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By Lori Buckley, Psy.D., CST. 
You don’t need a million dollar ad campaign to tell you what most of us already know. Men are concerned about their penis. Many men are insecure about the size of their penis, which is why your spam folder is filled with ubiquitous ads promoting products that will give you "a huge, gigantic penis.” However, most of the men I speak to in my clinical practice are much more concerned about the function of their penis and their ability to attain and sustain erections. Some men would like to get harder quicker, some want to stay harder longer, while others just wish they would get hard at all. The fact that erectile difficulties or dysfunction (also known as E.D.) affects men is obvious, but E.D. can also have a profound affect on wives and girlfriends, which often leads to increased anxiety and stress, exacerbating the problem. If this sounds like a vicious cycle you are right. Reading and becoming familiar with the following information and suggestions will increase your penis knowledge, and help you escape from this vicious cycle.
Erectile Dysfunction
Erectile dysfunction can be defined as the inability to attain or maintain erections that are sufficient enough for sexual intercourse, and is causing you or your partner distress. However, it is also important to differentiate between true sexual dysfunction and situational circumstances. Having difficulty attaining an erection one or two times is not a reason to panic or make an appointment to see your doctor. True E.D. means that you are not able to attain or maintain an erection at least 25% of the time. I certainly realize that not being able to achieve an erection can feel quite devastating to a man and/or his partner. But, know that erections are not always reliable, and that they can be negatively affected by alcohol, medication, age, or relationship problems. In my practice, I see many men who developed performance anxiety after one or two erection "failures”. This is a common beginning of a downward spiral and vicious cycle.
How Erections Happen
There are many potential causes of erectile dysfunction. But before we discuss E.D. let’s discuss what makes a penis hard or erect. Basically, an erection occurs when blood fills the penis. Erections begin with a sexual signal or stimulus such as a partner’s touch, erotic visuals, sexual sounds, sexy language, certain smells, a daydream or other varied and sometimes unique stimuli. Erections are an automatic response and occur when stimulation causes involuntary nerve impulses to the brain, spinal cord, pelvis and penis. This means that contrary to popular belief, erections are not something that we can turn on and off like a light switch. This is why erections sometimes occur at the most inopportune times, such as when receiving a massage or when seeing an attractive woman. On the other hand, a man may not be able to achieve or maintain an erection when he wants to have sex. Basically, during an erection, there is more blood going into the penis than out. This is why your heart and cardiovascular health plays an important part in the quality of your erections. And of course, all erections will eventually end. The common reasons are orgasm or some kind of disruption or interference such as someone walking in the room or an anxiety provoking thought…”I hope I don’t lose my erection.”
Let’s look at the many variables that can affect a man’s ability to obtain an erection.
Common Causes of Erectile Dysfunction
- Cigarette smoking (constricts and affects blood flow to the penis)
- Drugs and alcohol
- Certain medications
- Psychological factors (stress, anxiety)
- Relationship problems
- Fatigue
- Medical problems (diabetes, cardiovascular disorders)
- Poor diet
- Age (however, E.D. affects men of all ages)
- Trying to force an erection (performance anxiety)
If you or your partner is experiencing E.D., there are some things you can do. If you are able to regularly achieve and maintain an erection with masturbation, the causes of your E.D. may be psychologically based. However, the first "do” is to make an appointment with your doctor to rule out medical causes. While E.D. can result from psychological causes such as performance anxiety, unreliable erections are often due to medical or physiological concerns. It is also very common for men who have E.D. caused by illness to then develop psychological issues that compound the problem. After ruling out illness or medical causes, there are some things you can do to enhance the quality of your erections.
- Make lifestyle changes such as quitting smoking, decreasing alcohol consumption, adding daily cardiovascular exercise and eating healthier foods
- Relax, breathe, and focus on your partner and the pleasure your feeling. Worrying about losing your erection or trying to force a hard-on is guaranteed to make your Willie soft
- Remember that sex is much more than intercourse and an erect penis. Take the pressure off and incorporate more oral or manual stimulation into your sex play
- Kegels. Kegel exercises strengthen your pelvic floor, which can then lead to stronger erections and enhanced ejaculatory control. The best way to learn how to do kegels is to stop the flow of pee while urinating and notice the muscles you are using. Once you have learned to isolate these muscles (known as the pubococcygeus or PC muscles) you can begin your kegel workout program. Start by squeezing your pelvic muscles for a few seconds and then release. Begin by doing this ten times, three times a day, gradually increasing your reps from ten to twenty or more, three times a day. And don’t forget to breathe. Build up slowly and gradually or you might experience muscle soreness
How a partner can Help
- Don’t take it personally. Your partner’s erections don’t have a direct correlation to your sexual skills or attractiveness
- Don’t make jokes about it. While your intent may be to lighten the mood, this is never funny to your partner
- Create a relaxing environment
- Focus on relaxation and mutual pleasure rather than trying to make your partner’s penis hard
- Take a break from intercourse and explore other forms of sexual expression such as oral and manual sex play
- Assure him that everything will be O.K.
If none of the above works, I recommend you see a qualified therapist. An AASECT (American Association of Sex Educators, Counselors, and Therapists) certified sex therapist is trained and experienced in working with individuals and couples who experience sexual difficulties.
About the Author...
Dr. Lori is a licensed psychologist in Pasadena, CA and is internationally known for her work. She is quoted in magazines and is a sexual advice columnist for both Men’s Health Best life magazine® and the Sinclair Institute®, where she is on the advisory council. She also is a frequent guest on radio shows, and is the host of Personal Life Media’s pod-cast show “On the Minds of Men.” Last Update: 5/2/2009
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