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. 
ED used to be something most men could barely admit to themselves, much less discuss with their partner or doctor. But the arrival of drugs such as Viagra (sildenafil), which help at least 80% of men with ED achieve solid erections, changed that attitude in a hurry. The important thing is that many men now openly talk about their erection troubles with their doctor. ED can be a dipstick for your health -- an early warning sign of serious health problems such as high blood pressure, heart disease, and diabetes. By making healthy choices, you can avoid ED and heart disease. More than 25% of 80-year-old men still enjoy great sex regularly, so you are never too old for great sex.
Gray-haired men soaking in Jacuzzis overlooking canyons, thumbing through the morning newspaper in their thick reading glasses, cuddling their wives on gently swaying hammocks while drinking sensible glasses of cabernet...the classic erectile-dysfunction commercials of the past 20 years were pretty clear about who they wanted to reach. Ever since, those iconic images have defined who we as a society assume are in need of penis pills: men of retirement age.
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.
Remember those cultural messages we discussed earlier, about how men are wild sex aliens from the planet Weenus? Well, men are raised hearing those messages, too, and they can end up screwing with their sexual self-image —for instance, they can lead men to obsess over their own virility, and panic about impressing a new partner, until they've thought their boner into a corner and can't get an erection. Performance anxiety is one of the most common culprits behind lost erections, especially among younger, less experienced men.
There are many factors that can lead to ED. “Psychological causes of erectile dysfunction in young men can include performance anxiety, guilt about sex in general, guilt about having sex with a particular partner, feelings of anger or resentment towards a partner, or simply finding a partner undesirable,” said Carole Lieberman, MD, a psychiatrist on the clinical faculty of the UCLA Neuropsychiatric Institute in Los Angeles.

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Performance anxiety: Perhaps the most common cause of erectile problems among younger guys is performance anxiety. Many cultures place pressure on men to be the "experts" when it comes to sex, which can make men feel like they have to be responsible for sex or know how to please their partner every time. This pressure can be stressful and make it more difficult to get or maintain an erection. 

Some men have had success by using natural supplements to improve their erections. "There are also natural remedies that can be used to improve erectile dysfunction," says Dr. Axe. "This includes herbs such as ginseng, horny goat weed, maca root and ginkgo biloba. You can also try supplementing with L-arginine, DHEA and niacin. If you choose to try natural products to maintain a strong erection, it's still a good idea to discuss this with your doctor, especially if you are also taking medications."

Erectile dysfunction can be embarrassing and difficult to talk about for some men. Many men may feel like they need to hide their diagnosis from their partner. "Failure to communicate openly about erectile dysfunction can result in both partners drawing away from the relationship," warns Feloney. Remember that your partner is also affected by your problem; being open and honest is the best way to decrease fear and anxiety. Discuss options for achieving sexual satisfaction together, and be positive — most erectile dysfunction problems can be treated.


In an article on Men’s Health about things that wreck your erection, some examples of threats to an erection are sugar, lack of sleep, sleeping near a newborn baby, and lack of vitamin D. The common theme in the article is that reduced testosterone impacts your erection. Not all scientists agree with that. But there are definitely links between testosterone and erectile problems.
Don’t approach sex like a race. If you struggle with losing your erection quickly, you might be used to speeding things up. That’s counterproductive, though. Work on slowing things down and don’t be afraid of what happens in your body. By slowing down, you’re retraining your body to expect something different from sex. Right now, your body probably expects to climax in a very short period of time. If that’s not what you want, you have to train your body to take a little longer.

