As a relatively young man, Mher was in the minority of patients with erectile dysfunction, who are predominantly over the age of 50. But he's far from the only young man who's struggled with the condition. According to a 2013 study in the Journal of Sexual Medicine, an estimated one in four patients with new, onset ED are under the age of 40 — yet because we rarely hear about these men, they're left feeling embarrassed and alone.


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.
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.

As the nervous system of autonomic response, the erection can result in different stimuli that include the sexual arousal and stimulation which is not even under the control of the conscious mind. The absence of the nocturnal erection is also used commonly for distinguishing between the psychological and physical cause of impotence and erectile dysfunction.
Getting hard is also an overwhelmingly mental task. "Yes, men are saddled with the scheduled 'morning boner' and may experience an occasional random erection but by and large an erection needs to be achieved through mental stimulation," says Backe. "If you aren't turned on, your body isn't going to send more blood to the penis — bottom line. So, ultimately, you need a clean and clear mind for healthy and clear erections. Keeping the mind healthy will allow proper mental stimulation to occur at the right time."
Irrespective of how stage one was achieved, the next part is all about your plumbing. Courtesy of your nervous system stimulus, a powerful blood vessel dilator, nitric oxide, is released into the trabecular arteries and smooth muscle in your penis. This causes the arteries and the main bulkhead of your penis, the corpora cavernosa, to become engorged with blood. Helpfully, to keep this blood in place and maintain your erection, the ischiocavernosus and bulbospongiosus muscles of your penis constrict, effectively blocking the veins of your penis from draining blood out.

Don’t panic. That will only make it worse. Erectile dysfunction is common. In younger age groups it is more likely to be a psychogenic issue around performance anxiety (don’t seek to be like a porn star is a top tip). In men between the ages of 40 and 70, it is estimated that 50 per cent will have some degree of erectile dysfunction. In this age group, there may be a more of a physical issue around blood flow. In either case, consult your doctor and they will be able to give you some more advice. An erectile litmus test is, if you are getting nighttime or early morning erections, it is likely a psychological not a physical vascular issue.

Erectile dysfunction is about more than just the ability to get an erection (although that’s certainly a big part of it). It’s also about how hard your erections normally get, and if you can get an erection that’s hard enough and lasts long enough to have “satisfactory” sex. ED is really about how you (and your partner) feel about your sex life. And a lot of that has to do with how firm your erections get.

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.
The production factory of your semen is on an industrial scale, constructed from multiple locations in your genitourinary system. First there are the stars of the show, your spermatozoa, which are naturally synthesised in the seminiferous tubules within your testicles. During the ejaculation process, these then pass through your ejaculatory ducts and blend with fluids from your prostate, seminal vesicles and bulbourethral glands. This melting pot forms your semen as it arrives via urethral meatus (the end of your penis) to the cold light of day – or night.
There is no evidence that mild or even moderate alcohol consumption is bad for erectile function, says Ira Sharlip, MD, a urology professor at the University of California San Francisco School of Medicine. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions -- such as interfering with the normal balance of male sex hormone levels -- that can lead to ED.

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Use penile injection therapy. An alternative method that you may be advised on by a doctor is penile injection therapy. For this you will be trained by the doctor how to inject your penis with medicine that relaxes the blood vessels and promotes the blood flow that causes an erection. This treatment has been shown to be effective at treating a range of issues both physical and psychological.

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.
"I like to recommend that couples think outside the box," Dr. Hartzell said. "Intercourse doesn't always have to be the goal; look at sex as pleasure oriented vs. goal oriented." She suggested couples incorporating oral sex and manual stimulation into their bedroom routine. She also advised couples to "have fun" with their sex lives by not adhering to a specific schedule or routine: One woman she works with, for instance, leaves her partner's injection on her pillow as a subtle signal that she's in the mood to have sex. 

Erectile dysfunction is no laughing matter. And although it is not an easy thing to talk about, there are trained professionals who can give you good advice about what may be the cause of your current predicament. Many men like to talk about sex, but like women, they may find it harder to talk about sex when it is not going well. You won’t be judged or talked about at BPAS. We are here to help you with some of the more private things in life.

Andrew McCullough, MD, associate professor of clinical urology and director, male sexual health program, New York University Langone Medical Center. Lecturer: Auxillium. Research grant: Pfizer. Data safety monitoring board: Pfizer. Consultant: Slate Pharmaceuticals. Clinical trials: Warner Chilcott, Vivus, Lilly, Bayer-GSK, ICOS, Timm, Schering Plough, Aeterna.
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."
In the long term, the best thing you can do for ED problems is “stay playful and keep the focus off getting your partner erect,” says Goldberg. Experiment with new erotic scenarios and situations, like having sex in a different room, wearing lingerie, or role-playing your fave fantasy. Oh, and don’t limit yourselves to just intercourse either (which applies to all couples, whether or not you’re dealing with ED). “The broader your definition of sex,” Goldberg says, “the more sex you can be having.”
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.
The strength and frequency of your erection are an important indicator of your overall health. The blood vessels in the penis are smaller than arteries and veins in other parts of your body, so any problems like blockages, blood vessel dilation issues, or hormone imbalances will often show up as erectile dysfunction (or less firm erections) before something more serious like a heart attack or stroke.

Erectile dysfunction is no laughing matter. And although it is not an easy thing to talk about, there are trained professionals who can give you good advice about what may be the cause of your current predicament. Many men like to talk about sex, but like women, they may find it harder to talk about sex when it is not going well. You won’t be judged or talked about at BPAS. We are here to help you with some of the more private things in life.
Be intimate in new ways. If your sex is focused just on penetration and climax, you may feel under more pressure to quickly get and maintain an erection, which can make this harder to do. Try to find new and more varied ways to be intimate with your partner that are not just about sprinting to the finish line. Take time with each other, such as taking a bath or shower together or massaging each other.[9]
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.

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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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