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. 


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.

Can not drinking enough water cause erectile dysfunction?


Booze. Most men have learned: One too many cocktails doesn’t improve performance; instead, it can have the opposite effect. During a recent study of 1,506 Chinese males, the men who drank three or more drinks a week were more likely to have ED or some form of sexual dysfunction. “Men may find that alcohol decreases social inhibition, which makes it easier to approach a woman,” says Montague. “But alcohol is a depressant, and at higher quantities it can reduce both a man’s desire and ability to perform.”
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.
Occasional ED is common in all men, including young and healthy men. But if you have a persistent or recurrent problem with initiating or maintaining an erection and it's causing you or your partner distress, talk to your doctor. “Lack of nighttime erections is another cause for concern, said Wang. These occurrences serve to nourish the penis with oxygen and keeping the blood supply healthy, he explained. "Young men should get four or five of these a night. If you are not getting these and you are having frequent problems with ED, you need to check in with your doctor,” he recommended.
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.”

Now that he no longer has ED, Mher attributed the surgery to helping drastically improve his life. He told Mic that when he was dealing with the condition, most of his partners would eventually break up with him "because they couldn't understand" why he couldn't sustain an erection — a complaint that's common among younger men who struggle with erectile dysfunction. 


Now, it may be that all you need to do is tackle some of the issues outlined in these key tools. However, yes, that advice may also come in the form of a small magic blue pill. Sildenafil (Viagra) is a phosphodiesterase type 5 inhibitor, designed to promote blood flow to your penis and achieve a sustainable erection. It can sometimes be a short-term option to help you "get back on the horse" or a longer-term method (if there is an irreversible dysfunction) to help you enjoy a healthy intimate relationship.


Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
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.
"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."

"On the physical side of things, we most prominently have physical fitness as the No. 1 factor in erection achievement and sustainability," he continues "If a body isn't healthy, it's going to labor to send blood flowing properly and to function in many respects. Much like a car in need of a tune-up, a body which is out of shape or overweight is going to labor to perform functions — like causing an erection."

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The penis is the male sex organ, and the shaft of it is the longest part. The glans and head are located at the end of the shaft. The opening at the tip of the head when semen and urine come out is termed the meatus. Inside the shaft are two cylinder-shaped chambers called the corpora cavernosa and they run the length of the penis. They have blood vessels, maze, open pockets, tissue, and others.

How can I treat ED at home?


"If any of these physiological factors don't work properly, a man can experience weak erections," says Axe. "Problems maintaining an erection can be due to a number of issues, from hormone imbalances, to neurological issues, cardiovascular conditions, stress and issues with your mental health. There is not one clear way to explain erectile dysfunction — it depends on the man and his specific health 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.
Men with a healthy lifestyle and no chronic disease had the lowest risk for erectile dysfunction; the greatest difference was seen for men aged 65-79. For instance, men who exercised at least three hours per week had a 30% lower risk for ED than those who exercised little. Obesity, smoking, and excessive TV watching were also associated with having a greater risk of erectile dysfunction.
"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."
Like going bald, ED becomes more common as men age. According to the National Institutes of Health, about 5% of all 40-year-old men have ED and that number rises with age. Between 15% and 25% of 65-year-old men have ED. This is one of the reasons you see so many ED drug commercials during televised sporting events, Fox News programs, and other shows that typically attract men over 50 (just kidding, Fox).
Stiffy Solution: Obviously, no one should ever go off a prescribed med without consulting with a doctor. But there are erection-friendly alternatives to nearly every daisy-wilting medicine listed above. And your dude shouldn't let embarrassment keep him from talking to his GP about this — doctors are well aware that erectile difficulties are a possible side effect for all of these medicines; they just don't know which patients will experience what side effects, so they're waiting for you, the patient, to bring it up.
A very stressful or intense situation, or performance anxiety, could definitely make a man lose his erection. The pressure to perform could be psychologically too intense to keep a strong one. Another, lesser talked about erection killer is difficulty penetrating a partner during sex. It’s related to performance anxiety and stress, but also fatigue. If sex becomes tiring, fatigue will bring a quick end to an otherwise great night.

Does nitric oxide help sexually?


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.
The penis is the male sex organ, and the shaft of it is the longest part. The glans and head are located at the end of the shaft. The opening at the tip of the head when semen and urine come out is termed the meatus. Inside the shaft are two cylinder-shaped chambers called the corpora cavernosa and they run the length of the penis. They have blood vessels, maze, open pockets, tissue, and others.

How can I treat ED at home?


It may be that after trialling all the above, including the little blue pills, you are still having challenges. There are always other options. The only issue is that they tend to move further away from science, proven efficacy and fact and more towards anecdotal evidence and illegitimate science, all while preying on a natural desperation to find a solution. I would say, if you are at this stage, go and see your doctor to discuss a referral to see a urology specialist. It may spare you dabbling, unsuccessfully, with the various less-proven methods, including:
A dating death sentence: How men perceive their ED issues also changes with age. With older men, "they've had a life of good erections to look back on," Rose Hartzell, Ph.D., EdS, an AASECT-certified sex therapist with San Diego Sexual Medicine, told Mic. But with some younger men who haven't had much opportunity to be sexually active, "they might feel cheated" out of having a good sex life.
Condom troubles. Can the simple act of putting on a condom cause so much stress that it actually leads to erectile dysfunction? Sure it can — in fact, one recent survey of 234 young men conducted by the Children's Memorial Hospital in Chicago found that 25 percent had lost an erection while putting on a condom. “Putting on a condom requires a break from stimulation, and when it is on, it can reduce sensation,” says Dr. Montague.
But recently, slick, millennial-chic ads started popping up on social media from new men’s brands like Roman and Hims. Even though the (young) founders of these companies say they aren’t trying to market ED meds to your Tinder dates or male partners, clearly they are looping 20- and 30something guys into the deflated-D narrative for the first time ever.
"Stress and anxiety can adversely affect sexual performance and are common causes of erectile dysfunction,” warns Feloney. “Feelings of stress and anxiety can also lead to depression and a loss of interest in sex." It's important to get these feelings out in the open where you can deal with them. Issues that can lead to erectile dysfunction include fear from previous bad experiences with sex, family or work related stress, poor communication with your partner, and unrealistic goals and expectations.

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