Coping with Erectile Dysfunction - Addressing a Symptom That Erodes Male Self-Esteem
About a 3 min read.
ED Is Not Uncommon
According to estimates by the Japanese Society for Sexual Medicine, the number of men with ED in Japan is approximately 11.3 million. About 20% of men in their 40s, 40% in their 50s, and 60% in their 60s experience some form of ED. In recent years, ED among younger men in their 20s and 30s has also been on the rise.
ED is not "the end of your manhood." Yet many men feel exactly that way, and out of shame they cannot talk to anyone about it and begin avoiding sexual activity with their partner. This avoidance creates a vicious cycle of deteriorating partnership and further declining self-esteem.
Causes of ED
Organic (Physical Causes)
Arteriosclerosis, diabetes, hypertension, dyslipidemia. These lifestyle diseases damage vascular health and reduce blood flow to the penis. ED is sometimes called an early warning sign of cardiovascular disease, and it is not uncommon for lifestyle diseases to be discovered after an ED diagnosis. Declining testosterone levels due to aging are also a contributing factor.
Psychogenic (Psychological Causes)
Performance anxiety, work stress, depression, relationship problems with a partner. Most cases of ED in younger men are psychogenic. The worry "What if I can't get it up?" activates the sympathetic nervous system and inhibits the parasympathetic activity needed for erection. A single failure easily triggers a vicious cycle of escalating anxiety.
Drug-Induced
Antidepressants (SSRIs), antihypertensives, antiandrogens, diuretics - many medications have ED as a side effect. If you are taking any medication, do not stop on your own; consult your prescribing physician. (You can gain a deeper understanding of the causes from books on ED)
How to Address It
1. See a Urologist
ED is a medically treatable condition. PDE5 inhibitors (Viagra, Cialis, Levitra) are effective in roughly 70 to 80% of patients. Generic versions are now widely available, lowering the financial barrier. An increasing number of clinics also offer prescriptions through online consultations.
2. Improve Your Lifestyle
Research suggests that regular aerobic exercise (at least 150 minutes per week) can be as effective as medication in improving ED. Quitting smoking, moderate alcohol consumption, adequate sleep, and a balanced diet. Improving vascular health is the fundamental approach to addressing ED.
3. Talk Openly with Your Partner
Continuing to hide ED erodes trust in your relationship. By honestly saying "I've been having some trouble lately," you can relieve your partner's worry that they are no longer attractive. When ED is faced together as a shared issue, it can actually deepen the partnership.
4. Broaden Your Definition of Sex
Erection and penetration are not the only forms of sex. Oral sex, manual stimulation, massage, kissing. There are countless ways to share intimacy and pleasure regardless of whether an erection occurs. Letting go of the belief that "it's not sex without penetration" dramatically reduces the pressure caused by ED. (Books on partnership are also a helpful reference)
Summary
ED is not a shameful secret; it is a treatable medical condition. See a doctor, review your lifestyle, talk with your partner, and broaden your definition of sex. These four approaches are the key to reclaiming a life not controlled by ED.