My Penis Stuff

The following lifestyle changes may reduce the risk of erection problems (erectile dysfunction):

• Limit alcohol to fewer than 2 drinks per day, or eliminate alcohol if it seems to interfere with erections. Even small amounts of alcohol can result in erection problems.
• Stop smoking. Smoking interferes with the ability of the blood vessels in the penis to relax and allow blood to flow in, which can affect your ability to have an erection.
• Avoid the use of cocaine, heroin, and other illegal drugs.
• Check your medications. Many medications can cause erection problems. Ask your doctor or pharmacist whether the medications you are taking have any sexual side effects.
• Relax. Worrying about sexual performance may only worsen erection problems.
• Talk to your partner about your problems and concerns. Sexual intimacy is a form of communication. If you and your partner aren’t talking outside of the bedroom, it’s unlikely that you will have good sexual intimacy.
• Reduce stress. A heavy workload or stressful job can reduce your interest in and energy for sex. Regular exercise and other stress-relievers can help.

You may be able to avoid erection problems (erectile dysfunction) related to anxiety and stress by taking a more relaxed approach to lovemaking. Talk to your partner about your problems and concerns. Sexual intimacy is a form of communication. If you and your partner talk about your lovemaking, it will help reduce your stress and anxiety and you may become more relaxed.

Erections may gradually become more difficult to get and maintain as you get older. However, foreplay—erotic stimulation before intercourse—and the right environment can help increase your ability to have an erection, regardless of your age.

Other things you can do that may reduce your risk for developing an erection problem include:

• Quitting smoking.
• Avoiding use of excess alcohol and illegal drugs.
• Keeping your cholesterol level low to reduce the risk of hardening of the arteries (atherosclerosis).
• Treating high blood pressure.
• Keeping your blood sugar in a safe range if you have diabetes.
• Exercising regularly.
• Lowering stress in your life.

Treatment for an erection problem (erectile dysfunction) depends on the cause of the problem, which may be psychological, physical, or a combination of both. Erection problems that have one or more major physical causes also often have psychological factors that make the problem worse and make treatment more complicated.

Many doctors take a stepwise approach to treating erection problems, using the least invasive treatments first. These steps are:

1. Discovering and then eliminating medications that may be causing your condition. In some cases a different medication can be tried.
2. Trying an oral medication (such as phosphodiesterase-5 inhibitors [Viagra, Levitra or Cialis]), unless an easily treated cause—such as a medication side effect or testosterone deficiency—has been identified.
3. Trying a vacuum device and getting counseling if a psychological cause is suspected.
4. Trying medications that are injected or inserted into the penis.
5. Trying penile implant surgery or an external penile splint.

Counseling (also called psychotherapy) or behavioral therapy may be appropriate even if your erection problem has a physical cause. It may be offered if your health professional suspects psychological issues play a role in your erection problems.

What To Think About

It is important to involve your partner in your decision regardless of the treatment you choose.

Oral medications have revolutionized the treatment of erection problems, and they are commonly tried first before other medication or surgery.

Although phosphodiesterase-5 inhibitors have relatively few side effects, they can be dangerous in certain men. If you are taking nitrate-containing medications, such as nitroglycerin, you cannot use Viagra, Levitra, or Cialis. You also should not take certain alpha-blockers—used to lower blood pressure and to treat an enlarged prostate gland—with these medications because of the risk of a dangerous drop in blood pressure. Check with your health professional to see whether you can take Viagra, Levitra, or Cialis with your alpha-blocker.

Many men overestimate how important being able to have erections is to their relationships. Some men find that once they are able to have erections again, the hassle of using the treatment is not worth the effort. Other men may find that being able to have erections doesn’t change their relationship as much as they or their partner had expected.