TV off. Phones down.

Let’s chat about erectile dysfunction.


First of all, let’s define what we’re talking about here.

It’s pretty simple, your partner’s penis is not becoming erect when it should.

When talking to your partner about erectile dysfunction, forget sexual awkwardness, societal expectations, or anything else other than this. A body part is not performing one of its usual functions. If one of your ears stopped hearing, you wouldn’t be embarrassed would you? So why should penises be any different?

But the fact still stands that most men do feel awkward talking about the subject, so knowing how to approach it is important.


Where to start?

The context and setting is important for a discussion like this. Try not to broach the subject in a situation in which your partner is busy, stressed, or generally not in a good place to be discussing sensitive topics. Segueing into the conversation through a general conversation about your sex life can make it easier.

“Definitely do not do this in bed, or bring it up right after the problem has occurred,” advises sexologist Dr. Pepper Schwartz. No matter who is broaching the subject, she says a couple of things might help, including:

Bringing materials on the subject that you can refer to for expertise
Starting the conversation in a non-threatening situation, such as over breakfast
Having a drink, such as coffee or wine, to fill awkward pauses that may come up.


Why is it important to fix the problem?

Explaining to your partner the reasons why you would like them to seek treatment may motivate them to do something about it. Perhaps you’d prefer to be having more penetrative sex than you’re currently having? Mentioning this in a non-accusatory way is important. It’s better to say “If we were to sort out the ED, we could have a more active sex life” rather than “your ED is preventing us from having a satisfying sex life”. ED is a problem you have to solve together, so blame or finding who is “at fault” is not helpful.

You might perhaps be in a relationship in which sex is no longer as important as it once was, but that isn’t the only reason you should want to seek treatment. 90% of the time ED is a symptom of a more serious underlying health issue. The main underlying causes are:

  • Cardiovascular disease in 40%.
  • Diabetes in 33%.
  • Hormone imbalances in 11% (mainly high prolactin or low testosterone levels)
  • Neurological disorders in 10%.
  • Pelvic surgery or trauma in 3-5%.
  • Anatomical abnormalities in 1-3% (e.g. tight foreskin, short penile frenulum, Peyronie’s disease, inflammation).

Symptoms of ED are likely a sign you need to go and speak to your doctor, even if just to rule out the possibility of the above conditions. Most of these can be determined by a quick blood test, and your doctor can suggest the best course of action from there.


What to say if he says:

It’s not a problem, it’s just happening because of ….

Deflection of responsibility for the ED is a common form of defence. Some men may try and find a reason as to why the ED happens that pushes the issue out of their control. Many of these excuses, such as stress, lack of sleep, or depression/anxiety are very valid reasons as to why he might be experiencing ED, but these are not a reason to not seek help. Gently remind him why it is a problem, and also how easy it can be to seek treatment options.

It’s not a physical issue, I’m just not getting aroused anymore

A common assumption is that arousal is based solely on external stimulus, however it’s a two-way street. As we get older, we may produce less of various hormones (including testosterone) which aid arousal. Even if there is sexual stimulus present, a man might not become aroused because his body is not properly communicating the arousal with his penis.

It can be upsetting to hear that your partner is having issues becoming aroused, but do remember that arousal is as much a biochemical process as it is mental. Your first step should be trying to fix that before assuming that the problem lies elsewhere.

I’ll just take Viagra

Great! The problem has been acknowledged and a solution has been suggested. BUT, there are stipulations to this solution. Viagra can be a quick and effective way to treat the symptoms of erectile dysfunction, but it can also enable you to ignore symptoms of underlying conditions. Make sure you have a chat with your GP to check that firstly Viagra is suitable for you, and secondly that you are aware of all of your health issues.

Okay let’s do something about it

Even better! High-five your partner, you’ve made it through to the other side! Now is time for starting recovery

There’s a few different treatments you can use for erectile dysfunction. The aforementioned Viagra can be used before sex to help erections but is unsafe for men who suffer from cardiovascular disorders, low blood pressure, Peyronie’s disease, or those who are taking nitrates for chest pain. You should always talk to your doctor about the root cause of your ED before using Viagra.

If your partner believes their ED is caused by psychological factors, such as performance anxiety, they may want to seek a sexual therapist they can work through their issues with. They can either do this privately or ask their GP. There are also various online men’s sexual therapy apps which may help.

Shockwave therapy is a drug-free, pain-free treatment which involves passing painless, focused waves into the affected tissues, breaking down any fatty plaques and promoting the formation of blood vessels. It has a 75% success rate in men with ED, and if the lifestyle causes of the condition, such as diet and exercise, are addressed, it can be permanent.

Where can I get focused shockwave therapy for erection problems?