Living With Erectile Dysfunction

Erectile dysfunction (ED) can be stressful for both you and your partner. Sexual relations are an integral component of the intimacy couples build over time. You may feel you are letting your partner down because of ED, and they may feel frustrated and unsatisfied with the quality of your sexual relationship.

Stress in the bedroom often spills over into other facets of your shared life. Even in the closest of relationships, couples have issues come between them. When ED causes stress in your sexual relationship, these other issues could begin to surface. You may find you are arguing over issues you never argued about before or discover your partner has a list of grievances you didn't know about.

Having ED does not have to contribute to stress in either your intimate moments or the rest of your home life, because treatments are readily available.

Overview of ED

Most men will experience ED during their lives, but for many men, ED is situational—caused by stress, worry, sadness, anger and so on—and not a common occurrence.

You experience ED when you are consistently unable to achieve and maintain an erection. The process of attaining an erection starts with mental and sensory stimulation, but more goes on behind the scenes.

When you are sexually aroused, your nervous system signals your penis to respond, which results in a combination of brain chemicals and local nerve nudges that cause the muscles of your penis’s corpora cavernosa to relax. This allows abundant blood flow into your penis, which gives you an erection.

When you have ED, you may experience trouble getting sexually aroused, which makes getting an erection difficult or impossible. If sexual arousal is not an issue, then blood flow to your penis could be obstructed.

Physical health conditions that can cause ED

If ED is a recurring problem, then it could be a sign of other underlying health conditions. Frequent ED is often the first sign of:

• High blood pressure (hypertension)
• Heart disease
• Diabetes
• High cholesterol
• Neurological disorders (multiple sclerosis, Parkinson’s disease, etc.)
• Blocked arteries (arteriosclerosis)
• Sleep disorders (apnea, insomnia, etc.)
• Damaging injuries to your spinal cord or pelvic area

You may also experience ED regularly if you:

• Have undergone prostate surgery
• Were treated for prostate cancer
• Have reduced levels of testosterone (low-T)

If you are suffering from ED, you should make an appointment with your primary care doctor. They can run tests to see whether physical health problems are contributing to your ED. Your doctor can refer you to a urologist who specializes in male sexual dysfunction and can find solutions for your ED.

If you have diabetes, you need to know that it can cause ED because uncontrolled blood sugar can damage blood vessels and nerves. This can limit or prevent you from having adequate blood flow to your penis for an erection. Stabilizing blood sugar levels through medication and lifestyle changes are steps in the right direction for overall health and minimizing the risk of ED.

If you have heart disease, then it is the likely culprit for your ED. Heart disease comes in many forms. Coronary artery disease (CAD) is perhaps the most common type of heart disease. Over time, a substance called plaque—made of fatty deposits that contain cholesterol, fibrin, toxins, calcium and other substances—builds up in your coronary arteries. This can lead to partial blockage or total blockage of blood flow throughout the body, including the heart. In cases where CAD is undetected, a heart attack is the first overt sign. However, a lot of men who have had heart attacks that required hospitalization reported they were having problems with ED.

High blood pressure, when the force of blood pushing against vessel walls is too high, can be a cause of ED. When arteries and blood vessels are damaged by constriction or blockage, the heart must work harder to pump blood, which creates greater pressure (and less efficiency) in vessels and arteries. ED is often the first symptom that blood pressure may be consistently elevated.

Mental health conditions that can cause ED

For a long time, most medical professionals believed ED was caused solely by mental health conditions. Now researchers know ED is caused by both mental and physical conditions, as well as lifestyle choices.

If you are experiencing a lot of stress in your life, you will likely experience ED at some point. Stress is normal but should go as quickly as it comes unless you're experiencing chronic stress. Stress releases a hormone called cortisol. High levels of cortisol can reduce the amount of testosterone you produce, which can result in a loss of interest in sex or difficulty getting sexually aroused.

Depression is also a mental health condition that can cause ED. Because depressive episodes can occur throughout your life, you are just as likely to experience ED when you are young as when you are older if the primary cause is depression.

Depression inhibits the pleasurable desires in life, including sex. Depression dulls emotional expression and mutes your desire to be close to your partner and to be loved and caressed. Depression can leave you feeling perpetually exhausted and fatigued.

Depression may make you start pushing your partner away when sex is initiated because you are not interested, are feeling worthless and hopeless or you are afraid of failure (ED) and rejection.

Anxiety can also cause ED. Generalized anxiety disorder is the most common form and is characterized by being fretful or worried all the time about everything. You have adrenaline (the "fight-or-flight" hormone) coursing through your body all the time.

As a result, you may continually be agitated, restless, irritable, worried, unable to sleep and unable to concentrate. None of these is conducive to feeling romantic and wanting to have sex with your partner.

Sexual performance anxiety, a specific type of anxiety caused by ED, can occur when you want to get and maintain an erection but are so worried you won't that your brain steps in and causes failure.

Lifestyle choices that cause ED

You may not have any physical or mental conditions causing your ED, but the kind of lifestyle you lead can cause ED. You may have ED if you:

• Are obese
• Eat an unhealthy diet
• Do not exercise regularly
• Use tobacco
• Abuse alcohol
• Use recreational drugs

Prevention of ED

Your best strategies for preventing ED are to make healthy lifestyle choices and to find successful ways to manage and eliminate stress. Some steps that may help include:

• Good nutrition
• Regular exercise (at least 150 minutes per week)
• Eliminating tobacco, alcohol and recreational drug use
• Meditation

In addition, make sure any health conditions you have are being treated by your primary care doctor and/or medical specialists.

When to see a doctor about ED

You should see your primary care doctor about your ED if you are experiencing it frequently. Be honest with your doctor about what is going on in your sex life. If your ED is because of a physical or mental health condition, your doctor can either begin treatment or refer you to a specialist.

If you want guarantees you will be able to get and maintain an erection in spite of ED, your doctor can refer you to a urologist who specializes in male sexual dysfunction. Several types of available treatments can improve your sexual performance and eliminate the frustration you and your partner may feel in your relationship.