Most men may not openly talk about their erection problems, but erectile dysfunction — when a man cannot achieve or maintain an erection well enough or long enough to have satisfying sex — is very common. According to the National Institutes of Health, 5 percent of 40-year-olds and 15 to 25 percent of 65-years old have ED. But while ED is more likely to occur as a man gets older, it doesn’t come automatically with age.

Who do I talk to about erectile dysfunction?


Erectile dysfunction is the inability to attain or maintain an erection adequate for the sexual satisfaction of both partners. At one time, doctors tended to blame ED on psychological problems or, with older men, on the normal aging process. Today, urologists say physical factors underlie perhaps 90% of cases of persistent erectile dysfunction in men older than 50.

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Stiffy Solution: The good news is, almost all of these conditions can be successfully treated if you catch them early on. And since erectile problems may be the first side effect your dude has experienced, seeking medical treatment for his erectile problems may be the thing to get him into a doctor's office. So if your dude is a well-rested, non-drinking, non-smoking, paragon of relaxation who suddenly can't get wood, urge him to talk to his doctor — his misbehaving penis may actually be communicating something way more important than "Not tonight, honey."

Something James, 26, knows for sure about his penis is that it won’t get hard when he’s sleeping with a woman for the first time. No, it has nothing to do with how attracted he is to her. It’s just a classic case of performance anxiety, caused by his personal fears about how awkward and uncomfortable the experience could be—which, of course, turns into a self-fulfilling prophecy.


UW Health urologists with advanced training offer medical and surgical treatment options for men and their partners affected by erectile dysfunction. There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. Your urologist will help determine the most effective course of treatment for your condition. 
Regular exercise and a diet rich in antioxidants is also the foundation of permanent weight control and diabetes prevention. Studies at the Duke University Diet and Fitness Center show that weight loss is strongly associated with better sexual function. Other studies show that diabetes is a major risk factor for ED, and that a healthy lifestyle prevents the disease and can restore erection function.
Though few things are worse for your erection than a cigarette habit, coffee can actually help you out below the belt. A study by the University of Texas Health Science Center at Houston found that men who consumed the caffeine equivalent of 2-3 cups of coffee per day were less likely to suffer from erectile dysfunction than those who preferred to wake up with caffeine-free beverages.
Despite some very recent legislative changes, opioids—ultra-strong narcotic painkillers—have never been more popular. According to the newest stats from the Centers for Disease Control and Prevention (CDC), enough opioid prescriptions are written each year to stock the medicine cabinets of every single adult in America (with plenty left over for teens, too). “These types of narcotics suppress testosterone levels,” says Dr. Köhler. That means they also mess with your hard-on. So does smoking, drinking a lot of booze, and any other bad habits that hurt your heart and/or vascular function.

Is erectile dysfunction gradual?


The answers to these questions, as well as physiological tests like an ultrasound or neurological assessment, can help determine the root cause of ED. Depending on the cause, different treatment options are available. Treatments range from medication, to hormone replacement therapy, to vascular surgery, to sex therapy and/or couples counseling. It sounds like you have ruled out many physical factors, in which case it may be useful to consider psychological factors. Often, couples counseling and/or sex therapy (as a couple or individual) can identify factors related to ED, help with communication, and improve sex for both partners. For a sex therapist, check out the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) web site and click on the "Locate a Professional" link.
You should speak with a doctor before trying any medication that's meant to help with stronger erections. If you're looking to go that route, there are plenty of prescription drug options that have been engineered to help with this issue. "In terms of conventional treatment for erectile dysfunction, medications called PDE5-inhibitors are commonly prescribed," says Dr Axe. "Four PDE5-inhibitors that have been approved for use in the United States include sildenafil, tadalafil, vardenafil and avanafil."
Don't forget mental health, either! "If you are experiencing stress at work, in your relationships or at home, open up communication about these issues," notes Axe. "Try natural stress busters like spending time outdoors, taking some vacation time for yourself or seeing a therapist. You also need to make sure that you are getting enough rest every night — seven to nine hours of sleep per night."
The "Am I Normal?" study examined more than 15,000 men in the UK. The average erect penis was 5.16 inches (13.1cm), while the average flaccid penis was 3.61 inches (9.2cm). But maybe take this with a pinch of salt – the "study limitations" section of the research paper states “relatively few erect measurements were made in a clinical setting and the greatest variability between studies were seen in the flaccid stretched length”. Yes, how hard is too hard to yank for a study?
If you’re a guy over 40, there’s a fifty-fifty chance that you have a problem getting or keeping an erection. Now, I don’t mean the sort of erection you saw in American Pie! I mean an erection that’s firm enough and long-lasting enough for sexual satisfaction. Every guy has times when he just can’t manage an erection. Still, if you’re having trouble achieving a satisfying erection more than 50% of the time, you’ve got erectile dysfunction (ED).

Which Erectile Dysfunction Drug Is Best?


Regardless of the reason, men spend a lot more time on their butts than they ever have before, shows data from the CDC. And all that sitting hurts your heart and your waistline, which saps your vigor below your belt, Dr. Köhler explains. You need a good 30 to 45 minutes of vigorous exercise at least 5 days a week to counteract all your chair time, experts say.
Alcohol: A couple of drinks can loosen your inhibitions and help you relax. But alcohol can also impair sexual functioning. Alcohol works on the nervous system by slowing down brain function, breathing, and pulse. Initially, the effect is often psychologically stimulating, since emotions and desires flow more freely. However, while alcohol may boost sexual desire by helping a person to relax, it can decrease performance, especially where erections are concerned. For this reason, it's best for guys to limit their alcohol intake to one to two drinks (or none at all) for optimal sexual function.

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