Imagine this: You’re on a date, having a romantic candlelight dinner. She’s smiling at you, laughing at your jokes, readjusting her hair, and giving you every one of the signs she’s interested. You look at her with a passionate gaze and she gives you a glance that tells you there’s only one other place she’d rather be than dinner: in the bedroom with you. The sexual tension is mounting and the mood is right. You scurry to pay the bill and get to the car as quickly as possible.

You arrive home, just in time for the lust and passion to kick in and take over. While kissing her succulent lips and feeling every curve on her luscious body, you notice something -- something odd that doesn’t happen often, if ever.  What’s going on? She’s sexy, attractive, I’m turned on but the plumbing downstairs isn’t working.  Where’s my erection?

The prevalence of erectile dysfunction
If something like this has happened to you, you’re not alone. An estimated 150 million men worldwide have experienced what the medical community once referred to as "impotence," but now refers to as erectile dysfunction or ED. It is estimated that half of all men between 40 and 70 years of age will experience ED at least once. Why must we call it a dysfunction? There’s nothing dysfunctional about us. The word dysfunction sounds more like a computer crashing or glitch in the matrix than a penis issue we’re dealing with. Nope, lets call it erectile difficulties because no matter how difficult the battle gets, we should stay resilient.   

The different types of erectile dysfunction
The two major classifications of ED are: 1) Lifelong ED; and, 2) Acquired ED. Lifelong ED is when a man has never successfully maintained an erection long enough to penetrate their partner. Acquired ED is when a man has previously had successful erections, but is unable to at the current time. Contrary to popular beliefs, getting older isn’t the only reason guys have ED. Lots of younger people battle ED, too. Nearly half of men at age 40 and more than 80% of men at age 70 experience ED symptoms. It’s estimated that men in their 50s are twice as likely as men in their 20s to experience ED symptoms. That’s a lot of people. So, instead of us skirting around this important topic, let’s put the issue on the table and talk about it.

The causes of erectile dysfunction
There are a number of factors that contribute to ED and erection difficulty symptoms. Besides aging, there are medical issues, psychological issues and lifestyle issues that play a big part in the ED equation. Organic medical issues such as heart disease, nervous system issues (strokes, spinal cord trauma and prostate surgery), circulatory issues (diabetes, hypertension and poor circulation) and endocrine issues (kidney, testicular, thyroid, hormone and pituitary) can affect our erectile ability and lead to ED. Psychological issues can also affect erections, including performance pressure, depression, anxiety, trauma, and other mental health difficulties. In addition, what we put in our bodies can impact erections, such as a poor diet, alcohol, marijuana, cocaine, antidepressant medications, nicotine, hormones, and many prescriptions medications.

The treatments for erectile dysfunction
After reading that last paragraph, it might seem overwhelming to fight ED, but it’s not. Medicine and therapy have made a world of difference for many men, and you could be one of them too. Treatments for ED have come a long way since prayer and wishful thinking. Medical treatments include oral medications like CIALIS, VIAGRA or Levitra which are incredibly effective for men (see chart at bottom of page). There are penis vacuum pumps, often used with constriction penis rings, which help increase engorgement of blood in the penis for firmer, longer-lasting erections. Intracavernous injections into the penis and urethral suppositories are also used as well.

As a last resort, there is the option of penile prostheses surgery, which implants an artificial erection system inside the penis. In addition to medical treatments, psychological treatment is often effective. Finding a good psychotherapist to help work through psychosomatic ED or mental health difficulties can lead to dramatic improvements in erection capabilities. Lastly, changing your lifestyle can do wonders for current and future ED. Putting down that cigarette, eating salads instead of fast food, and going to the gym for a cardio workout are simple lifestyle changes that can have lasting, positive effects on your penis.

The professionals focusing on erectile dysfunction
Now you have some basic information. What’s stopping you from seeing a doctor or urologist and getting to the bottom of your ED? I use the metaphor of fighting a “battle” because it’s wise in battle to have the best weapons by your side to produce a favourable outcome: Information, being proactive, a medical doctor (MD), and a psychotherapist are your best weapons in the ED fight. MDs can prescribe medication and order important and necessary tests like urine analyses, complete blood work-ups, and hormone analyses to help rule out possibilities and find the origins of your ED. MDs can also order tests using nocturnal penile tumescence (NPT), which monitor erectile activity during sleep and ultrasonagraphy, which measures the blood flow and size changes of arteries in the penis.