Erectile Dysfunction Causes

As a sexologist I see many men with Erectile Dysfunction (ED) due to various causes. It’s frustrating for you and you may be very embarrassed about seeking help.

Because I am a clinical naturopath (ANPA), sex therapist, hypnotherapist (AHA) and mental health professional (PACFA) I look at all the possible causes and am competent in each field to help you.

Don’t expect your family doctor to have a concise knowledge around sex as its not in their training. Also, they simply don’t have the time to make extensive investigations or can teach you what to do.

It also depends on your age because different causes are more common at certain ages. So, a comprehensive analysis of your physical and mental health is needed.

What is erectile dysfunction?

This depends on so many factors like:

• Your age and physical health
• Mental health
• Knowledge around sex
• Medications and nutritional health
• Previous experiences
• Expectations of performance
• Social rules and guidelines
• State of your relationship

All these and more frame the way you relate to your penis and what you expect of its erectile ability and performance. What may be satisfactory for one person mightn’t be so for another.

Some definitions say inability to engage in intercourse, others the ability to maintain and erection for more than a couple of minutes. (1)

I say to you that the definition of whether you experience this is whether you are happy with the erectile function. It your body, life and penis so only you can gage your happiness with those sexual interactions.

How common is erectile dysfunction?

Well, it’s much more common than you think. Research shows us that it mainly affects men over 40 years of age. (2) This was of course due to ageing and age-related diseases like cardiovascular disease, diabetes, prostate problems and depression.

These figures, however, are probably underestimated due to the fact that younger people who experience ED generally don’t seek help so researchers can’t include them.

Numbers go much higher with men over 70 years of age who tend to have much lower testosterone levels.

ED is often accompanied by premature ejaculation in many cases, but family doctors do not ask patients those extra questions, so a correct diagnosis is not made.

What are the physical causes of erectile dysfunction?

If you’re suffering from a physical disease or disability, it lowers your ability to engage in sex. (3) The body may be busy fighting off infection or trying to cope with a disability, so it draws energy away from your sexual needs.

Some males are born with genetic differences which means that their testicles are small, so they don’t produce enough testosterone to create and maintain erections.

Other men’s bodies may have problems recognising testosterone, so the body isn’t getting the message that initiates sexual interest and performance (The sex response cycle).

One of the major causes of loss of erectile function is prostate problems. Whilst you need high testosterone for erectile function that also makes prostate problems more likely. If you have a prostatectomy due to prostate cancer, that can also damage the nerve that initiate erections.

Obesity, high cholesterol and blood lipids, and type 2 diabetes are also contributory factors.

What is constantly dismissed by doctors are the effects of poor nutrition on sexual health. Also, the toxicology of poisoning from the environment like heavy metals, plastics and chemicals that cause males to have high levels of estrogens that interfere with testosterone.

During treatment, I may test all of these factors.

The effects of mental health on erectile function

The mind and the body are not separate. When you have a disturbance in your mind you will have disturbance in your body and your sexual performance.

It’s well recorded that males with mental illness have higher levels of erectile defunction. (4) If you are delusional or unable to survive a normal day your body produces high levels of cortisol. This hormone interferes with testosterone and erectile function.

Psychiatric medications and antipsychotics have the same effect, but many psychiatrists dismiss the patient’s need for a reasonable sex life. Therefore they don’t balance that patients’ whole needs and consider sex to be unimportant.

Psychological disturbances life anxiety, depression, trauma PTS, phobias and addictions also interface with the sex response cycle that initiates an erection.

I make it clear to patients that creating good mental health adds to you sex life no matter who you are or your circumstances. Not only do I check for balance of mind but also balance of lifestyle. If they are disturbed, I help you restore them.

Medication for erectile dysfunction

We live in a world where marketing tells us that a single pill can fix our problems including, erectile function.

Consider this – you go to the doctors and tell them about the problem, they do no tests, ask you very few questions, but just give you a drug.

What are the odds they have made a correct diagnosis?

You may be given Viagra or Calais, which could help, but the doctor hasn’t investigated the cause of your erectile problems. The pills might work for a while, but sex has many aspects and when something goes wrong it needs a thorough investigation.

Doctors, however, aren’t trained to do this so they may have even less knowledge than you about the causes. (5)

Why see a sexologist?

Because we as sex therapists are specifically trained in sex, how to do it, enjoy it, and what to do when things go wrong. It’s a whole different field from general medicine.

We may work with your family doctor, but they generally don’t have the time to do the follow-up work with you that we require to help you. (6)

The changes I ask you to make can be very large to reduce stress, get healthier, eat better and learn more about sexual performance. Sex is an art as much as it’s an instinct. There are practices you need to learn to support your sexual function particularly as you get older. I teach you tantric sex that has be used for thousands of years to help people with their sex lives.

As a teenager you probably woke up with an erection in the morning (morning glory), it was involuntary. From your early twenties, however, your testosterone levels begin to drop so you need to practice with art of sex.

