Q&A: Erectile Dysfunction

”Can you give us an article about what wives can do to help their husbands who have ED?  Techniques?  Positions?  Toys?  Where can we get real honest info about pumps? The sex toy sites offer 100s of penis pump choices. Do these really work? How can one choose one? Which ones are “novelties” and which ones are real tools (as opposed to toys)?  But it seems that the best approach would be a couple-based approach. Any advice or ideas?”

Erectile Dysfunction is the inability to get or maintain an erection.  It isn’t something that just affects men.  It can wreak havoc in a marriage and leave both spouses at a loss as to how to handle the physical and emotional stresses it brings.  It often leaves men feeling frustrated, inadequate, and confused, and leaves their wives feeling helpless.  Causes of ED vary and can include but aren’t limited to:

  • Head/spinal cord trauma
  • Alcoholism
  • Stroke & heart conditions
  • Diseases (kidney disease, Parkinson’s disease, vascular disease, & others)
  • Depression
  • Anxiety & stress
  • Obesity
  • Smoking
  • Certain surgeries
  • Medications (antidepressants, blood pressure medications, and others)
  • Low testosterone

Once you have sought medical help and have been diagnosed with ED, there are several treatments out there.  Usually doctors like to start off with the easier suggestions and then move on to more invasive ones as needed.  Not all treatments work for all couples, so you will need to be patient as you try the suggestions given to you, to see if they help.  Here is a list of several treatment options out there for today’s couples:

Lifestyle Changes: This involves losing weight, becoming more active, eating healthier, cutting out alcohol, and quitting smoking.  Also, making sure that you have your diabetes under control.  (Diabetes that is out of control can do permanent damage to the nerves in the penis.)  It helps if the couple makes these lifestyle changes together, so that the husband feels totally supported by his wife.  And just think of how much healthier you both will be.

Sex Counseling: This involves seeing a licensed sex therapist or counselor.  He will work with you and your spouse together, to try and find the specific cause for your ED and then discuss with you both which options/treatments he thinks will be the most effective in your case.  You can get your PCP or Urologist to refer you to a sex counselor in your area.  This is usually helpful along with other treatments, and helps you both keep your communication open.

Pelvic Floor Exercises: Remember those Kegels?  Well they are good for men too!  They strengthen the muscles and help the blood supply for the penis.  Check out this article for more in-depth information about how Pelvic Floor Exercises can help couples that suffer from ED.

Oral Prescription Drugs: This includes drugs such as Levitra, Cialis, and Viagra.  These drugs do not automatically cause an erection.  They simply improve the blood flow to the penis, so that when sexual stimulation occurs, an erection is easier to get and to maintain.  (So yes, wives, your loving hands and/or mouth is still needed!)  Uprima is a newer prescription out there that works differently, although it is still taken orally.  It stimulates the part of the brain that is believed to be partially responsible for erections.  You will need to ask your doctor for more information on this drug.

Suppositories: You may hear this called “MUSE” in the medical field.  This is simply where you (or your wife) use a small plastic applicator to inject a caplet full of medication into the urethra of the penis.  It is absorbed into the penis and helps increase blood flow to allow for an erection.  This is reported to be less effective than other treatments in most men, but is a good alternative for men who are unable to take the oral medications.

Injections: There are some medications that can be injected directly into the penis via a very small needle.  Your doctor will decide on the right combination of drugs for you, and then show you how to inject yourself (or show the wife how to do it).  I have actually heard men speak positively about this procedure, saying that it really isn’t painful like one may think.  There is more in-depth information about penile injections  found here.

Vacuum Devices: This is where you can use a small vacuum pump to aid in getting an erection.  You place your penis into the chamber and then pump out the air, which causes the penis to become engorged with blood and expand.  Then you put on a restriction ring (penis ring) to help maintain the erection and slip the penis out of the chamber to have sex.  It is best to get your urologist to recommend a vacuum that has been proven to produce results, rather than searching through toy sites online looking for something you hope will work.

Penile Implants: This is surgery to implant two expandable cylinders into the penis that attach to a small fluid reservoir and pump located at the scrotum.  You mash on the skin under the scrotum to fill the chambers with fluid, thus causing them to expand, giving you an erection.  The implants are all inside and nothing can be seen externally.  (Yes, there is a ‘deflation valve’ that lets you return the penis to its regular state.)

