Masculinity and ED

By Austin Davis

Erectile dysfunction isn't just a physical health issue–it can also be psychological in origin and have a profound effect on your and your partner's quality of life and mental health. Understanding the emotional and social aspects of erectile health are important factors in coping with the stress of ED and taking back control of your sex life.

Mind, body, penis

Myriad physiological factors can cause erectile dysfunction, from poor circulation to crimped blood vessels and heart disease. But research conducted over the past 30 years reveals that psychological conditions such as depression and anxiety can be both root causes and exacerbating factors of ED as well.

Your central nervous system handles communication between your brain and the rest of your body, including the penis. A strong, relaxed central nervous system makes for a more confident erection. But following that same logic, a stressed-out and overloaded central nervous system can mean a worried, stressed-out penis–and a weak erection

These psychological factors persist long after experiencing erectile dysfunction for the first time. Much of that has to do with how shame and embarrassment from not meeting our own and society's expectations carry over into future sexual encounters. Sixty-two percent of participants in an online survey by the Sexual Dysfunction Association reported that ED had a long-term effect on their self-esteem, for example. This confidence hit only compounds anxiety, pressure to perform, and ultimately, issues achieving a healthy erection.

That's why research now suggests that mindfulness training–in combination with medicinal treatments for ED–can be a worthwhile practice for regaining erectile function. Breathing exercises and meditation can strengthen your central nervous system and help your brain shut out those negative emotions that can be distracting during intercourse.

The double-edged sword of stigma and masculinity

Erectile dysfunction affects millions around the world. But if it's such a common medical issue, why are men so embarrassed and ashamed about it?

Surveys indicate that those suffering from ED carry deep wounds from the double-edged sword of stigma and masculinity. Social cues picked up from popular media and porn shape men's perceptions of their bodies and how they should perform sexually. Those unable to get hard see themselves as lesser than the hyper-sexual, emotionless, strong and spontaneous masculine ideal. Fearing becoming the butt of jokes, they swallow their shame and carry it around for at least two years on average before seeking the help of a physician.

Such stigmas are crippling to a man's identity and his perceived social standing, lending to feelings of isolation and despondency. Psychologists refer to this relationship between identity and the penis as "phallocentric," a phenomenon not necessarily limited to heterosexual and cisgender men. Non-heterosexual men, whose identities challenge the traditional construct of masculinity, are especially susceptible to depression and anxiety when suffering from sexual dysfunction, studies show. They come to see their ED as proof positive of a "damaged gender identity," only adding to their feelings of insecurity.

Studies suggest that key to coping with these feelings is finding a community that can help you reaffirm your own, flexible definition of masculinity by opening up about your experience. In understanding you're not alone in your struggle, you can regain confidence, take back control of your body, and support others on their journeys as well. The traditional masculine ideals of power, strength and leadership don't have to be defined by the penis alone–they can be realigned to help support your personalized health journey.

The 'couple's disease'

When you can't sustain an erection, it can feel like everything is working against you–including your capacity to live up to the romantic expectations of a committed relationship. The shame that follows can feel like a burden to bear alone.

But more often than not, your partner is experiencing similar thoughts: am I not attractive enough; am I unable to stimulate my partner anymore; is it something I said or did?

The stress and shame of erectile dysfunction can impact both partners in equal proportion, which is why ED is sometimes referred to as "the couple's disease." Stress in the bedroom can leach into every aspect of the relationship as both partners grapple with the shame of not being able to sexually perform. This not only negatively impacts the health of the relationship, but overall sexual health as well, as future sexual experiences become colored by the anxiety of not being able to perform.

Medical professionals suggest strategizing about when and how to discuss the issue with your partner, meaning it's not the best idea to jump into a conversation directly following a failure to launch. Let your partner know that you want to handle things as a team by going to doctor's appointments together, and lower the stakes by focusing on other ways to share pleasure instead of achieving penetrative sex as soon as possible. Alleviating ED is a multifaceted process for which there isn't a one-size-fits-all solution, so it’s important to check in, communicate progress, and focus on what feels good to you in the moment.

Sex therapists say that this doesn't have to be a heavy and intense process–developing new communication pathways, moving slowly, and trying out new things in the bedroom can help to renew your relationship and catalyze more enjoyable and satisfying sex in the future.