Understanding erectile disorder

By Madeleine Castellanos, M.D.

Picture this: You're in the middle of a fierce make-out session and reach down to grab what you expect will be a hard, throbbing erection. Instead, your hand is met with a disappointingly soft penis. Or maybe he's got an erection now, but loses it before you can actually get busy. Sure, what goes up must, eventually, come down, but so soon? Your first thought is probably, "Why can't he get it up? Isn't he attracted to me?"

But it's not that simple. As I discuss in my book, A Woman's Guide to Men and Their Penis Problems, erectile issues are actually incredibly common. According to the results of the Global Better Sex Survey, published in the April 2008 issue of the Journal of Sexual Medicine, 65% of men aren't satisfied with the quality of their erections (and neither are 63% of women).

It's no wonder erection issues are so widespread: They can have any number of causes, and very few of them have anything to do with your attractiveness. So before you start taking it personally, take a look at some of the reasons why he may have trouble getting hard: 

Want to know if the cause of his erectile problem is physical or psychological? Work with him to understand how his body responds in various situations by trying these tricks:

While these are only two basic facets of physical and psychological causes, they can help determine what type of expert to contact in an effort to understand what is going on and who to see for help.

While many people think of ED as an older guy's issue, there are some common causes of erectile problems in healthy young men:

If your guy complains that he can't stay hard during intercourse because of a condom, which often reduces sensitivity, he can try a thinner latex condom, like the Kimono brand, or a condom made from polyisoprene or polyurethane, which may provide even more sensation for many men.

Of course, most men have trouble getting or staying hard from time to time. That's normal, and you can usually trace it back to nervousness about a new relationship or a night out pounding back beers with the guys, for example. Try not to jump to conclusions: In many cases, it is a fleeting, situational event that shouldn't be cause for concern and doesn't indicate a lack of attraction to you or a loss of sexual function. So don't sweat it. The best thing to do is to move on to other enjoyable activities (such as kissing, breast stimulation, sensual massage, oral play) or call it a night.

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