Breaking through the stigma of erectile dysfunction

For a condition that affects up to a staggering 40 per cent of men at age 40 and nearly 70 per cent of men  at age 70, you’d think there would be much more conversation in the wind about it. But given the stigma surrounding Erectile Dysfunction (ED), many men are understandably reluctant to open up  – and the true incidence could be even higher.

According to sex therapist Mia Harris from Sunshine Sex Therapy, “ED can be caused by physical conditions, psychological issues, or a mix of both.”

“It is very important that when erectile problems are first noticed, a person should consult with their general practitioner. This is because erectile issues can be an early sign that someone is at a much higher risk of developing serious cardiovascular disease (heart attack, stroke or peripheral vascular disease),” Harris says.

“Psychological concerns can cause ED by themselves. Relationship problems, performance anxiety, life stressors, general anxiety, and depression can all cause someone to develop ED. These factors can also all occur as a response to ED that is caused by a physical condition or medication. It can become quite complex!”

Given the complexity of ED, in order to best remedy the issue, it’s important to reach out to medical professionals for help.

However, as with all things, taking the first step is always the most difficult. Having the strength to address this delicate subject with your doctor or even your partner does present its fair share of challenges. The anxiety that accompanies not only experiencing erectile dysfunction but also seeking treatment for it, combined with the ridicule that the condition can be met with, and suddenly the idea of broaching the topic quickly becomes too overwhelming.

Some sufferers fear it will make them appear “weak” or “unmanly”. In recognition of this difficult reality, Starts at 60 went to the experts to determine the most efficient and anxiety-free ways to talk about erectile dysfunction – and in the process, break the harmful stigma surrounding this incredibly common condition.

Having the conversation with your doctor

Great work. You’ve made an appointment with the doctor. But as you sit in the waiting room nervously anticipating your name being called, the exit door is starting to look pretty enticing. Before you reach for the handle to freedom, take heed of Lovehoney Ambassador and Sex Coach Cam Fraser’s advice about seeking medical advice for erectile dysfunction and sticking with that dreaded appointment. Fraser reminds those seeking medical advice that “it’s important to remember that they are all professionals and have probably seen and heard it all before”.

“Their main priority and focus is to help and assist you,” says Fraser. “It’s completely natural to feel a little anxious or nervous to talk about your genitals but the more open and honest you are with the doctor the more appropriate counsel and solutions they can provide.

Continues Fraser: “This includes your lifestyle, eating and drinking habits, as well as sexual experiences and concerns. Consider whether or not you’d be more inclined to speak with a male or female practitioner, as this can also be a source of anxiety.

“If you have a partner, I suggest reflecting on how comfortable you feel with them – you may find you’re more honest and upfront with a partner there for support, or you may find that you feel too embarrassed to speak candidly with them present.”

Fraser also seeks to put mens’ minds at rest about feeling ashamed of an ED issue.

“People with a penis often have this idea of what masculinity should look like and being vocal about vulnerabilities is often considered taboo. There is a common belief that our very manhood is dependent upon whether or not we can get and maintain an erection. This is of course, not true at all. ED is common and treatable – think of it as a small road bump that you can get past, not a crisis.”

When the signs of ED appear, Harris points out that the “first stop should be your GP.”

“They can do a thorough physical workup to determine if your ED is caused by a physical condition. If it is due to a physical condition, your GP will organise appropriate referrals and/or treatment,” she says.

Managing the fear and anxiety

When faced with a potentially serious medical condition, it’s perfectly natural for anxiety to set in and worst-case scenarios to swirl around in your mind. In the case of erectile dysfunction, this can rear its ugly head in the form of avoiding medical appointments, over analysing your sexual performance or burying the problem, and ignoring it. Fraser says that changing your views around sex and your sex life “is crucial for relieving fear and anxiety”.

“Compared to people with a vulva, men and people with a penis have a tendency to suffer in silence and sexual health, in particular, can be a minefield. When you notice symptoms, it can be helpful to remember that sex doesn’t exclusively revolve around an erect penis,” Fraser explains.

Fraser also highlights that “unrealistic expectations around the penis as a result of inadequate sex education” can contribute to ongoing anxiety around sexual performance.