There are different side effects to all of the above-mentioned treatments, and so it is extremely important for you to discuss these things thoroughly with your primary doctor or urologist.  He will be able to look at your medical history and help you decide which option is best for you.  Urologists also are able to give you specific information as to which vacuum pumps are the most reliable so that you aren’t wasting money on “novelties” and toys that say they produce results.

I agree that a ‘couple based approach’ is best.  ED causes both physical and emotional ramifications for couples, and it is important to seek help together.  You are right about the many toys out there that are marketed ‘to enhance’ your sex life, but it’s important to get solid recommendations from your doctor about vacuum pumps and penis rings that are actually made to help ED and not just sold as toys.

Related Articles:  ED Part 2 (by Lauren Jordan, Licensed Sex Therapist)


  1. Wow, sounds rough.

  2. All of the above suggestions are great, particularly lifestyle changes. When I hit 50 and began to notice the onset of ED, I began a running and weight-training regimen which includes supplementation with the amino acids L-glutamine and L-arginine for recovery and circulation. L-arginine is also used in many of the herbal Viagra knockoffs, is relatively cheap and safe without the side effects associated with prescription ED meds. It’s done wonders for me and my wife has been pleasantly surprised with the results as well.

  3. I am suffering from a fairly severe and long term ED problem, beginning in about 1999, 10 years ago. I started on 50mg of Viagra and it worked for a while,but then became less functional, so the Doc increased my dosage to 100mg. This also worked for a while, but then also tapered off like the 50mg. Side effects of headaches and sinus difficulties were also present. I am being treated at the Veterans Administration for hypogonadism also. This is a condition where testosterone levels are below the normal range. I receive an injection of 200mg of testosterone every two weeks. In addition to the hypogonadism, the testosterone is being injected due to an osteoperosis condition caused my medication that I have been taking since 1968 to prevent grand mal siezures. This is from a head/brain injury that I received in the military in 1966. I don’t notice any change in sexual attitude, performance or libido from the injections, and I still l suffer from ED. The VA tried me on Levitra, but is was like taking sugar pills, no effect whatsoever. The also had me try MUSE, which is a plastic device inserted into the urethra and aprodosil (sp) is injected as the person (male) breaks the tip of the plastic off while it is in his penis. This product worked very well, but I had a 25 minute drive home from the VA and my testicles, penis, and prostate hurt so bad I had to stand in the swimming pool for 30 minutes, and I took six aspirin to help kill the pain. So MUSE was a no-go in my book.

    Recently I was diagnosed with a BPH prostate condition. I had to go to a urologist and I mentioned the ED prob to her. She said “get a vacuum device”. I can get it free through the VA but in reading about the functions of such a device, it not only draws arterial blood into the penis but also veinous blood (the stuff going back to the heart). Therefore, there is no circulation in the penis at all, and it will actually feel cold, relative to other parts of the body. I opted out of this option too. I went to another urologist, and he suggested that I get penile injections. The thought of a needle down there is not appealing, but if the results are within what I have read, it will be worth it. After the injection, the penis should get erect within 5-20 min and last up to 2-3 hours. So, on November 7, I will present to the urologist’s office and a PA (female) will talk to me about the injections and then inject me for the first time in a private setting. I am encouraged that there is a small piece of hope out there. However it works out, I will re-post in this forum/thread to let the others know about the injection process and success/failure of such a treatment. Am I a bit anxious? You bet !!!!

  4. Please do post back here and let us know how the injection went, and if it was successful for you and your wife. I’ve heard from a couple of sources that it really isn’t as bad/painful as men think. It sounds like you have already tried many of the options out there and I hope this works for you.

  5. The book ” How to make love to a man over 50 yrs old” by Dr. Barbara Keesling gives alot of information on how to use massage in the pelvic regions to aid a man in increased blood circulation to aid erections. Dr. Keesling is a Sex Therapist on the West Coast and has writen several books and also has some audio tapes to help couples. Hope you can find a copy of this book I am being helped alot by it.

