Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor. Erectile dysfunction is defined as trouble getting or keeping an erection that’s firm enough for sex. It affects as many as 18-30 million men in the USA, or 1 in 5 American men 20 years or over.  By the age of 75, greater than 75% of all men will have some degree of ED.  So if you are reading this and you have ED, know that there are many, many others suffering from this.  Aside from the commercials for things like Viagra, no one talks openly about it, so for many people, it’s a really awful secret.

Erectile Dysfunction is a very challenging medical diagnosis for many reasons, but especially because of the emotional toll it takes on a man and his partner.  It can disconnect a couple emotionally and can leave both partners feeling really bad about themselves.  They often have no idea how to help themselves manage their feelings, and to help one another to maintain their intimacy and their feelings of self-worth. Neither partner knows what to do to “fix” things and it feels overwhelming, shameful and hopeless.

How does the person with ED respond?

Typically, the partner with erectile dysfunction feels intense shame and feels let down and betrayed by his body.  It becomes extraordinarily embarrassing and frustrating to have trouble with his erection either by himself or with a partner.  He may beat himself up, feel like he is less of a man and not worthy of a relationship.  He may worry that his partner will see him as “less than” because of his erectile dysfunction.  He may not know what to do or what to say when he is unable to maintain an erection. 

Overcome with embarrassment and frustration, he may not respond well to his partner and may end up hurting his partner’s feelings.  His performance anxiety may become overwhelming and he also may begin to avoid all intimate encounters for fear of what might happen.  He may even avoid things like romantic dinners because they often lead to sex. Any of this can leave his partner feeling rejected and unloved.

What about his partner?

His partner also struggles with the fallout of erectile dysfunction.  The partner may feel such sadness for them and may be equally frustrated about what to do and may become afraid about what their intimacy will look like in the future if this continues to happen.  Sometimes partners say hurtful or inappropriate things.   This may fuel the performance anxiety of the one with erectile dysfunction and make things even worse. The partner may also want to reassure them but frankly, not really know what to say.

Even though medical treatments exist to help with erectile dysfunction, the plethora of painful emotions and residual performance anxiety can be too much for most individuals and couples to cope with on their own.  Just popping a magic pill or using a penis pump or injection is not going to fix the emotions both partners feel.  

How can therapy help?

I love helping couples through this messy part.  I love to give them a caring ear and supportive environment in which to talk about all of this.  I provide them with helpful information and guide them through this awful experience by helping them to share their feelings with one another in a way that strengthens their relationship. I also like to help single men that are struggling with erectile dysfunction. I help both individuals and couples realize that sex is all about pleasure.   Truly, it is more about feeling pleasure than it is about having intercourse and an orgasm.

If you or your partner struggle with erectile dysfunction, please contact me. I’d love to help.  You don’t need to live with this secret or with the painful emotions that come along with ED.

If you would like to watch free training on the role of performance anxiety in erectile dysfunction, which helps you to understand how worries about erections of sexual performance contribute to erection problems, please click here or in the menu to access the free training.

If you are interested in transforming your sex life and erection issues, please click here or in the menu to find out more about my masterclass in erectile dysfunction.



NIH Consensus Conference. Impotence. JAMA 1993:270;83-90

Rogogatis LR and Burnett AL. The epidemiology of sexual dysfunctions. J Sex Med 2008;5;289-300

United States, Dept Health Human Services 1987

Martin-Morales A et al. Prevalence and independent risk factors for ED in Spain. JUrol 2001:166;569-74

Panser  LA et al. Sexual Function of men 40-79 years – the Olmsted County Study of Urinary Symptoms. J Am Geriatr Soc 1995

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