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.”

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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 reversal of an erection is obviously necessary, but as Dr. Michael Reitano, physician in residence at Roman explains, this can be the impetus for weaker erections. "Usually there is a balance between the chemicals that result in the increased blood flow that results in a firm erection and the chemicals that allow blood to exit the penis and return it to being soft," he says. "That balance is precise and occurs in a sequence that allows an erection to last only as long as needed. However, in someone who experiences a softer erection, the balance of the chemicals that make the penis hard and the chemicals that return it to being soft is off. The scale is tilted."
"One of the reasons erectile dysfunction increases with age is that the diseases that lead to it also increase with age," notes Dr. Feloney. Evaluating the causes of erectile dysfunction starts with your doctor taking a good health history and giving you a physical exam. Common medical issues that can lead to erectile dysfunction include diabetes, high blood pressure, hardening of the arteries, low testosterone, and neurological disease. Talk to your doctor about better managing these health conditions.
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. 

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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.
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?


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.
“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.
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.
Erectile dysfunction in older men. Because erections primarily involve the blood vessels, it is not surprising that the most common causes in older men are conditions that block blood flow to the penis, such as atherosclerosis or diabetes. Another vascular cause may be a faulty vein, which lets blood drain too quickly from the penis. Other physical disorders, as well as hormonal imbalances and certain operations, may also result in erectile dysfunction.
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.
“Although having sex at 70 is not the same as having sex at 20, erectile dysfunction is not a normal part of aging,” according to Michael Feloney, MD, urologic surgeon and expert on sexual dysfunction issues at the Nebraska Medical Center in Omaha. “You should still be able to have a satisfying sex life as you age." If you are experiencing erectile dysfunction, these 10 dos and don'ts may help. 

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