Erectile Dysfunction
Erectile dysfunction (ED) is a common problem that most men never open up about. While many men feel it’s an embarrassing problem, you are not alone if you experience erectile dysfunction. About 1 in every 5 men over the age of 35 experience this issue, and about 1 in 10 men cannot have erections. It’s more common in older men but often affects younger men too.
We’ll be the first to tell you there’s nothing to be embarrassed about. The stigma attached to ED makes men less likely to seek help, and the main reason men don’t discuss erection issues is the fear of being ridiculed, rather than the condition itself. Just because no one talks about it doesn’t mean it’s not happening.
Does erectile dysfunction last forever? Is there anything you can do to fix it? Here’s what you need to know.
What is Erectile Dysfunction?
Erectile dysfunction is the inability to achieve or maintain an erection. You might have trouble getting hard, or lose an erection during intercourse. ED can be mild, moderate, or severe, and doesn’t always mean that you can never get an erection.
What are the Symptoms of Erectile Dysfunction?
If you have erectile dysfunction, you might experience:
- Difficulty getting hard enough for penetration
- Difficulty maintaining an erection
- Losing your erection during intercourse
- Loss of confidence during sex
What Causes Erectile Dysfunction?
There could be multiple contributing factors behind erectile dysfunction, and the cause can be physical, psychological, or both. Some of the contributing factors include age, weight (obesity), and cardiovascular health. One of the most common physical causes of ED is atherosclerosis (narrowing of the arteries).
Other contributing factors can include:
- Cigarette smoking or vaping
- Pain
- Pelvic surgery
- Pelvic radiation
- Pelvic trauma
- Penile abnormalities, e.g. Peyronie’s disease
- Neurological conditions such as Parkinson’s disease, multiple sclerosis, and stroke
- Spinal cord disorders
- Endocrinological conditions (thyroid disorder, hyperprolactinaemia, hypogonadism)
- Substance abuse
There can also be psychological and psychiatric issues, such as problems with self-image, anxiety or depression, and partner-related stress, guilt, or situational anxiety. Some medications can also cause erectile dysfunction, as can a history of sexual abuse.
Suffering in Silence
Erectile dysfunction often starts with denial. “I was drunk,” “I had a long day at work”: the list of excuses goes on. After a series of misfires, you’re confronted with the truth that something isn’t right.
Instead of doing what you’d normally do if another part of your body wasn’t working as it should, many men ignore the problem. They feel embarrassed and ashamed, and can’t talk to anyone about it, even their partner.
How Erectile Dysfunction Affects Your Relationship
Erectile dysfunction can have a big impact on relationships. Men with ED often stop initiating sex, worrying about their ability to perform. They may become distant and avoid physical contact for fear it might lead to sex.
The lack of intimacy can leave a partner feeling alone, rejected, and unattractive, and it can take a huge toll on their self-esteem. They might even believe you’re having an affair.
Partners often stay silent too. They worry about upsetting you by bringing it up, and fear the worst: that you no longer find them attractive.
What is Involved in Diagnosing Erectile Dysfunction?
When diagnosing erectile dysfunction, it’s important for doctors to check for underlying conditions. These include hypogonadism, diabetes, and dyslipidaemia. You can also talk more generally about your symptoms, lifestyle, and health.
Does Erectile Dysfunction Last Forever?
It can, if you stay silent and don’t get the treatment you need. But treatment for erectile dysfunction has come a long way, and for most men, ED doesn’t have to last forever. The first step in overcoming it is to identify its root cause, whether that’s physical or psychological.
What is the Treatment for Erectile Dysfunction?
Erectile dysfunction can be treated in several ways, depending on the possible cause.
Lifestyle Changes and Medical Management
If your ED has a physical cause such as narrowing arteries, your doctor might suggest lifestyle changes, such as losing weight and adding regular moderate-intensity exercise to your routine. If you have high blood pressure, they may prescribe medication to lower it.
Low Intensity Extracorporeal Shockwave Therapy (LiESWT)
Low Intensity Extracorporeal Shockwave Therapy, also known as focused shockwave therapy, has been shown to improve erectile dysfunction and erectile hardness scores. It’s most suitable for men with vascular-driven erectile dysfunction, where there’s a problem getting enough blood flow in, as well as keeping it in.
LiESWT uses low-frequency sound waves from a handheld applicator, which releases focused energy into the targeted tissue and promotes the formation of new blood vessels. It can have several positive effects, including increased blood flow, reduced inflammation, reduced calcification, and ultimately improved erectile hardness. Your pelvic health physiotherapist will help determine if this treatment is appropriate for you based on your history.
Sydney Pelvic Clinic provides LiESWT to help improve erectile dysfunction.
Pelvic Floor Physiotherapy
Improving pelvic floor function has also proven effective in treating ED. Your physiotherapist will give you specific exercises to strengthen or relax your pelvic floor muscles, improving the quality of your erections.
Sex Therapy and Counselling
If the cause of erectile dysfunction is psychological, sex therapy and cognitive behavioural therapy are effective treatments. Couples counselling can also help.
Other Treatments
Other treatment options include PDE5 inhibitor medications like sildenafil (Viagra), and testosterone replacement therapy.
Are There Any Home-based Treatment Options?
Physiotherapists can provide you with pelvic floor exercises to perform at home, but we recommend these as part of an overall treatment plan overseen by your physiotherapist. Some men also find penile (vacuum) pumps useful, as they stimulate blood flow to the penis.
5 Tips to Prevent and Manage Erectile Dysfunction
- Keep your heart healthy
- Manage stress
- Avoid smoking (nicotine)
- Maintain a healthy pelvic floor
- Exercise regularly: 4 x 40 minutes of moderate to vigorous exercise per week
Common Myths about Erectile Dysfunction
Myth #1: Erectile dysfunction can’t be treated. Truth: Erectile dysfunction is treatable, and it’s never too late to optimise your pelvic floor muscles and get the strength back.
Myth #2: Erectile dysfunction means weak pelvic floor muscles. Truth: Tension in the pelvic floor can also cause erectile dysfunction.
Myth #3: Only older men get erectile dysfunction. Truth: It’s more common in older men, but ED is not an “old man’s” disease. It affects men of all ages, and at Sydney Pelvic Clinic we see men in their 20s and 30s with erectile dysfunction.
Myth #4: Viagra is the only treatment available. Truth: Other methods include physiotherapy, sex therapy, and couples counselling.
Myth #5: Erectile dysfunction only occurs because of relationship problems. Truth: Relationship issues can be a big factor, but they’re not the only cause of erectile dysfunction.
Myth #6: A “real man” is always ready for sex. Truth: Pop culture paints men as always ready, never having performance issues, and treats not being able to “get it up” as a slur on masculinity. This couldn’t be further from the truth, and the pressure it creates hurts men’s self-esteem and their relationships. ED is more common than you think: chances are, some of your mates are dealing with it too.
Get Treatment for Erectile Dysfunction
Don’t suffer in silence. Erectile dysfunction is treatable, and it doesn’t have to last forever. Book a consultation with a physio or enquire about focused shockwave therapy at Sydney Pelvic Clinic.
