Understanding ED

Erectile dysfunction (ED) can be equally devastating for a man and his partner. There is hope for every man with ED to regain the confidence, control and wholeness to enjoy an active, satisfying sex life.

Did You Know?

The prevalence of ED in men over age 40 increases with age.2

Erectile Dysfunction Statistics
Erectile Dysfunction Statistics

Erectile Dysfunction: A Men's Health Issue

Life can get in the way of a rock-hard erection: stress, anxiety and outside factors play a role. Occasional erectile dysfunction (ED) is a common condition that affects many men and impacts their partners. Many men experience it during times of stress. Once these problems are managed, you should return to smooth sailing in the bedroom; but continued problems getting or keeping an erection may indicate a more serious health condition.

ED is defined as the inability to achieve or maintain an erection that is firm enough to have sexual intercourse.6 In other words, the penis doesn’t get hard enough to allow you to have sex. It may begin in the bedroom, but it can have a profound effect on a man, his self-esteem and his relationships.7

How an Erection Works72

When aroused, the nerves surrounding the penis become active. The muscles around the arteries relax and more blood flows into the penis. This additional blood makes the penis stiff and hard, or erect. The erection tightens the veins so the blood can’t leave the penis, enabling the penis to remain erect.


Erection Hardness Scale73

How hard is hard enough?

This Erection Hardness Scale may help you and your partner identify if ED is suspected. The measure is done when the erection is active. Note food analogies are for illustrative purposes only.73 If you can’t achieve a Grade 4 erection more than 50% of the time, talk with your GP or urologist about the problem.

Penis is larger but not hard.

Unpeeled banana
Penis is hard but not hard enough for penetration.
Peeled banana
Penis is hard enough for penetration but not completely hard.
Penis is completely hard and fully rigid.

ED Symptoms and Causes

Signs and Symptoms

You may be surprised when you experience ED for the first time.  ED can manifest in multiple ways, signs of ED include:48

  • A significant increase in the amount of time it takes to achieve an erection
  • Difficulty maintaining an erection long enough to have intercourse
  • Decreased frequency of spontaneous erections

In fact, more than half of men over 40 suffer from some degree of ED.1 If you can’t get an erection more than 50% of the time, you should see your GP or a urologist. To better understand the link between your symptoms and ED, take our quiz to get your ED Score.The results should be shared with your GP or a urologist to help initiate a conversation about the right treatment options for you.

Get your ED Score 

One Condition, Many Causes

ED happens when blood flow to the penis is limited or nerves are damaged.  There are several possible causes physical and/or psychological reasons for ED, some common causes include: 1, 7-9, 46-47

  • Prostate cancer treatment, trauma to the pelvic area can cause nerve and vascular damage
  • Diabetes, which can compromise the blood flow to the penis
  • Cardiovascular problems including high blood pressure and heart disease, can compromise the blood flow to the penis
  • Other surgery (prostate, bladder, colon, rectal), trauma to the pelvic area can cause nerve and vascular damage
  • The side effects of some medications,1, 9 including some for high blood pressure and antidepressants can interfere with blood flow to the penis
  • Lifestyle choices (smoking, excessive alcohol, obesity, lack of exercise, stress, lack of sleep), can also affect your performance
  • Spinal cord injuries
  • Hormone problems
  • Depression and anxiety

In other words, ED affects men of every ethnicity, age and lifestyle.

Prostate Cancer Treatment and ED 

Peyronie’s Disease and ED 

Low Testosterone and ED 

Heart Disease and ED 

Diabetes and ED 

Treatment Options for ED

ED is treatable at any age.  Treating the underlying cause of ED is a good place to start, such as adjusting your lifestyle, quitting smoking and reducing your stress. Oral medications are typically the first line of therapy, but some men may need more. Medications are typically followed by one or more of these treatments:  vacuum devices, penile implants or penile injections.

Treatment Options 

Stop wondering about ED

Start by taking the quiz

Ways to Help Your Partner

ED is a difficult topic for couples to discuss. Talking openly can help reduce stress and improve your relationship. Acknowledge your feelings, reassure each other and resolve to work through the problem, together.

Helping Your Partner Who Has ED

Get Informed

ED is a common medical problem. It is both physical and emotional, but that doesn’t mean you have to accept it. Most importantly, ED is treatable. The more you know about ED, the more helpful and positive you can be. Go to your GP or urologist and ask the right questions.

You can help him seek treatment, something many men are hesitant to do. If you both have adjusted to a life without sex, you may also want to explore treatment options for yourself.

Prostate Cancer Treatment and ED 

Peyronie’s Disease and ED 

Low Testosterone and ED 

Heart Disease and ED 

Diabetes and ED 

Choose the Moment

Try to find a non-sexual place to talk at a time when both of you are relaxed. Communication is key. Turn off the TV and mobile phones. Take a deep breath and take the plunge. Focus on ways to solve ED, rather than on how it affects your relationship. If he isn’t ready to talk about it, see if he will talk to your GP or a urologist.

Conversation Starters  

Be Sensitive and Honest

A man with ED may withdraw from sex and his partner. Be patient. You may blame yourself, thinking you are no longer desirable. You may blame him and suspect infidelity. Be honest. Talk about what you each expect. If you noticed changes during sex, bring it up to him. While difficult, talking about ED may bring you closer and strengthen your relationship.

Get Talking 

Come Back Stronger

The fact that your partner is open to talking about ED is overcoming the biggest battle. But, it may not be as easy as taking a pill. Find solutions acceptable to both of you. Don’t be afraid to experiment. Many couples report an increase in desire after focusing on intimacy – kissing, hugging, stroking, etc. Talking about ED solutions may lead you both to healthier lifestyle choices.

Talking about ED can change your life.

Recovery can start with a simple question. Millions of couples deal with this and you can, too.

Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.  All images are the property of Boston Scientific. All trademarks are the property of their respective owners.

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