“There is an expectation that penises should get and remain erect on-demand as desired, for as long as needed. However, it is totally normal for a penis’ firmness to wax and wane throughout a sexual encounter,” he stresses.

“Sex and intimacy aren’t just about penetration. Take the pressure and emphasis off performance and outcome and focus on activities and experiences that are pleasurable to you both. There are plenty of ways to experience pleasure with a partner, for example exploring different types of touch on erogenous zones around the body, or exploring oral sex. You can also introduce different sex toys which provide internal and external stimulation for both parties. ED doesn’t mean you can’t have a fulfilling sex life.”

Harris stresses the importance of “having a supportive team of people around you!”

“This means seeking out appropriately qualified and empathetic health professionals, including doctors, sex therapists and psychologists,” Harris explains.

“If you have a sexual or romantic partner, it is about getting them on board to see this as an issue you can work through together.

“Another thing people can do is pay attention to their lifestyle. Getting enough exercise, eating a varied and healthy diet, quitting cigarette smoking, and drinking alcohol responsibly can all help increase your sexual desire, improve your erectile function, as well as helping you to feel more energetic in your everyday life.”

Check-in with your partner

Sharing is caring but when you’re faced with a potentially serious medical condition, it’s easy to close up and shut out those close to you. However, it’s important not to forget about how those around you are coping and how they are affected by your erectile dysfunction as well. Fraser said, “it’s essential to talk to your partner and be open with them about how you’re feeling”.

“ED affects the couple, not just the man. I recommend that partners attend doctor’s appointments, or an appointment with a Sex Coach/Sex Therapist, too, to ask any questions they may have and to understand more about what their partner is experiencing,” he said. “Taking a team approach to both talking and communicating about the experience and what actions or solutions can be implemented takes the pressure off you – and puts the focus on pleasure vs performance as you explore new ways to be intimate, sensual, and sexual with each other.”

Simply ignoring the issue and not communicating with your partner in a healthy way can lead “to feelings of rejection and inadequacy”, warns Fraser.

“Sweeping the issue under the rug is no help to anyone. Instead, try to be clear about what you are experiencing, share some literature on the subject, listen to a podcast together, and let them know that what you’re experiencing isn’t either person’s fault,” he said. “You may find this reduces your anxiety and stress around sexual performance, which may have a positive impact on holding an erection. It also opens up a platform for you to discuss any lifestyle changes which may be impacting sexual performance.”

Harris explains that it is helpful to “talk with your partner about what is happening for you both.

“Be empathetic and supportive and see it as a problem for you both to work through,” Harris says.

“Try to think of sex more broadly, not just as penetrative sex: kissing, massage, oral sex are some other examples. An erection is not necessary for both of you to have pleasure.”

There’s help out there

If you’re diagnosed with erectile dysfunction Fraser wants to be clear that it “isn’t the end of your sex life” and suggests trying to “relax and focus on having fun, connecting with your lover and enjoying intimate time together”.

It’s also worth remembering that – unless you have a complicating factor such as a long history of diabetes or smoking, a recent heart attack, surgery or stroke – there are a number of medical interventions available that make erectile dysfunction “very treatable” in many cases, reassures Fraser. These include single or multi-agent oral medication, injections and even some surgical options for severe cases that don’t respond to other approaches.

Harris spoke further of the medical interventions that are available that can help those experiencing ED before reminding those impacted that they “are not alone”.

“More generally, there are medical and surgical treatments, and there are psychological treatments (talking therapy),” Harris explains.

“Psychological treatments focus on providing education around sex and relationships, helping to improve couples’ communication skills, and addressing thoughts and beliefs that underpin a person’s actions and behaviours.

“The medical treatments all aim to produce functional erections for people with erectile problems.

“Remember that you are not alone. The incidence of ED increases with age and roughly 10% of men in their 60s have ED, and 30-40% of men in their 80s have it. To compare it to diabetes, 10.3% of men aged 55-64 are diabetic, so a lot of people have ED.

“Talk about it with your partner, close friends and health professionals. Ask for reputable resources of information from your GP and understand what is happening; remember knowledge is power!”

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.