Many of the men I see come to me because they are experiencing erectile dysfunction problems. The men, who vary in age, had previously taken their ability to perform in the bedroom for granted and have trouble understanding why this is happening to them now.

A common cause of erectile dysfunction, in many men, is sexual performance anxiety. They experience great fear every time they engage in sexual intercourse, especially if it is with a new partner. They terrify themselves with thoughts of: ‘will I get hard enough’, ‘will I keep it up’, ‘how long will I last’, and ‘will she tell her friends?’

These are common performance anxiety thoughts, but they can cause men to lose their erections immediately. This, in turn, exacerbates their anxiety and leads to troublesome feelings of sadness, disappointment, guilt and shame.

The more this happens, the more these men lose their confidence. They may start avoiding sex or become so traumatized they stop having sex altogether. This cycle often continues until it is addressed. To break the cycle, they first need to admit there is a problem.

These men also need to be vulnerable and share the problem with their partner. At the same time, the partner needs to be understanding; guiding, and supporting the man by letting him know he can relax, take his time, and let things happen naturally. Unfortunately, some women can be cruel, often without realizing how hurtful it is, by telling their partners how well their former lovers performed. This will only compound the problem.

It is also important to seek professional advice for erectile dysfunction

I always take a client’s sexual history into account. If a list of possible causes is ruled out, it is often a performance anxiety issue. This can be successfully treated with counseling, practical sexual advice, and reassurance.

Men need to know that occasional sexual difficulties are normal and can happen to any guy, young or old. Research shows that most healthy men occasionally experience erectile dysfunction or failure.

However, young men need to be aware that how they treat their health now can affect their sexual performance in the future. For instance, there is a strong link between smoking and erectile dysfunction due to limited blood flow. In 2006, there was a major advertising campaign in the UK warning that smoking can cause impotence and ruin your sex life. Graphic ads appeared with the slogan, ‘Your Penis Thinks You Should Stop Smoking Now.’

Smoking can cause erectile dysfunction
SMOKING can cause Impotence

In Australia, however, there is no mention of impotence in anti-smoking advertisements so most men are not aware of the sexual damage it can cause. Smoking causes hardening of the arteries, and delicate penile arteries can be affected and damaged. Some research suggests that smoking also affects testosterone levels and reduces the volume of ejaculate, lowering sperm counts, and fertility.

There are other important health issues contributing to erectile dysfunction:

  • Stress, depression, and anxiety – can all affect sexual performance.
  • Obesity – being very overweight can make men impotent, although with a change in eating and drinking habits this can be reversed. 
  • Heavy drinking – too many drinks affect the ability to get an erection, even with the most desirous of intentions.
  • Drugs – party drugs and many prescription drugs create huge problems and can turn a ‘willy into a will not.’

Women can support their partners and reclaim the sexual pleasure; both of you, once enjoyed by helping them to be healthy, lose some weight and get fit again.

As I mentioned before, in most cases erectile dysfunction can be fixed with the help of a sex therapist, which will lead to an overall happier life for both of you. Couples who enjoy having sex together stay together!

This post originally appeared in The Sydney Morning Herald and was published on July 9, 2012. This article is republished here with permission and updated on November 25, 2020.