Erectile Dissatisfaction vs Erectile Dysfunction

People sometimes assume the source of erectile changes in men as they age is a condition called - erectile dysfunction or ED. This is not always the case. In this episode I am discussing some of the normal sexual changes men may experience in midlife and beyond. Listen to learn about normal changes in erections, sexual functioning, and desire for men.

More on these topics
Erectile changes vs. erectile dissatisfaction blog
Cam Fraser: Can Men Be Multi-Orgasmic
Scheduling Sex video blog
Three tips for boosting your arousal
Talking about sexual health with your medical provider
Medication and your sex life
The different ways to experience desire
Partner desire discrepancies

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Transcript

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SPEAKER_00 0:05

Hello everyone and welcome to Permission for Pleasure. I'm Cindy Sharkey, your host. I'm delighted you tuned in to listen today. I offer a workshop all about perimenopause and the menopause transition, and at every workshop I do QA. And literally every time a woman asks the question, Do men experience any changes with midlife? Or is it only us? And I thought, I'm gonna do a quick little episode to answer this question for my whole listening audience about men and changes in sexual functioning as they age, specifically around their erections. As always, friends, this podcast is not medical advice, but rather education and information for you to consider and ask questions as it pertains to your own individual sexual health. While most people are aware that women experience sexual health changes in midlife, menopause, and beyond, many are not so aware that men can experience changes with midlife and aging as well. For men, erection changes can be normal as they move into middle age and beyond. Many people assume the source of the changes is a condition called erectile dysfunction or ED. Just because you experience changes as you age does not necessarily mean you have erectile dysfunction. People think this because they're just inundated with ad after ad after endless ad on TV, social media about medications to address ED. So let's backtrack here and talk about some potential normal changes that might occur with aging. Number one, it may not become erect as quickly. Number two, it doesn't become erect with fantasy alone. Number three, to become erect, you need direct stimulation. Four, erections may not feel as firm. Five, erections may droop from minor distractions. And lastly, it takes longer to get an erection again after orgasm or ejaculation. These changes that I've listed are symptomatic of the lesser known term erectile dissatisfaction. Dissatisfaction being the result of a man comparing his current erections to those when he was younger and feeling his erections aren't quite the same and don't add up, basically dissatisfaction. So let me define true erectile dysfunction. It is the inability to get and keep an erection firm enough for sex, or in another way, the inability to get and keep an erection despite vigorous and persistent stimulation. If you are experiencing erectile changes, now is the time to get proactive about educating yourself, figuring out perhaps why the changes are occurring and when they're occurring and how they're occurring, as well as what options there are for help. Giving up on sex doesn't have to be the answer. Though this is what I'm hearing from people is that this is what men do. So first of all, where do we start? We start with having an honest conversation with ourselves. First, acknowledging what's going on, like I said, when and why. And then if you are partnered, opening a discussion with your partner about the changes. See if the two of you can figure out ways to adapt your sex life to the changes. You're thinking, how do I adapt? If you think you're experiencing erectile dissatisfaction, here are a few initial adjustments to try. First, keep your head in the game. Stay mentally focused at present. You may not have had to do this as much when you were younger, but now it's game on. Another adjustment. Plan for sex before big meals and alcohol consumption, not afterwards. You want to keep the blood flowing to your genitals, not your digestion. And alcohol is not your friend if you're struggling to keep an erection. The term whiskey dick, that's not just slang. There's science to back that up. Next, as it relates to timing, morning or afternoon sex instead of evening or night hours is your friend. You have more energy and your testosterone levels are highest in the morning. Also, try exercising before sex. This will increase blood flow to your genitals for faster arousal. Another really important adjustment is reframing penis-centered sex, meaning focus less on your penis and more on full body pleasure. Also, a soft penis or flaccid penis still experiences pleasure. If you want to hear more about this from a man, listen to the episode with Cam Frasier, leading men's sex coach out of Australia. I'll link to that in the show notes. He talks extensively about this in that episode. Next, keep performance anxiety in check. Erection changes do not equal sexual failure. This is a really unspoken about topic for men. Women too, but men especially, I find. Next, have an agreed-upon plan in place if you lose your erection with partnered sex, such as switch to oral or a manual stimulation, have toys available, talk about these things ahead, and kind of have an agreed-upon plan that helps the transition not feel like, oh, we lost the whole