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. 
Medications for erectile dysfunction don't work for everyone and may cause side effects that make a particular drug hard to take. "Work with your doctor to find the right treatment. There are still options for people who fail at medical treatment," advises Feloney. Alternatives to erectile dysfunction drugs include vacuum pump devices, medications injected into the penis, testosterone replacement if needed, and a surgical penile implant.
"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.
Instead, bench any P-in-V action for a beat and lower the stakes by telling him you want to fool around—not as a precursor to penetrative sex but just for the fun of it, suggests Natalie Finegood Goldberg, a sex therapist in Los Angeles who specializes in erectile dysfunction therapy. If this is a hookup situation, make it clear to him that you don’t expect or need him to have an erect penis for the two of you to have a good time, Goldberg says. You can always have oral sex, make out, or do some manual stimulation—because the worst thing you can do is freeze him out.

“With the success of Viagra-type drugs, there has been a tendency to start all patients with ED on one of these drugs and not look much further for a medical cause. But we now know that ED may be an early warning for heart and blood vessel disease, so it is important to look for common risk factors. These include high blood pressure, diabetes, medications, smoking, drinking, and drugs,” said Dr. Wang.


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).

What causes a man not to be erect?


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."
Another way to keep your libido up is to act when you do get aroused. This might mean going home at lunchtime to have sex with your spouse, or leaving a party early with your date if you’re both aroused. Staving off an arousal trains your body to disassociate arousal with erections. You want the opposite. You want to get and keep a strong erection when you feel aroused so that you can have better sex. So this is a great excuse to tend to your sexual needs as they come, if you can.
The third tip for how to keep an erection longer is to frequently switch positions during sex. You’ll like some positions, but hate others. Keep mixing it up. Return to the ones you like every so often, but spend just as much or even more time in the positions you don’t like. As long as the positions aren’t painful for either you or your partner, doing this will lengthen your erection.

"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.
If you find yourself with a man who is experiencing these problems, naturally, you might concern yourself with how to provoke and maintain their erection. This is often not not so much because you fear for your own personal enjoyment, but because you care about the pleasure and self-esteem of your partner. Follow these tips if you want to know more about how to handle a man who is impotent:
Another clue it’s psychological: He starts going soft around the same time your commitment level has shifted. In fact, sudden ED happens so often among newlyweds—there’s the pressure of becoming a married man plus, hi, the expectation of amazing wedding-night sex, says Dr. Trost—it even has a name: honeymoon syndrome. And a study published in the journal Translational Andrology and Urology found that once a guy’s sexual confidence takes a hit, he can get anxious about it happening again, and all that pressure creates a vicious cycle of erection fixation.
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.

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