Reasons for Erectile Dysfunction

By Dr. Marie Hartwell-Walker

i have been married for 4 yrs and from the first time we had sex he has had problems getting and or maintaining an erection. he has always maintained that it is not me but i am at a loss for what it could be behind this issue. i was hoping that you could offer some insight on possible reasons maybe ideas on underlying issues that could cause this type of long term issues .

A: I’m worried that the ads for ED that drug companies have been putting on television for the last few years have led people to believe that all it takes is their pill to solve this problem. It’s not that simple. One explanation does not fit all. Before deciding on treatment or worrying about who or what is to blame, it’s important to do a systematic analysis.

First, I hope your husband has seen a doctor. Most of the time there is a physical cause, not a psychological one. Some possible medical issues include low testosterone, high blood pressure, atherosclerosis, high cholesterol, obesity, metabolic disorder, diabetes and cardiac disease — to name only a few.

Only after he has been medically cleared should we move to considering a psychological problem. An evaluation by a qualified mental health provider can then be helpful. Psychological problems include stress, depression, former trauma and relationship issues that aren’t being dealt with.

I hope you will encourage your husband to get the assessments he needs. Once he understands the cause of the problem, he’ll be able to decide on treatment so you can both enjoy the tender intimacy you crave.

I wish you well.
Dr, Marie

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Last reviewed: By John M. Grohol, Psy.D. on 4 May 2013

APA Reference
Hartwell-Walker, D. (2013). Reasons for Erectile Dysfunction. Psych Central. Retrieved on December 20, 2014, from http://psychcentral.com/ask-the-therapist/2013/05/04/reasons-for-erectile-dysfunction/