  6. one thing i would say to men with this problem is that, depending on the woman of course, it is not as big a problem for us as for you. what i mean is that, many if not most women cannot reach orgasm through straight intercourse anyway. that is why foreplay is so important.

    therefore, do not feel bad or less of a man or anything, at least from my point of view and i think many women would agree. it is simply a medical problem and you should get it fixed so that you can reach orgasm too, but i would not get all embarrassed.

    just be sure to tell your wife that it is ED and not that you do not find her attractive any more. that is probably the only big issue for women. your spouse may have self-esteem issues if she thinks you do not like her any more. women are generally used to having issues “down there” with going to the gynecologist and everything, so your wife will likely be very sympathetic.

    plus … um … 🙂 while you and your doctor figure stuff out … don’t forget the foreplay 🙂

  7. For all of those who think Male performance Products are just for older guys, please read.

    Unfortunately there are prescription drugs out there that say “may cause sexual side effects.” I took one of these prescrption drugs and now that has ruined my ability to do the deed without assistance. It sucks that this happens, but not being able to get it up is not the fault of the person nor does it make them less of a man. Many times its because of physiological problems or medical reasons.

    I started taking the Dr Max Powers HGH Spray and it had allowed me to carry on a somewhat normal sexual life. It seems to be a very natural way to boost male sex drive and erections without harmful side effects.

    My point is people: Go the more natural alternative way like the Dr Max HGH Spray. I sure wish I found it sooner that the prescription stuff I took.

    I highly recommend it. Thank you

  8. My earlier post regarding L-arginine stopped short of saying this, but ALWAYS check with your doctor before taking anything. L-arginine should not be used in cases where heart disease is pre-existing.

    Similarly, HGH is a naturally-produced hormone in humans whose production declines with age. There are ways of increasing its production naturally (e.g. interval training, L-glutamine supplementaion and with sufficient sleep and proper diet). However, taking HGH through injections, sprays and powders has been linked to severe side effects.

    Again, please research carefully before taking any meds, whether prescription or “natural”.

  9. This is a follow-up to my previous post regarding injections. Yesterday, November 7, I presented to my urologist’s office with the sole intent of getting my first penile injection. I was nervous, scared, and embarrassed to say the least. After the normal prelims, (BP, pulse rate, weight, height, et al), a young female came into the room and introduced herself. I told her about all of my anxiety regarding getting injections.

    She was a very calming person, and explained to me that it was not a big deal, that she sees many men with the same situation, and that she had been doing injections for about 4.5 years.

    She walked me through the process of uncapping the needle, cleaning the vial of injectable medication, inserting the needle into the vial, and pulling the proper quantity of medication(s) through the vial and into the well marked and graduated needle. The needle was about 1/2″ long and scared me a bit to look at it. It is however, the same type of needle used by diabetics to inject insulin so it is very thin.

    After withdrawing the medication from the vial, she re-capped the needle and set it on the medication tray. At this point, she pulled the head of my penis and pulled it out as far as possible without pain. She then took the needle, uncapped it, cleaned the area to be injected with an alcohol pad, and then injected my penis at about a 2:00 o’clock position in order to hit the corpa cavernosa (sp) area of the penis. She inserted the needle and depressed the plunger to inject the medication. I felt no pain whatsoever. She then left the room and told me to “manipulate” my penis for about 10-20 minutes to get the medication distributed properly throughout the tissue. After about 10 minutes, I could tell that the medication was starting to work. She came back in at about a 20 minute point to check the progress. There was not a sufficient enough erection for PIV activity, but for the first time in over two years, I felt as though I had a good sensation down there. I was happy, but not totally.

    I am to return next week, and this time she will double the quantity of the medication (called “bi-mix”), and I have to inject myself without her help. The urolologist will not issue an Rx for injectibles and needles without the patient knowing how and where to inject, as well as prepare the equipment and injection site. More to come. This is a very new experience for me, and good information for males who have not been sucessful with oral medications or pumps.

  10. Thank you for letting us know. Knowledge really is the key. If you know what to expect, it makes it a lot easier.

  11. Just a though for you ladies.

    We men may turn on like a light bulb, especially during our younger years. But that does not necessarily mean that any lack in performance is due to lack of stimulation for our wives. My wife got very upset that she could not excite me anymore. Truth be told, it took very little to excite me for the first 20 years of our marriage.