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While the end product is the same, the journeys take three very different routes. The most common erection is your reflexogenic erection, caused by physical contact. The second is your psychogenic erection, caused by audiovisual arousal or imagination (but no contact). The third and final is your nocturnal erection that comes when you are in the deep REM stage of sleep – and which, in fact, has very little do to with sexual stimulation.
Erectile dysfunction can be embarrassing and difficult to talk about for some men. Many men may feel like they need to hide their diagnosis from their partner. "Failure to communicate openly about erectile dysfunction can result in both partners drawing away from the relationship," warns Feloney. Remember that your partner is also affected by your problem; being open and honest is the best way to decrease fear and anxiety. Discuss options for achieving sexual satisfaction together, and be positive — most erectile dysfunction problems can be treated.
"This triggers the release of a neurotransmitter called dopamine, and it sends a chemical message from the brain to the penis, causing an increase of blood flow to the penis. The blood vessels leading to the reproductive system then relax and this allows increased circulation in the genital area. When you aren't aroused, the blood vessels in your penis are only partially open. But when your brain sends messages to your penis that you are ready for sex, the vessels open and allow more blood to enter the area. Because of the increased blood flow, blood gets trapped in the penis, which makes the penis expand and causes an erection."
About 5 percent of men that are 40 years old have complete erectile dysfunction, and that number increases to about 15 percent of men at age 70. Mild and moderate erectile dysfunction affects approximately 10 percent of men per decade of life (i.e., 50 percent of men in their 50s, 60 percent of men in their 60s). Erectile dysfunction can occur at any age, but it is more common in men that are older. Older men are more likely to have health conditions that require medication, which can interfere with erectile function. Additionally, as men age, they may need more stimulation to get an erection and more time between erections.
A “cycle”, as you put it, can certainly become established after a man experiences a number of erectile failures and begins to lose confidence. Once the idea of attempting intercourse produces anxiety rather than excitement, it becomes less and less likely he will successfully produce a reliable erection. Pharmaceutical agents can bypass this cycle, but it can also be extremely important to learn to be less fixated on erectile ability and instead focus on pleasure. Learning it is possible to give and receive enormous pleasure without an erection can be a vital aspect of a return to sexual health. This knowledge can lead to a reduction of the pressure you mentioned, as well as to a lifetime of sexual confidence and enjoyment.
"This can take some time, but it can help to stop a cycle of too much anxiety, followed by an erectile issue. It also can help you realize where you draw the most physical pleasure. People tend to focus only on the genitals when it comes to sex. However, they can experience pleasure all over their bodies. If they learn how to utilize this, it can be a resource for future arousal, fun and pleasure."
The American Medical Association (AMA) estimates that more than 30 million men in the US experience ED. And they expect that number to double by 2025, largely due to the fact that erectile dysfunction is affecting more and more guys in their 20’s and 30’s. ED in your 20’s is becoming more common, and that can signal some serious health risks to a growing number of young men.
Eat well: if you are willing to know how to maintain an erection, then you must understand that the key to a healthy erection is a healthy diet. One must not load themselves on fatty junk food or eat ready-made meals. Look out for something which is good for your heart, includes healthy fats, eating low cholesterol that is good for your diet. Erectile dysfunction is common for men of the age, and it is necessary the part of aging. One can avoid ED in simple ways.
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 this scenario sounds familiar, you're in good company. "In an ideal world, strong erections would come simply and naturally," says Caleb Backe, health and wellness expert at Maple Holistics. "However, due to a myriad of reasons, erectile dysfunction can set it at any given time or for a prolonged period of time for a large part of the male population. It is estimated that as many as 30 million men in the United States alone suffer from ED."
What young men should not do is take an ED drug like Viagra without a prescription, or mix them with other drugs. “This is a huge problem and not a safe practice,” says Penny Kaye Jensen, PhD, president of the American Academy of Nurse Practitioners. “Some young men are mixing ED drugs with mind-altering drugs, such as ecstasy or crystal methamphetamine. This is on the rise and is a potentially deadly combination.”

And be aware that the vast majority of physical or psychological causes of erectile dysfunction are temporary. They may go away as quickly as they occurred. But if anything is bothering you or your partner, you should seek out confidential, professional advice. There is no point in worrying and not doing anything about it. It may just make the situation worse.

Gray-haired men soaking in Jacuzzis overlooking canyons, thumbing through the morning newspaper in their thick reading glasses, cuddling their wives on gently swaying hammocks while drinking sensible glasses of cabernet...the classic erectile-dysfunction commercials of the past 20 years were pretty clear about who they wanted to reach. Ever since, those iconic images have defined who we as a society assume are in need of penis pills: men of retirement age.
If he's over 40 and not the most healthy, then years of "bad habits" could have provoked the incident; lack of exercise, shitty eating, alcohol abuse, drugs, tobacco, all damage our blood vessels. The same exact blood vessels that take the long juan from 6 to 12. Plus, you guys were taking a hot bath together, which also thins blood. So, right off the bat, there are six different variables you have no control over. If his exterior his A-ok, then lets dig deeper...
If you notice that it is becoming a common occurrence, then a dialogue needs to happen because then it is less about him going limp and more about his personal health. Recommend he see a doctor and let him know you are there for him. Our bodies are clever and are always giving us signs, both positive and negative. This could be a tipping point in his life.
So not only are erectile problems common, they're nothing for you or your special friend to be freaked out about. Check out the nine most common reasons that dudes sometimes can't get it up, and get ready to become the soothing voice of reason the next time the guy you're with has a hard time pitching his tent in your happy valley. Everything (and every penis) is gonna be fine!

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