Erectile Dysfunction and Men’s Health

I often say that whatever is going on in your life shows up in your sex life. Usually, though, I’m talking about how relationship dynamics, unspoken resentments, unresolved issues, or old emotions can affect things. It’s really common for individuals and couples to seek a therapist for help with their sex lives when the real problem is something else- arguments about money, stress about work, communication falling apart or such. Quite often, when those concerns are resolved, sex suddenly becomes much easier. While sexual difficulties may be the initial reason for getting support, they’re not always the actual challenge.

There’s more and more information coming out about how similar patters can emerge on a physical/medical level, too. According to this report on, erectile dysfunction can be a signal of coronary artery calcification, which is a known predictor of “future cardiovascular events.” There are still many questions that need to be answered, such as whether men with erectile difficulties should be screened for coronary artery calcification or other signals of cardiovascular issues, so it’s still early days in the research process.

What this says to me, however, is that the easy fix of “pop a viagra/cialis/levitra” isn’t what men really need. Despite the idea that male sexuality is simple, especially relative to women’s sexuality, it’s just as complex and there’s just as much going on below the surface. We often forget that the most effective approach is a holistic one, in which we look at the connections between sex, the body, the heart, and the mind. Unfortunately, we usually return to this idea that it’s all about getting it hard, getting it in, and getting it off. This “single button” model of male sexuality is one of the biggest barriers to experiencing authentic pleasure and sexual health.

Personally, I really dislike the term “erectile dysfunction” because it assumes that there’s necessarily something wrong with the body when it doesn’t do what we think we want it to do. For example, it’s well known that anxiety inhibits erection by limiting the ability of the blood vessels in the penis to expand. The irony here is that it doesn’t matter what the source of the anxiety is or whether it’s a realisitic fear, so worrying about whether you’ll be able to “perform” can become a self-fulfilling prediction.

But if you think about it, this mechanism makes sense. If your fight-or-flight reflex has kicked in, there’s a good chance that you’re in danger, at least according to the hard-wired responses that evolution has given us. That’s not a good time to be getting some action, so your body sends blood to the large muscles of the body to help you protect yourself or run away. So really, when job stress or relationship fears keep your erection from happening, your body is doing exactly what it’s supposed to be doing and I don’t see how that can be a dysfunction. What’s really going on is a disagreement between what you want your body to do and what it wants to do.

I think this is another example of why we need to take a holisitic view of male sexuality- if your erection difficulties are being caused by stress or such, taking a pill isn’t going to address the real issue. In fact, it’s quite possible that it can make them worse by masking the underlying problem, which can make it come out even more strongly. Similarly, if your erection difficulties are caused by cardiovascular problems or other health concerns, it’s pretty obvious that it’s important to get them taken care of.

Instead of getting angry or frustrated, blaming yourself or your partner, chill out and step back. In the moment, look for other ways to have fun- your sexual pleasure doesn’t have to revolve around having an erection. If the situation is the result of anxiety, that can be a great way to let those worries go. And if it’s the result of a medical issue, getting stressed out isn’t going to help. Either way, if you’re finding that difficult emotions are arising, whether they seem to be the cause of or the result of your erection challenges, a sex-positive therapist can be a big help. If your erection difficulties are happening regularly, or if they happen when you’re masturbating as well as when you’re with a partner, that may be a sign of a medical concern. Get checked out by a doctor and ask to be tested for cardiovascular risk.

Whatever the cause and however you experience it, erection difficulties can be a sign that something needs attention. It might be your phsyical health or your emotional well-being. Maintianing health means stepping back and looking at the entire picture. It’s not as easy as a “quick fix” but it’s much more effective and long lasting. Plus, if it inspires you to discover new ways to experience pleasure and deepen your relationship with yourself and your partner(s), that’s going to be a good thing.

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