Erection Quality - When Your Erection Isn't So Great by Dr. Drai

Hello, #MomentumLovers. It’s me, Dr. Drai, talking about sex and sexual health to keep you safe, happy, and healthy. Erectile dysfunction (ED) is frequently referred to as the inability to achieve or maintain an erection long enough to complete intercourse. 

Also called sexual dysfunction, erectile dysfunction (ED) is known as one of the more common medical conditions that can affect a man’s sexual performance. Estimates show between 15 and 30 million Americans currently suffer from some form of erection problems. 

Several different things can cause these kinds of erection problems, but the most common include excessive stress, recreational or prescription drug use, liver disease (usually form alcoholism), or even from a penile implant that isn’t working properly. 

Most of the causes are physical rather than psychological, to begin with, but some estimates show up to 70% have a psychological component as well because erection problems can be crushing to a man’s self-image. 

Let’s discuss the common causes of  and treatment of Erectile dysfunction: 

Common Causes: 

For most men, impotence comes from one of many fairly common sources. 

  • Common medicines (typically those for blood pressure, antidepressants, and appetite suppressants) may cause ED as a side effect. 
  • Psychological effects-stress, guilt, anxiety, fear, depression, fear of sexual failure, and low self-esteem can account for as much as 20 % of cases on their own but are also usually contributors to the other 80% of cases. It is safe to say that once a man begins to have problems, his fears and concerns usually add to the problem. 
  • Excessive alcohol use and smoking - also cause cardiovascular problems that can lead to lowered testosterone and ED. 
  • Injury to the spine or pelvis (or cancer surgery on the prostate or bladder)- there can be damage to the nerves near the penis that may lead to problems with erections in the future. 
  • Damaged nerves and tissues (smooth muscles, arteries, etc.) - the most common source of problems. Diabetes, kidney disease, excessive alcohol use, and conditions like multiple sclerosis and atherosclerosis account for the majority of cases of impotence. Up to 50% of men with diabetes experience sexual problems at some point. 
  • Aging -is associated with erection problems as well. 


Luckily for most men, ED is a curable condition. Several different treatments are available that can make a real difference, even completely reversing the effects. 

Physicians typically suggest treatments starting with the least invasive, moving up to higher risk options only after all the low-risk options have been attempted. 

If, for example, you suspect that the heart medication you are taking is the problem, telling your doctor may result in his trying a different class of medicine or altering the dosage. Some patients may be suited to have psychotherapy or behavior modifications. 

Oral drugs (like Viagra) are often considered next, followed by locally injected drugs. Vacuum devices are often the next step, followed by surgery as a last resort after all other methods have been tried. The dangers involved with surgery make it a last resort. 

Thank you for reading this #MomentumLovers! As always...I'm Dr. Drai a board-certified OBGYN, sexual health expert, and founder of Momentum Intimacy. Through my FDA-approved condom & lubricant line called Momentum, I help people improve their intimacy and have a more satisfying sex life. 

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