What causes erectile dysfunction?
There can be many contributing factors that lead to erectile dysfunction (ED). It’s important to consult your doctor, and address underlying health concerns such as high blood pressure, diabetes, weight issues, stress levels or side-effects of any existing medications you are taking etc.
For many men that I work with ED is a side-effect of an over-dependence on porn. This is a sharply increasing phenomena, particularly in younger men under 30. As Gary Wilson succinctly summarises in his great book ‘Your Brain on Porn’:
‘…how would a guy know if his sluggish sexual performance is related to porn use or stems instead from performance anxiety (the standard diagnosis for guys without organic below-the-belt problems)?
- First, see a good urologist and rule out any medical abnormality.
- Next, on one occasion masturbate to your favourite porn (or simply imagine how it was if you’ve sworn off it).
- Then, on another occasion masturbate with no porn and without fantasising about porn.
Compare the quality of your erections and the time it took to climax (if you can climax). A healthy young man should have no trouble attaining a full erection and masturbating to orgasm without porn or porn fantasy.
- If you have a strong erection in #2, but erectile dysfunction in #3, then you probably have porn-induced ED.
- If #3 is strong and solid, but you have trouble with a real partner, then you probably have anxiety-related ED.
- If you have problems during both #2 and #3, you may have progressive porn-induced ED or a below-the-belt problem for which you will need medical help.’
If you want to re-wire your brain and body to be less dependent on porn, and more tuned in to your own physical erotic body, check out my YouTube video ‘How to quit porn: 3 steps to freedom’.
Erectile dysfunction and chronic tension
If over-dependence on porn and underlying health issues can be ruled out, the other major contributing factor that I see in male clients with ED is chronic tension and lack of mobility in the hips, pelvis and glutes. Be curious: next time you’re masturbating or having sex, pay attention to your butt cheeks, your pelvic floor (the muscles you contract when you’re trying to stop a pee half way through), the front of your pelvis and your lower abdominals. Are those areas holding, bracing, contracting, squeezing? If you can start to consciously interrupt that habit you will be relaxing tension in those muscles. That, in turn, allows more blood flow to your pelvic area and the erectile tissue of your cock. More blood flow means more engorgement i.e. an erection.
It’s totally contradictory to squeeze and tighten your body harder and harder if your cock isn’t getting hard. Erection is a product of the parasympathetic nervous system – the part that facilitates relaxation. That’s why many guys get ‘morning wood’…your body has been all relaxed and sleepy, allowing blood to flow into the erectile tissue of the cock. It’s also why Viagra is so successful: Viagra affects the blood supply to the penis through a chemical reaction that produces smooth muscle relaxation in the corpus cavernosa (the erectile tissue in the shaft of the penis) allowing inflow of blood. This is a state you can access without chemical assistance – it just takes effort and practice. Exercising, incorporating regular stretching and receiving genital massage will all help you learn to relax those chronically tensed areas, and your nervous system more generally.
How does genital massage help improve erectile dysfunction?
ED can often be exacerbated by being overly focussed on the goal of penetration and ejaculation, which creates performance anxiety and a vicious cycle: the less relaxed you are the less likely you are to get a sustainable erection. Taking the pressure off penetrative sex, by incorporating genital massage into your intimate life, opens up a whole new world of ‘sensate focus’ pleasure. Exploring touch, massage, ‘slow sex’ and foreplay without the goal will allow you, and your partner, to drop into more relaxed arousal and different kinds of orgasmic sensation. If you and your partner want to learn how to give and receive genital massage, you can enrol on my online course HERE.
Giving and receiving genital massage (without the expectation of penetrative sex) is a great way to bring relaxation and engorgement to your body and your genitals. This creates a relaxed imprint/memory in the body that will counter performance anxiety or ingrained tension patterns when you then do explore penetrative sex. Breaking the negative feedback loop of anxiety generated by previous ‘unsuccessful’ experiences is a big part of the solution!
Improve erectile dysfunction with mindful masturbation...
