5 Reasons Why Erectile Dysfunction Happens
What is Erectile Dysfunction?
Different disciplines of study struggle to agree on the definition of Erectile Dysfunction (ED). Traditional definitions of ED are defined by “failing at intercourse” more than 25% of the time (what a shaming way to word it but that’s the medical definition). But what if you have strong erections and lose them after insertion? Or what if you have insertion for a few minutes but don’t last as long as you want to? And what does it mean if you maintain your erection during masturbation but not during penetrative intercourse? Would it be considered ED then?
Because of these individual, complex situations, many medical and sexual health professionals disagree on the definition of ED. Here, we will define ED as a lack of comfort and confidence with an erection and can be due to a variety of contributing factors.
Physiological Factors
Your physiological factors involve anything from your eating, exercise, medication, sleep patterns, drug use (alcohol, tobacco, and other substances), health issues (such as high blood pressure, weight, diabetes etc.), underlying medical problems, hormones, neurological issues, etc. The list goes on and on!
Consulting with your team of medical professionals such as your general practitioner, urologist, endocrinologists, etc. can help you determine if your ED may be due to a physiological factor. It is important to rule out any possible medical issues contributing to ED and more than likely the first stop in determining your contributing factors.
2. Psychological Factors
Psychological factors include anything related to the psyche. This includes anxiety, depression, stress, and other mental issues that lead to ED. Some folks worry about their appearance; whether they are pleasing their partners enough; and feelings of fear and shame around performance. And it becomes a cycle of self-fulfilling prophecy: anxiety arises about performance, which literally can impact an erection, and the loss of erection causes shame, which makes the situation worse!
Psychological factors can include feelings towards issues around ED but not exclusively. Feelings of worry about finances, a recent death in the family, or general self esteem issues can impact experience around ED. As mental health issues can be stigmatizing, assessing for psychological factors can be challenging.
3. Relationship Factors
Relationship factors can also impact ED. Relationship being your connection to your sexual partner and factors such as comfort, attraction, trust, intimacy, cooperation, and safety can impact your ED. How you feel with and about your partner and the sex you have together can impact your desire, arousal and sexual functioning. Emotional conflict or issues that are hard to work through (unrelated to ED) can contribute.
How your partner responds to ED also impacts your ED further. For example, if you struggle with sustaining an erection or ejaculate prematurely, and your partner reacts with shame or blame, that can further impact arousal, desire, and/or ED. It’s important to have open, nonjudgmental, honest, respectful, and caring conversations with your partner—about ED, sex, and in general. This is where a couples therapist can help!
4. Psychosexual Skills Factors
Psychosexual skills are all about the skills and exercises that increase our pleasure, closeness, and satisfaction in sex. Did you know that most men over the age of 30 begin to experience loss of erections? And it’s not considered ED! This is because it is typical to have “windows of erections” and softening throughout with age, and it’s important to pull on psychosexual skills to continue enjoying partnered sex. For example, one might experience a loss of erection during penetrative sex and a couple who is well versed in psychosexual skills might switch to oral sex or practice mindfulness in order to experience another erection. But many people misinterpret this as ED not understanding that it is a normal part of aging and just requires sexual skills to move through.
5. Situational Factors
Last but not least are situational factors. These include any external and environmental factors that impact our sexual functioning. For example, if you were visiting family out of town and staying in their home, knowing your parents’ room is right next to yours can impact sexual functioning. (Colloquially, some refer to these as a “cock block.”) Another example is setting an expectation to have sex at night but feeling exhausted by the end of day.
Since these factors vary wildly by person (even between partners), they must be unraveled per individual. While some people find the idea of being “caught” to be arousing, some don’t. Either way, situational factors can contribute to ED.
Many people may experience ED for a variety of reasons and perhaps even multiple factors at once. If you are concerned you struggle with ED, we hope this list has been helpful in identifying the many factors that cause it. There is no one-size-fits-all approach to the treatment of ED, so consider consulting with medical and sexual health professionals to get individualized assessment and treatment.
Belonging Counseling offers sex therapy for individuals and couples including issues with ED. Contact us for more details.
