ED and the question of Skills Vs. Pills
How do I stay hard longer? Should I get a prescription for Viagra? How can I better please my partner? What are some tips for better performance in the bedroom? Why can’t I stay as hard as l used to?
One of the most common sexual difficulties that I treat is erectile dysfunction, or ED. And you better believe that the clients I work with are not coming to my office because the WANT to see me. Usually, my clients come to me as a last resort. They’ve tried everything:
…Staying up late in the night on Incognito Mode Googling tips or tricks to ‘get it up’, scrolling through web forums, trying ‘natural supplements’ (red ginseng??), trying new techniques in the bedroom.
…Other men will avoid sex all together in order not to feel the disappointment when their body betrays them.
The truly determined (or brave… or desperate…) will work up the courage to talk to their family doc, who may provide a prescription for Viagra (or one of Viagra’s cousins; Cialis or Levitra) or who may send them to a urologist. By the time they arrive on my door, they are bruised, beaten, and feeling down right awful.
THE UNFORTUNATE TRUTH…
What many people don’t realize is that one in three men will experience erectile dysfunction at some point during their life.
ED isn’t actually a problem. It’s a normal part of owning a penis. But ED can get to be a problem when people expect erections to work like an on/off switch. The unfortunate truth is that erections DON’T work like an on/off switch. When we expect them to act like a simple switch and they don’t… well… that’s when problems start to arise.
SO WHAT’S THE DEAL WITH ERECTIONS?
There is a great deal of misinformation out there about sexual health and functioning.
It should come as no surprise that Sex Ed is lacking. Most importantly, it’s lacking any discussion at all about sexual pleasure or sexual enjoyment. And because these very important messages are missing, we turn to other sources for our information:
…The media, movies, porn, swapping stories between buddies, etc…
The problem with relying on these sources for the majority of our Sex Ed is that they aren’t based on the facts (in the case of porn, its complete fantasy… not that there’s anything wrong with porn, you just need to recognize that it’s the result of movie magic).
Misinformation makes way for sexual myths. As a sex therapist, I hear sexual myths all the time and they Drive. Me. Crazy. When it comes to ED, sexual misinformation teaching us things like:
“Erections should work like an on/off switch,” | “I should want sex all the time,” | “I need a rock solid erection in order to please my partner,” | “My erections should last as long as they do in porn,” | “If I was really enjoying myself or really attracted to my partner, I should be able to get it up and keep it up”.
…Any of these sound familiar?
WHAT IS “NORMAL,” ANYWAYS?
The truth is, erections can actually be fairly complex. There are a lot of checkboxes that need to get checked in order for an erection to happen, and for it to last during sexual activity. Erections do not work like an on/off switch!
In order to “get hard” and “stay hard”, here is a sampling of the checkboxes that need to be checked:
- PHYSICAL HEALTH: Some of the most common medical condition that affect men’s health also impact erections, like cardiovascular health, diabetes, and smoking. Many medications or medical treatments also impact erections, like antidepressants or prostate cancer treatments.
- AGE: While ED impacts about 1out of 3 men throughout their lifetime, that number climbs with age. After the age of 75, three-quarters of men will have some problems with ED. Erections don’t always look the way they did when you were 17!
- DISTRACTION: As a clinical-researcher, I’ve studied men’s sexual arousal in the lab. For some of these studies, we need to make sure men are not physically aroused. But, of course, sometimes it just happens. In order to get rid of any unwanted erections during lab studies, we ask men “Please count down from 900 in multiples of 7. Out loud”. Erections immediately disappear. So if you are attempting to engage in sex, but your mind is distracted by a million other things (“I’ve got so much to do at work”, “Dinner reservations are in 20 minutes!” “Am I going to last long enough this time?” “Is my partner even enjoying themselves?”), good luck maintaining your arousal.
- STRESS: If you are living a typical human life, I’m willing to bet that you experience some level of stress. The neurochemical and the physiological responses of stress (i.e., the goings on of the brain and the body) are completely incompatible with a sexual response. In the case of ED, this can frequently act as a Catch-22: “I’m worried that I wont be able to get an erection, so now my body kicks into a stress response and I can’t get an erection”.
Those are just a few examples. There are many more.
ED IS A PROBLEM WITH MY BODY, SO WHY CAN’T I JUST TAKE VIAGRA?
Since the introduction of Viagra to the market in 1998 (1999 in Canada), a belief (read: sexual myth) has developed that ED can be “cured” with that little blue pill. And for some people, that’s true! And trust me! If Viagra worked like the magic cure-all people believe it to be, I would encourage everyone to take it!
But the research paints a very clear picture that Viagra isn’t a magic fix.
A closer look at the research shows us that most men stop using erectile aids (like Viagra, Cialis, Levitra) after only six months.
What this tells us is that Viagra doesn’t address the entire picture.
Sexual functioning is a function the three pillars of health: the body, the mind, and relationships. When treatments for ED only focus on the body (i.e., medication) it leaves a lot of the bigger picture completely unaddressed. So if, for example, a man experiences a great deal of stress around a sexual encounter because he is afraid he will loose his erection, all the Viagra in the world will not help him “stay hard”.
BUT WAIT. THERE’S HOPE.
If you have ED, and your doctor has ruled out serious medical reasons for it (like cardiovascular problems, for example), there is a lot that can be done to make sex great again. Medication might be a start. Learning tips and tricks to stop worrying and start marking sex fun again is another excellent option (this is a big part of sex therapy). Addressing underlying issues within the relationship that may be adding to erectile problems, like feeling distant from your partner or living more like a roommate than a spouse. Or perhaps you will try a combination of all three pillars.
One step that’s critical to improving erections is to stop believing sexual myths. The first step towards unlearning sexual myths is to learn how to identify when a sexual myth is just a myth, and replace it with sexual facts.
You also need to learn more about what checkboxes exist for you to have a healthy, pleasurable sexual experience. Is stress a factor for you? Where does your mind go during sex? Is there novelty in your sex life, or has it gotten predictable? Is sex even fun?! Are there many activities on your sexual menu, or only a few? Do you feel comfortable expressing your sexual needs to your partner? Do you know what sexual needs your partner has?
If you are using erectile aids, like Viagra/Cialis/Levitra, make sure you’re using them properly! I worked with a client once who swore up and down that Viagra didn’t work for him. When I asked him to walk me through how he used it, he calmly explained that he took a pill, grabbed the morning paper, and sat out in the garden to read the news while he waited for the erection to arrive. Of course it never did! You need to engage sexually and cultivate arousal and desire in order to erectile aids to work.
THE BOTTOM LINE
If you are struggling with ED, know that you are not alone.
Also, know that it is very possible to overcome ED.
It’s not that you’re not trying hard enough or that you are “broken” sexually. You just need the right tools.
For some men, medications like Viagra are enough to do the trick. Research has shown that sex therapy (as little as a single session, in some cases) acts like a Viagra booster, making the drug more effective. The bonus of therapy is that it works by targeting the whole picture (the brain, body, and relationships), thus making sex better overall, and giving men the tools to maintain an awesome sex life far into the future.
Believe it or not, the best way to get firmer erections is to learn tools to stop focusing on the firmness of your penis, and focus instead on making your sex life as fun, exciting, and enjoyable as possible.
Dr. JENN BOSSIO, C. Psych is a psychologist and sex therapist servicing Kingston, Ontario and the surrounding areas including Bellville, Nappanee, Brockville, and everywhere in between. She works with individuals and couples to help make their sex lives better over all. She specializes working with men who have ED.