    Now, the heart is willing and eager but the body is uncooperative. If erect PIV is not working, please accept our other offerings. ED can be very discouraging. And what men call ‘blue balls’ can be very uncomfortable. It can result from a failure to finish.

    btw, For me, Levitra helps with the erection but not the ejaculation. Plus, it leaves me with a head ache and insomnia the next 24 hours.

    Taking supplemental testosterone has not helped yet. I rub a 1/2 cc of 10% testosterone cream on a hairless butt cheek each morning. Women’s International Pharmacy compounds it at the best price. They have my wife’s post-menopause libido off the charts with bio-identical hormone replacement therapy. Now, I just need to catch up.

  12. We first detected my husband’s ED 13 yrs ago on our honeymoon. Needless to say, it was quite the blow to a young newlywed couple who had struggled to remain pure (for the most part). As a young wife, I was devastated and blamed myself all the time..he was depressed as well..it was a mess. (Now, we believe it is connected to a penile surgery he had as an infant; but in our younger years, we lacked that clarity). Anyways, he finally started Levitra about a year ago and we love the results! He only takes it when he needs it (the ED comes and goes), and because he can tell when he will need it a few hours in advance, he takes it about an hour before we go to bed. Works great! It also helps him last longer. Just wanted to chime in if anyone was considering that specific drug. Obviously, different things work for different people.

  13. Casualobserver,
    I’m sorry to hear that Levitra gives you those problems. I am going ask my husband if his headaches (which he gets often) are worse after taking it. The cream sounds interesting; good luck to you and your wife with those remedies.

  14. guys and gals,
    ED is sad situation i experianced the problem especialy sad when you want to please your bride, yes she’s still my bride after 25 years. Before i discovered this site Christainnymphos. I was serching the web for answers without pils cream etc.because i’m not to fond of things that aren’t natural. Found a book that didn’t really address ED but i thought I’d give a try it’s called Ejaculation Guru by Jack Grave he has 3 books i checked all 3. there isn’t any pictures or imoral thoughts, well one thought that can be replaced by your spouse.All the exercises etc. are natural. Guys you’ve gotta increase blood flow and oxygen in the blood. Quit smoking, loose weight get physically in shape, drink lots of water,and the exercises that Jack perscribes. there is one side effect I’m embarresed to say i increased in length. I’m cured of ED. You’ve gotta get that blood flowing.
    well i really didn’t find CN on my own i prayed that there must be some site out there that didn’t include any porn or immoral thoughts and the Lord brought me here. It’s a blessing there is a site such as this one that a person can go to for answers and opinions without being bombarded with imoral stuff. And permoting being faithful to our spouses. that huge in this day.
    I’m not a bloger or aface booker i’m just an inspector that barly knows enough about computers to do my work requirements and emails. so please be patient with me.
    you can post this if you find it excepible.

    God Speed

  15. Regarding the use L-arginine for ED, I’ve seen the results from a clinical study that showed that 1500mg (yes, that’s 1.5 grams) of L-arginine plus 150mg of pycnogenol had a 92.5% success rate for men who had ED that was not due to injury or structural deficiency. This is significant because studies show that normally, it takes about 3,000mg of L-arginine to achieve a 75% success rate for ED.

  16. Have any of you with ED issues tried L-arginine and pycnogenol? It is supposed to resolve 90% of ED. 1500 mg of L-arginine and 150 mg of pycnogenol per day is much cheaper that $6.00 to $8.00 Lavitra pills.

    Herbalife sells it as Prelox Blue, combined in one pill.

  17. I am late in discovering this discussion, but just wanted to share something that has worked well for us. After trying a few different models out, we found a comfortable/stretchy [penis]ring (sorry, thats the only word I know for it) that my husband could put on around the base of his penis. I would then perform OS with strong sucking to draw the blood into the phalllus, and the cockring traps it there, leading to a very large/turgid errection. I recommend ones that have some sort of release/connector, so that it can be comfortably removed after completion. This keeps the fun factor up and the anxiety down. We will plant it in fun places to let the other know we’re in the mood (I.e. toothbrush drawer in the morning.) Either way, make sure he knows its not the end of the world, since after all, he has so many other ways to bring you pleasure.

    PS–plus the one we like only runs about 8 dollars online or in speciality shops, and is certainly cheaper than jumping to more expensive solutions first.

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