There are various ways to retore these, but it requires expert clinical knowledge and not something you may attempt yourself.

Diet and exercise

One of the more common causes of ED is vascular occlusion (blockages of blood vessels). This may be in your penis, heart or brain. They are caused by saturated fats that cause inflammation in the vessels.

If your penis is not getting enough blood pumped into it, then it won’t swell and become hard or maintain an erection.

When you are young you generally move a great deal so build and maintain the muscles in your pelvis, abdominal and back muscles that activate and maintain erections.

In adulthood people become so occupied with making a living and raising a family that you neglect the need to create and maintain physical excellence. Therefor those muscles become weak, which increases the likelihood of erectile failure. (7)

As a medical nutritionist and naturopath, I always guide you to change what you are eating and how you’re living your life to promote erectile function. (8)

Slowing sex down

We live in a fast-food society. In other words, people want everything fast so get impatient when instant results don’t happen.

Sex needs to take time so I teach you tantric sex where everything is slowed down making and protecting time to enjoy the experience. Savor and be enthused about each part of the encounter. (9)

This of course requires you to have absolute commitment to the process and follow through with what you need to learn.

Part of this is also learning how to breathe. If you’re nervous and afraid of erectile dysfunction you will either hyperventilate or hold your breath, neither of these serve you.

I teach different breathing techniques for the different parts of sex because your body changes during the sex response cycle.

Sexual confidence for erectile function

Erectile failure causes you to have a loss of confidence in your ability to perform, particularly during intercourse. It’s not just you as it generally happens when men experience erectile dysfunction.

Pornography has led us to believe that you should have a hung strong erection all the time. It’s not realistic.

To have good erection you need to be confident in your ability for that to happen, being comfortable in your identity.

Therefore, part of treatment needs to be to help reframe what has happened into being a steppingstone towards resurrecting you sex life. So, building your confidence back up is part of treatment. (10)

How hypnotherapy can help erectile dysfunction

ED can have both physical and psychological causes. First, we must screen for the physical elements and remedy them if we find a problem.

If no physical problems are found, then there is a need to use hypnosis to find previous incidents that cause you to lose your sexual confidence.

We use hypnosis because it’s quicker and you can recall what happened much more effectively in a hypnotic state. (11)

Also, hypnotherapy is comfortable and puts you at ease, making you feel relaxed as we’re doing the work.

In building back up your confidence hypnosis also can help the process go faster, building your confidence stronger.

Dr Tracie O’Keefe sex therapist, clinical naturopath, hypnotherapist and psychotherapist who has over 50-years’ experience in sexual health issues. To get help with erectile dysfunction book your sex therapy and hypnotherapy appointment with Dr Tracie O’Keefe DCH by calling 0403 398 303

 

References

(1) Pastuszak, A. W. (2015). Current diagnosis and management of erectile dysfunction. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394737/

(2) Leslie, S. W., & Sooriyamoorthy, T. (2021). Erectile dysfunction. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562253/

(3) Advances in physical diagnosis and treatment of male erectile dysfunction. (2022). Frontiers in Physiology. https://doi.org/10.3389/fphys.2022.1096741

(4) Ciaccio, V., & Di Giacomo, D. (2022). Psychological factors related to impotence as a sexual dysfunction in young men: A literature scan for noteworthy research frameworks. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2022.9326597

(5) Beebe, S., Payne, N., Posid, T., Diab, D., Horning, P., Scimeca, A., & Jenkins, L. C. (2021). The lack of sexual health education in medical training leaves students and residents feeling unprepared. Journal of Sexual Medicine. https://pubmed.ncbi.nlm.nih.gov/34711518/

(7) Sever, Z., & Vowels, L. M. (2023). Barriers to seeking treatment for sexual difficulties in sex therapy. Journal of Sex & Marital Therapy. https://doi.org/10.1080/15332691.2023.2264470

(8) Silva, A. B., Sousa, N., Azevedo, L. F., & Martins, C. (2016). Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. Journal of Sexual Medicine, 13(5), 726-736. https://doi.org/10.1016/j.jsxm.2016.03.372

(9) Bauer, S. R., Breyer, B. N., Stampfer, M. J., Rimm, E. B., Giovannucci, E. L., & Others. (2020). Association of diet with erectile dysfunction among men in the health professionals follow-up study. American Journal of Clinical Nutrition. https://pubmed.ncbi.nlm.nih.gov/33185675/

(10) CE Corner: Sex therapy for the 21st century: Five emerging directions. (2019). Monitor on Psychology. https://www.apa.org/monitor/2019/02/cover-ce-corner

(11) Silva, A. B., Sousa, N., Azevedo, L. F., & Martins, C. (2016). Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. Journal of Sexual Medicine, 13(5), 726-736. https://doi.org/10.1016/j.jsxm.2016.03.372

(12) Brown, J. M., & Chaves, J. F. (1983). Hypnosis in the treatment of sexual dysfunction. Journal of Clinical Psychology, 39(5), 722-732. https://doi.org/10.1002/1097-4679