What really goes down when you can’t get it up.
No matter how confident, mature, and carefree you may be, there are plenty of opportunities for embarrassment for sex. And for those with penises in particular, one prospect in particular stands out as especially shame-inducing: Not being able to get it up. Erectile dysfunction (ED) is a common problem, though—and one, like all natural bodily occurrences—shouldn’t merit any pangs of self-reproach.
According to the Cleveland Clinic, one in ten men will suffer from erectile dysfunction in his life—ED being defined as the inability to become erect more than 50-percent of the time (the inability to get erect about 20-percent of the time is not unusual, and not typically a sign that something is amiss). Yet in spite of how common this struggle is, there are still so many stigmas and stereotypes surrounding it: The image of an older gentleman reaching for a Viagra in a TV show or movie has never been more than a punchline or insult. No wonder many have come to consider erectile dysfunction the biggest taboo in men’s health.
Since we can’t rely on sex education to cover all the bases of what might be considered a taboo topic by some, a bit of unpacking can make this not-so-shameful struggle a bit easier to parse.
Myth: Erectile Dysfunction Only Happens After a Certain Age
Fact: Erectile dysfunction is more common the older you get. But you don’t need to qualify for AARP to experience this struggle, either. One 2013 study showed that erectile dysfunction among younger men has grown more common, with one out of every four newly diagnosed patients under the age of 40, and 26-percent of all men under 40 experiencing ED. This study found that these younger patients were more likely to smoke than older patients—one lifestyle habit that increases likelihood of developing ED. The numbers do increase as patients get older—about 40-percent of 40-year-olds and 70-percent of 70-year-olds struggle with impotence, according to the Cleveland Clinic.
Myth: Erectile Dysfunction Is Always Psychological Because ED is less common in younger men, those who struggle with it before the age of 40 may assume that it’s a mental block that makes it impossible for them to perform—and many even assume that porn and masturbation are to blame for difficulties once a partner comes into the picture. While psychology can play a role in erectile dysfunction, it’s not quite so black and white.
The reality is that stress and anxiety can have a big impact on erectile dysfunction—to the point that one 2003 paper suggested that the best treatment could be found when a therapist and a urologist worked together to help a patient. But often, psychology isn’t the only factor at play. Erectile dysfunction can be caused by a wide array of factors, including, but not limited to: high blood pressure, type 2 diabetes, prescription drugs including antidepressants and blood pressure medicine, smoking, and alcohol. Point blank: It’s probably not just in your head.
Myth: Erectile Dysfunction Can Only Be Treated By Viagra
Yet again, pop culture convinces us that this is one health issue that can simply be solved by popping a pill and sliding back under the sheets. But the reality is that erectile dysfunction can have a number of different causes—and so it’s treatable in different ways.
Viagra (aka, Sildenafil) is undoubtedly the most common treatment for ED, but other medications like Cialis (tadalafil) or Stendra (avanafil) may be better, depending on what your doctor says. Some studies have also shown testosterone therapy to be helpful in the treatment of erectile dysfunction—though it’s not recommended for those with normal levels of testosterone. And because lifestyle factors like stress, smoking, drinking, and exercise can also play a role in your likelihood to deal with ED, you may consider behavior changes in conjunction with medication, or before trying medication. Your primary care physician can diagnose and help figure out an optimal treatment plan, though you can also see a urologist or endocrinologist.
At the end of the day, what’s most important to realize that as healthcare problems go, erectile dysfunction is perfectly normal (if a total buzzkill) and better yet, it’s treatable. If you’re struggling to get it up, don't let that difficulty get you down. Stick it to the stigma and talk about it—with your partner and your doctor—and you’ll find the solution that works for you.