5 Things Men Need for a “Normal Erection” and a “Common Erection”

There is no need to be in the flop era.

In the United States, 30 million to 50 million men suffer from erectile dysfunction (ED) – defined as difficulty getting and keeping an erection – up to 70 percent of men over the age of 70.

Two doctors explain to The Washington Post what’s behind this common condition and how to get your mojo back.

What causes erectile dysfunction?

Relaxation is often caused by blood flow problems caused by hardening of the arteries, high blood pressure, high cholesterol, and smoking.

Nerve damage that disrupts signals from the brain or spinal cord to muscles is also a major factor.

“A normal erection requires coordination between the brain, hormones, nerves, blood vessels and smooth muscle. Any disruption in this pathway can lead to erectile dysfunction,” Dr. Justin Homan, of Cedars-Sinaita Urology, told The Washington Post.

Metabolic, hormonal, and neurological disorders can interrupt these important nerve signals.

For example, diabetes is a metabolic disease characterized by high blood sugar, which can damage the nerves and blood vessels necessary for erections.

“Medications including blood pressure medications, antidepressants, and chemotherapy drugs may cause erectile dysfunction,” adds Homan.

“Pelvic surgery, obesity, sleep apnea, chronic kidney or liver disease, and smoking also increase risk, while psychological factors such as depression, anxiety, and relationship stress may trigger or worsen erectile dysfunction.”

Could you be attracted to your partner, but still suffer from ED?

“It’s a very common complaint,” Dr. Jay Amin, a urologist at Orlando Health Urology, told The Washington Post.

“In these cases, we want to rule out medical or hormonal issues and then address reversible issues like blood flow issues.”

Homan points out that desire and arousal are two different processes.

“Men who find their partners attractive may still have difficulty achieving erections if blood vessels, nerves or hormones are damaged,” he explains.

“Partners often think the problem is a lack of attractiveness, but that’s rarely the case.”

Homan adds that anxiety about performing or underperforming can create an avoidance cycle that can easily be misinterpreted as disinterest.

“Open communication and medical evaluation can help couples understand that erectile dysfunction is often a medical problem and not a reflection of their relationship,” he says.

Both experts encourage couples to discuss ED.

“Just having a conversation with your partner can often relieve your stress and show that you care about their needs and are actively looking for solutions,” Amin says.

Research shows that men who have a stronger emotional bond with their partners tend to have fewer ED problems or recover more quickly.

What should you do if you have ED?

Amin and Homan agree that men with ED should first contact their primary care physician.

“Primary care physicians can evaluate underlying conditions such as heart disease, diabetes and hormonal disorders, as well as manage simple cases. If erectile dysfunction persists or requires specialized treatment, doctors can refer patients to a urologist,” Homan said.

Because ED can be a sign of a more serious underlying condition, especially heart disease, it should not be ignored.

The good news is that there are many treatment options for ED.

Amin noted that thanks to direct-to-patient platforms like HIMS or Ro, medicines are more accessible than ever before, so you don’t even have to go to the doctor in person.

How is ED treated?

Treatment varies based on the cause of the emergency and the patient’s goals, but any plan should start with lifestyle changes, Homan said.

“Lifestyle changes are fundamental: controlling blood pressure, cholesterol and blood sugar; losing weight; exercising; reducing alcohol consumption and quitting smoking can improve erectile function,” he said

Addressing sleep apnea and/or depression can also reduce ED symptoms, while oral medications can enhance blood flow to the penis.

Additionally, counseling can help with performance anxiety, depression, and relationship stress.

For those who require more intensive treatment, vacuum erection devices are designed to draw blood into the penis through a plastic cylinder and pump. The constriction band helps maintain an erection.

In addition to bands, Houman said intracavernosal injections or intraurethral medications can produce reliable erections and satisfy the needs of about 70 percent of patients.

“When other treatments fail, inflatable or semi-rigid penile implants can provide reliable erections and high satisfaction,” he said.

More experimental treatments, such as low-intensity shock wave therapy, platelet-rich plasma injections and melanocortin activators, show promise but require further study, he reports.