Physical causes of ED are often related to reduced blood flow, which can be tied to a range of cardiovascular issues. In some cases, medication interactions, injuries, and obstructions (such as tumors) can also be factors. You may feel embarrassed to bring up the issue with your doctor, but remember that ED is a very common condition, not just for men over 40 but for younger men as well. ED isn’t abnormal and it isn’t inevitable—it’s a common and treatable condition. Be direct in discussing the issue: “Over the past couple of months, I’ve been having a lot of trouble maintaining erections during sexual encounters, even though I feel the same amount of arousal as before. ”
There are a wide range of medical interventions that can improve your ability to physically achieve and maintain an erection. These include pills, injections, manual devices, and implants, among others. Taking a pill may (or may not) enable you to get an erection if your ED is psychological in nature. It won’t do anything, however, to address the psychological issues that are causing your ED in the first place. You’ll simply be masking a deeper problem.
Depending on your condition, your therapist may help you develop strategies for managing anxiety and reducing stress that aren’t directly related to sex. They might also utilize cognitive behavioral sexual therapy (CBST), which is a variation on CBT that can help you develop new thoughts and behaviors related to sexual activity.
The key to relieving excess stress is finding calming techniques that work for you. Try activities like yoga, meditation, deep breathing, light exercise, talking to loved ones, listening to soothing music, reading a good book, or other healthy activities. Doing some deep breathing exercises before a sexual encounter, for instance, may provide the calming effect you need. Work with a professional therapist if you need help dealing with stress.
Your therapist may use strategies such as cognitive behavioral therapy (CBT) to help you recognize and overcome your anxieties. Your doctor may in some cases recommend medication to help you manage anxiety. However, some anxiety medications can contribute to ED, so you may want to exhaust your alternatives first.
In some cases, changing up your sexual routines may be helpful. Or, taking a break from sexual activity for a while might benefit you. Talk to a therapist to get specific advice that may help you.
Take time each day to think deliberately about your life and your accomplishments. You may even want to write down a list of your achievements each day. Look for opportunities to help others, such as by volunteering. Talk to your partner about your feelings, and don’t be afraid to contact a therapist for assistance.
Choose times when you’re both calm and focused in order to talk openly and honestly about your feelings. Use “I” statements, focusing on how you’re feeling, rather than using accusatory “you” statements. Give your partner an equal opportunity to speak, and listen carefully to them. Contact a couples therapist for additional assistance.
Your therapist may use CBT or other therapy techniques to help you recognize and better manage your feelings. As with anxiety medications, some antidepressants can contribute to ED. Work closely with your doctor to determine your medication needs and options.
Be straightforward: “I think I may be experiencing ED, and that it may be related to all the stress in my life right now. I’m going to make an appointment with my doctor. ” If your partner judges or criticizes you for your inability to perform sexually up to their expectations, rather than being supportive, you may want to reconsider their suitability as a partner. Don’t let them blame themselves—for instance, by saying they must not be “exciting” or “sexy” enough for you: “This has nothing to do with you—I’m still very aroused when we’re together. It’s a treatable condition that I need to discuss with my doctor. ”
Increasing the frequency and variety of your intimacy can help you to overcome the psychological barriers that may be contributing to your ED. You may feel more confident, comfortable, and relaxed with your partner in intimate situations, instead of feeling an overwhelming pressure to perform in a particular manner. Take the opportunity to find new ways to pleasure your partner—they won’t complain!
Add more emphasis on foreplay and treat your intimate encounters as times to be savored, not rushed through. For instance, plan for a solid hour of intimacy rather than a “quickie. ” If you have kids who tend to barge into your room at night, tell them you need some private time and lock the door. Or, even better, send them to spend the night at your in-laws’ house!
Use sex therapy as an opportunity to talk openly and honestly about your intimate lives together. You may uncover both sources of your psychological ED and solutions for it. If your partner is unwilling to attend sessions, it will still benefit you to see a therapist on your own.
Eat more fruits and vegetables, whole grains, lean proteins, and healthy fats, and fewer packaged and processed foods, high-sodium foods, unhealthy fats, and sugary drinks. Aim for 150 minutes of moderate-intensity cardiovascular exercise per week, as well as 2-3 sessions of both strength training and flexibility training per week. Talk to your doctor before starting a new diet or beginning an exercise program, especially if you have existing cardiovascular issues or other health conditions. Discuss your best options for quitting smoking with your doctor.
Work with your doctor to determine if you need to lose weight, what your weight loss goal should be, and how best to achieve it. Choose healthy weight loss options like diet and exercise.
Start by stopping your urine stream mid-flow to identify your pelvic floor muscles. Empty your bladder fully before doing the exercises. Contract your pelvic floor muscles for 5 seconds, then release the contraction for 10 seconds. Repeat this process 10 times in total. Work your way up to doing 3-4 sets of these exercises per day, and see if you can increase the contractions to 10 seconds at a time. A man’s pelvic floor muscles help hold blood in his penis during an erection.
Utilizing pornography and especially masturbation in moderation can in fact help address psychological ED factors. The goal, however, is to recreate more realistic scenarios that approximate your sexual experiences and behaviors with a partner. You may want to view porn and masturbation as ways to train your mind and body (including your penis) to respond in a certain manner during sexual encounters.