mood. Next, recognize that your refractory period lengthens as you age. Refractory period is your recovery time between an orgasm or ejaculation and your next erection. As we age, the refractory time lengthens for penises. So take that into account and try refraining from masturbating 12 to 24 hours before partnered sex, see if that helps. Also, scheduling sex can be helpful to manage that. I'm a big fan of scheduling sex. Now let's pivot and talk about some causes. Outside of normal changes with aging, there are many factors that can contribute to or cause difficulties with erectile function. This is not an exhaustive list, friends, because this is a short episode, but there are three top potential contributors to erectile issues for men. One, stress, two, anxiety, and three, fatigue. When we talk about stress, work, home, and especially if there's conflict in the relationship. When we talk about anxiety, especially if you're feeling what I mentioned before, feelings of anxiety around performance and fatigue. Desire comes from the same energy tank as everything else. Sometimes men, I think, they haven't heard this information because I know the women haven't. So fatigue is a big factor. And if you're tired, you're not going to want to have sex and you may have issues with your erections. You know, let's not dismiss these three important things. They matter for sure. I also mentioned earlier about excessive alcohol use, and also a history of smoking can impact erections as well. Now, a note about hormones. As we age, we have a decline in testosterone. That's across the board and normal. But you may have a testosterone deficiency, you know, less decline than is normal. And that's something you want to be evaluated for by a provider. There's also some medications that can be a culprit, things like diuretics, antihistamines, blood pressure meds, antidepressants, treatments for cancer. I have a whole episode on medications and your sexual health. I'll link to that in the show notes. And I do want to mention underlying health conditions here because they have to be taken into consideration. Things like cardiovascular disease, diabetes, MS Parkinson's, clogged blood vessels, hypolesterol, thyroid functioning. That's off. And if you've had treatments for prostate cancer, these are things that need to be addressed with a provider. And side note here, not just for prostate cancer survivors, but for other men with erectile concerns, pelvic flora therapy can be a game changer here. I just cannot believe what's happening with pelvic flora and men. It is not just for women. And there is just a lot of success with pelvic floor therapy, especially post-prostate cancer treatment, but also for other erectile issues. So that might be something you want to ask a provider for an evaluation for a referral for and see if that's something that can help. Friends, sometimes a combination of physical and psychological issues can be the cause of dissatisfaction or dysfunction or issues with the erections. You can see this is a long list, and it's so it's worth scheduling a visit with your healthcare provider if you think any of these things might be an issue or you want to rule them out. Sometimes ruling out things that you're afraid might be a major health risk can relieve your anxiety and stress. If opening these kinds of conversations feels daunting with a provider, read my talking points from medical visits. I'll link it in the show notes. That gives you a game plan in place before you see your healthcare provider and you feel organized and ready to go. Now, let's talk about how important it is to understand these things as well as sexual desire as we move into midlife. Desire is not stagnant, it changes. And many men normally move into a more responsive desire in midlife. This means that if you used to experience spontaneous desire or wanting sex out of the blue, this may not be how you experience desire now. And this is normal. I know no one's told you this, but this is normal. It may feel really different for you, but it's normal. Perhaps when you were younger you needed only the sight of bare skin or kissing a touch, just seeing anything, smelling anything, and you were turned on. More things motivating you to have sex. And now it takes more than that. Or you need more touching, more kissing, more stimulation to spark desire. And this is a topic that needs more education. I'm going to link to my blog in the show notes, and also a couple episodes if you're interested in learning more about the different ways we experience desire. Erectile issues, whether due to aging, dissatisfaction, or dysfunction, is a bigger topic than a quick episode like this. But my hope is that you will have some conversation points first with yourself and to talk about with a provider, with a partner, and know that there is hope for adjustments, changes, possible treatments, medications, devices that can help you with erectile functioning. You are not alone. Men, you are not alone in this. And as freaked out as you might feel about your penis not doing what it used to, these changes don't make you less, and they certainly don't require a retirement from sex. Please get educated, get talking, make the adjustments, try the ones I mentioned first, and schedule an appointment with your provider. Community, if you found this information helpful, please do share this episode with someone. Let's keep helping others find solid, fact based sex education. Let's keep breaking the silence around sexual health. And as always, let's give ourselves permission for pleasure.