Talking About Erectile Dysfunction

By John Briley

By John Briley, Washington, DC

I remember the first time my dad talked to me about erectile dysfunction. He said … um, well, he … of course, I’m kidding! My father was born in the 1930s. Men of his generation might have walked 16 miles through an ice storm to watch their sons play football, but they weren’t penis-health-talk kind of guys.

But penile health—and, more specifically, sexual health—are important. And while I can’t find a stat on how much time men spend thinking about their sexual health and performance, I would wager the answer is “a lot.”

The problem is that men with erectile dysfunction, or ED, do not spend a commensurate amount of time discussing their problem, with either their partners or their doctors.

Erectile Dysfunction in Context

An estimated 30 million men in the U.S. have ED, according to the National Institutes of Health. About 4 percent of men in their 50s report total inability to achieve erection; the rate jumps to 17 percent of men in their 60s and 47 percent of men older than age 75. 

Yes, penile health declines naturally with age, but ED is not inevitable. As the stat above suggests, a fair percentage of men older than age 75 can achieve—and presumably use—erections.

Lifestyle, Diet, and Stress: Partners in Sexual Health

For many, ED is traceable to diet and lifestyle. If you eat well, exercise regularly, and control your weight and stress levels, you can expect fairly normal sexual function into your 60s and, possibly, beyond. “Normal” does not mean “like a 25 year old,” but it does mean your maleness will respond to neural messages of arousal and will be capable of “finishing” sexual interactions.

Outside of poor general health and fitness, other factors that could cause ED include:

  • Alcohol and drug abuse

  • Surgery (especially radical prostate and bladder surgery for cancer), which could injure nerves and arteries near the penis

  • Injury to the penis, spinal cord, prostate, bladder, or pelvis

  • Medication side effects—for example, with some blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and the ulcer drug cimetidine

  • Depression, general sadness, low self-esteem, and other psychological conditions that might make a man more self-conscious about sexual performance

If something is bad for the heart—excessive alcohol use, cocaine, poor cardio fitness—it is also bad for sexual health. (Anything that impairs blood flow also weakens erections.) Same for factors that originate in the mind, like stress and depression: They, too, send messages throughout the body, generating very real physical symptoms.

Putting Penis Health into Words

This is where self-awareness, honesty, and—yes—a willingness to talk about penis health come in. Even in this enlightened time, we men are all too often trained, conditioned, and encouraged to brush it off, to “take it like a man” and neither complain about nor shy away from any amount of pain or stress. Big mistake.

If you have sexual health or performance issues, you need to be honest with your partner (provided you trust her or him). Of equal priority: Get to your doctor and describe your problem. Your physician can try to cure only what he or she knows about, and, to my knowledge, very few doctors will test your erectile response unless they know you have issues.  

So far I’ve been lucky—age 43 and no sign yet of ED. And, as squirmy as the topic may be, I’ve already discussed penile health twice with my 18-month-old son: Once to tell him my wife and I decided against circumcising him, and a second time when we treated him for a minor health issue. I know he didn’t catch all the details, but he did learn how to say “penis,” and that’s a promising start.

Medical Reviewer: Louise Spadaro, MD Last Annual Review Date: 2010-04-14T00:00:00-06:00 Copyright: © 2000-2010 The StayWell Company, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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