You may fear that having erectile dysfunction (ED) makes you less of a man and, as a result, are ashamed to bring it up. But talking about it with your partner and your physician is the first step toward coping with a very common condition.
Erectile dysfunction is defined as the inability to achieve or sustain an erection for sexual intercourse. As many as 30 million men in the United States have erectile dysfunction, according to the Urology Care Foundation of the American Urological Association. “There is certainly less of a stigma now, and men seem more confident speaking with their physicians because of the fact that there are several available therapies,” says Daniel A. Shoskes, MD, urologist at The Glickman Urological and Kidney Institute at Cleveland Clinic in Ohio. The availability of drugs such as Viagra, Levitra, and Cialis have made erectile dysfunction, or ED, something of a household name.
Dr. Shoskes says that the time to seek medical help to cope with erectile dysfunction is when it is occurring in a persistent way and interfering with your quality of life.
“It is worthwhile to start the conversation with a physician to see the state of your general health and see what can be done for the libido and sex drive,” says Shoskes.
Sometimes erectile dysfunction is caused by stress or other emotional issues, but it can also be the first sign of a potentially serious vascular disease. “New onset of erectile dysfunction in a middle-aged man can often herald the development of blood vessel disease anywhere in the body, and should prompt a visit to your internist or preventive cardiologist,” he says.
A recent study shows that men with erectile dysfunction are more likely to have heart disease and to die from it. The worse the erectile dysfunction, the greater these risks, the study showed.
This is why merely talking about erectile dysfunction can be lifesaving. If you have vascular disease, make sure you are doing everything you can for vascular health including stopping smoking and getting control of blood pressure, cholesterol, and blood sugar levels,” Shoskes says.
Bruce R. Gilbert, MD, PhD,the director of reproductive and sexual medicine at the North Shore LIJ’s Smith Institute for Urology in Lake Success, N.Y., confirms that erectile dysfunction affects more than just quality of life. “It often precedes the diagnosis of heart disease or another vascular disease, such as diabetes, by two to ten years. Erection problems can be a harbinger of more significant cardiovascular problems down the road,” Dr. Gilbert says.
“We have changed from giving out pills to treat ED to making sure that we figure out what is going on,” he says. “It’s not an embarrassment, and it might portend something else that you now have the opportunity to take care of.” “The way to cope with erectile dysfunction is to get help,” says Diana Londoño, MD, a urologist at Kaiser Permanente in Los Angeles. Start with your primary care doctor who can then decide if you need a referral to a urologist, a vascular specialist, or possibly a mental health counselor.
Therapy may help uncover personal issues such as performance anxiety or relationship issues that contribute to ED. Your therapist will help with developing coping strategies to address these issues.
It’s also important to discuss erectile dysfunction with your partner. “Be honest,” recommends Dr. Londoño. “Tell her that you’ll be going to the doctor to get checked out. Honesty and openness will reduce stress and anxiety about it and will make it easier to get help.”
The good news is that there are many treatments available, she says, depending on if you need to address medical problems that are causing ED, reducing the number or types of medicines you’re taking that lead to ED as a side effect, or treating the ED directly with pills, a penile erection pump, injectable medication, or surgery.
Dealing with erectile dysfunction from the start is the best thing that you can do for your relationship, your overall health, and your quality of life, she says.