issues. The most common causes of ED are vascular issues or problems with blood flow to the penis. "[Vascular ED] is usually secondary to other health issues like high blood pressure, high cholesterol diabetes and obesity," Roker said.
In nearly all cases of ED, there is a component of performance anxiety, she added.
"That doesn't mean it's all in your head," she said. "It means that stress and anxiety that can come from having failed sexual experiences can make it harder to get and keep an erection the next time."
How to date a guy with ED
As a partner of someone with ED, you can play an important role in supporting them, Roker explained.
"Having a supportive partner that's in tune with what's happening only makes things much better and easier," she said.
Experts we talked to shared six pieces of advice for someone supporting a boyfriend, husband or partner with ED or performance anxiety.
This is the single most important strategy for supporting someone with performance anxiety, according to Chris Kyle, M.D., a urologist with Oregon Urology Institute in Springfield.
"Open lines of communication are important for any relationship, and even more so in a relationship where one partner has erectile dysfunction," Roker said. "Having an open line of communication can prevent misunderstandings and hurt feelings, and helps you to come up with productive plans to have a healthy and enjoyable sexual portion of your relationship."
Kyle recommended opening discussions about your partner's ED with your clothes on and not immediately before or after any kind of sexual activity.
In terms of language to use to kick off a conversation, he suggested saying something casual, similar to, "Hey, I noticed we had some problems last night. What are some things we can do?"
2. Normalize the issue
As men get older, a higher percentage of them will develop erection issues, said Michael Werner, M.D., the medical director and founder of Maze Sexual & Reproductive Health in New York City and Purchase, New York.
"One thing I always say to men is you should expect that during your lifetime. If you are lucky enough to live long enough, you will have erection issues," he said. "Just like if you live long enough, you're going to need reading glasses."
Similarly, it can be helpful for a partner to verbally accept and acknowledge ED as normal, common and manageable.
"If both members of the couple say, 'This is just a normal part of the aging process. It's not catastrophic and we'll work on it together as a team,' that's very helpful," Werner said.
3. Don't criticize or compare
"Your feelings about your partner's ED are valid, but reacting in an angry or critical manner in the moment can make the problem worse," Perri said. "Your partner may even start to avoid sex, fearing your negative reaction if ED symptoms were to occur."
She stressed the importance of avoiding comparisons to previous partners or implying that this has never happened with anyone else.
"These comments are hurtful and can lead to feelings of inadequacy," she said. "No one wants to be compared [in a negative way] to their partner's exes, especially sexually."
4. Seek professional help
Suggest that your boyfriend consult with a healthcare professional, such as a urologist or sex therapist, Snyder suggested. An expert third party can help determine the cause of erectile dysfunction and recommend appropriate treatments or lifestyle changes.
Men are notorious for not seeking help until forced to, he said, so it can be helpful if the two of you find a doctor or therapist together.
5. Seek ED solutions
Werner often reassures his patients, "If you have a penis, we can get you an erection."
In addition, he suggested that lifestyle changes—get more exercise and limit alcohol consumption—can have a positive impact on erectile function.
6. Explore alternative forms of intimacy
Remember that physical intimacy doesn't solely rely on erections or sexual intercourse.
"There are many ways to be sexually intimate with a partner that don't involve the fully erect penis," Kyle said. "When you relieve some of that pressure, the performance anxiety may take care of itself."
To take the pressure off the penis's performance, Perri suggested trying to "broaden your sexual repertoire." She recommended exploring other forms of intimacy, such as oral sex, manual stimulation and sex toys.
Don't let a manageable disorder that you're not responsible for derail a relationship you want to pursue. Sometimes, men need a gentle nudge to seek help. And if they know you're there to help, the process can be easier for everyone involved.