The subject of men’s health covers a vast number of topics, but one single part of a man’s body occupies a large proportion of the field: his penis. If you want an explosion of resources and links, type this question into your search engine: “Why are men obsessed with their penis?” You may be amazed at the ocean of articles and links that floods your computer.

You may not agree personally with the assumption that men are preoccupied with their penis, but undoubtedly it’s an important part of masculinity and sexual identity. For instance, “One large study surveying 25,592 men found that 45% of these men wanted a larger penis size compared with only 38% of men who wanted to be taller in height.”^[i] In fact, more men than ever are interested in products or procedures to enlarge their penis. But when you get right down to it, function matters more than size.

Universally embedded in global cultures is the belief that a man’s ability to achieve and maintain an erection is one of his defining elements. Whether for pleasure and/or procreation, his erectile function is perceived as essential, yet ED is very common. About 30 million U.S. men experience ED.^[ii]

Thus, the inability to “get it up” is loaded with negative meaning. Shame, guilt, depression, anxiety—the emotional and psychological baggage is a heavy burden that comes with erectile dysfunction, or ED. As Joni Mitchell sang in Big Yellow Taxi, “Don’t it always seem to go that you don’t know what you’ve got till it’s gone?” As sad as it seems, there’s no need to plummet to the depths of despair. ED is very treatable, so there’s no excuse for not seeking the help of a physician who specializes in it.

5 things to know about ED

Here are five reassuring things to know about ED:

1. There are two types of ED, organic and psychogenic, so proper diagnosis is essential. Organic ED is the result of physical causes that interfere with sufficient blood flow to the penis, e.g., cardiovascular conditions, diabetes, nerve/tissue damage from prostate cancer surgery, side effect of certain medications, hormonal issues, etc. Psychogenic ED is related to psychological difficulties such as performance anxiety or guilt/conflict around sexual issues. It’s important to address underlying physical or emotional problems rather than take a “Band-Aid” approach to resolving ED. Once you know the underlying cause, ED can be successfully treated in tandem with treating other conditions as necessary.
2. The most common starting point for ED treatment is a class of oral drugs called PDE-5 inhibitors (Viagra, Cialis, Levitra, etc.). Most prescribing doctors will wait to make sure pills are working before turning to other methods.
3. Pills won’t work all by themselves. You can’t pop a Viagra and wait for an erection to occur—you’ll wait a long time. This is why doctors instruct patients to stimulate an erection either alone or with a partner. Why? Because the brain, not the penis, is the most important sex organ. Arousal begins with desire triggered by an idea, a sensory perception, or physical stimulation.
4. In turn, PDE-5 inhibitors boost the biochemistry that allows blood vessel walls to relax so more blood can fill them. Voila! An erection occurs.
5. If pills don’t do the trick, the doctor can recommend treatments that localizedrug delivery directly into the penis (injections or urethral suppositories), or mechanical means (vacuum erection device, VED, penis pump) to draw blood into the spongy penile tissue. If all other therapies fail, a penile implant can be surgically placed to generate an artificial but satisfactory erection.

There is no universal ED therapy that will work for everyone. If nothing helps, here are promising therapies (many still in research/experimental stages):

• Shock wave therapy (SWT) uses sonic waves to cause very small injuries. In theory, as tissues heal, they will regenerate toward natural function. No one knows exactly how it works. Professional organizations caution that this treatment is being heavily promoted and to look into it carefully and learn about cost. It does not seem to cause harm, but results may not be as advertised.
• Stem cell therapies use stem cells from the patient’s body. Stem cells are special cells that can transform into the type of cells they touch. The patient’s stem cells are multiplied in a lab, then injected into the penis or intravenously. Studies show some improvement in erectile function, and so far, there are no reports of harmful effects.
• Platelet-rich plasma (PRP) relies on the growth factors and other biochemicals in platelets, small fragments in blood that play a role in clotting during bleeding. The biochemicals are thought to help regenerate the blood vessels or other tissue components needed for erection. At least one comparison study reported some improvement for mild-to-moderate ED,^[iii] “but no recommendation can be made because of scarce evidence.”^[iv]

If erectile dysfunction is troubling you, the best thing you can do is see a doctor for evaluation. Doctors who specialize in treating ED are generally urologists or sexual medicine practitioners. Remember, you’re not alone. Don’t let embarrassment or guilt keep you from picking up the phone. For the sake of your overall health (and happiness), do it now.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Sharp G, Fernando AN, Kyron M, Oates J, McEvoy P. Motivations and Psychological Characteristics of Men Seeking Penile Girth Augmentation. Aesthet Surg J. 2022 Oct 13;42(11):1305-1315.
[ii] https://www.singlecare.com/blog/news/erectile-dysfunction-statistics/
[iii] Poulios E, Mykoniatis I, Pyrgidis N, Zilotis F et al. Platelet-Rich Plasma (PRP) Improves Erectile Function: A Double Blind, Randomized, Placebo-Controlled Clinical Trial. J Sex Med. 2021 May;18(5):926-935.
[iv] Alkandari MH, Touma N, Carrier S. Platelet-Rich Plasma Injections for Erectile Dysfunction and Peyronie’s Disease: A Systematic Review of Evidence. Sex Med Rev. 2022 Apr;10(2):341-352.