Giving yourself regular genital massage as part of a mindful masturbation practice will help you develop the skill of accessing arousal through physical sensation (rather than through visual stimulation). Exploring different kinds of touch, and therefore generating different kinds of sensations, will literally grow and change your brain through the process of neuroplasticity. Instead of masturbating in your habitual way and only accessing arousal through a tiny area of your genitals (usually the tip of the cock), genital massage lets you access relaxed arousal through stimulation of all of your genitals (the perineum, the root of the cock, the testicles, the shaft of the cock, the frenulum and the tip) and the whole of your body! It’s like taking the roadblocks out and allowing ‘pleasure traffic’ to flow freely through multiple roads, rather than there being a bottle neck and a reduced flow of ‘traffic’ from your genitals to your brain.
If you want to learn more about self-massage for genitals you can pre-enrol for my Online Self-Pleasuring course which will be released in 2021.
The 3 best techniques to include in genital massage to improve ED...
1. Massaging the perineum...
The perineum is the area at the base of your pelvis, between your anus and your balls. Massaging here will relax the muscles of the pelvic floor – the pubococcygeus or PC muscle – as well as stimulate the root of the cock and sometimes even give access to external prostate stimulation. For self massage, use the pads of the first three fingers to make circles from the anus towards the testicles. For partnered massage, use your thumb pads or heel of the hand. This encourages blood flow into the shaft of the cock. Start with light pressure and gradually increase. You can also explore light, feathery touch with the fingertips or smooth, sliding touch using lube or oil.
2. Moving root to tip...
Most couples and men that I work with habitually ‘pump’ the cock down into the body: the little finger is closest to the body and the emphasis of movement is compressing the cock into the pelvis. This is basically working against the natural flow of blood, which moves from the body out towards the tip of the penis. Switch the direction of your pressure and work from root to tip. This ‘decompresses’ the cock and allows more blood to flow into the shaft. For self massage, stroke down over the belly and out to the tip. Turn your hand so that your thumb is closest to your body and give your cock a nice ‘stretch’ as you slide from your pelvis and pubic bone to the tip. For partnered massage, make a ‘crook shape’ with your first and second fingers and slide along each side of the shaft. You can squeeze the shaft of the cock between the two fingers as you go.
3. Rolling the hips
The hip flexors, and glutes are often a place of great tension and restricted movement. Massaging here will bring more fluidity and mobility to the pelvis. For self massage, use your thumbs or knuckles to release trigger points as indicated in the image. For partnered massage, try using the full fist and rotating the knuckles on those spots. Go gently to begin with, it can be a very sensitive and tender area – an almost bruised feeling.
Other things to be aware of...
Also pay attention to what’s going on with your breath: are you breathing fully, deeply and in a constantly flowing rhythm in through your nose and out through your mouth? Or are you holding your breath, breathing short and shallow and mainly ‘gulping’ or ‘sipping’ through your mouth? Breathing through your nose increases levels of nitric oxide in your blood. Nitric oxide plays a huge role in dilating the blood vessels in the tissues surrounding the penis. Dilated blood vessels means more blood flow and (as we’ve already established) more blood flow means more engorgement. So, practice breathing guys! It could literally change your life.
As a confidence booster I sometimes suggest using a cock ring. It ‘traps’ blood in the shaft of the cock so the tissue stays engorged and helps to maintain your erection. It can also add a layer of excitement and a new stimulating sensation that keeps you connected to your body where you might normally be distracted by thoughts and performance anxiety.
Do daily Kegel exercises. R Louis Schulz comments in his book ‘Out In The Open: The Complete Male Pelvis’ …
‘With lack of use, the (PC) muscle may lose it’s tone, which will decrease sexual function and pleasure’.
Kegel exercises help you to learn to isolate and train the muscles of the pelvic floor, leading to more ‘tone’ and more support for your erection. A teacher of mine, Joseph Kramer, has suggested that every man should do 100 Kegel squeezes per day! I suggest starting with a set of 10, twice a day. They’re easy to do, and you can literally do them anywhere without anyone realising…So when you’re on your 5th Zoom meeting of the day why not use the time well and do your Kegels!
If you are struggling with erectile dysfunction and want more support in addressing the issue from the core, then get in touch via email on firstname.lastname@example.org