Erectile challenge

BY DR. LAURIE BENNETT-COOK

I just got a call from my boyfriend who wanted to let me know he’s had a stressful few days. Turns out, while I’ve been traveling, he’s been in the emergency room with symptoms that led to a diagnosis of high blood pressure.

Recently he’s been struggling with erections. He’d stress about it and say it’s because he’s getting older; he’s tired; he’s stressed at work, etc. While the less potent erections didn’t send him running to the ER, the headaches, heart palpitations and shortness of breath did.

Erectile dysfunction is something that most people with penises (PWP) do not want to experience. Usually, along with the diagnosis, can come a lot of stigmas that many find worse than the problem itself. Unfortunately, it is all too common. Most PWP will experience some sort of lack of cooperation with their penis at some point in their life. Because it is something that most will experience — lets right now stop calling it a “dysfunction” and switch to “Erectile Challenge.” (EC)

High Blood Pressure is just one health concern that can lead one to experience EC.

For many people, experiencing EC can be a first sign that their blood pressure may be high. When arteries become clogged, blood flow is restricted to many parts of the body, including the penis. This can create an inability for one to maintain, or sometimes even obtain, an erection. When blood pressure cannot be lowered through diet and exercise, medications for lowering blood pressure may be prescribed. Unfortunately, many of the most common drugs for lowering blood pressure also list EC as a side effect.

Some of the most commonly used medications for high blood pressure include water pills (also known as diuretics). By decreasing forceful blood flow, achieving an erection can become difficult. Additionally, they can deplete zinc in the body. Zinc is necessary to create testosterone, which is a primary sex hormone.

So here we have a person with high blood pressure. Because of their high blood pressure, they’re unable to maintain an erection and therefore struggle with sexual anxiety and are unable to enjoy being sexual with their partner. They go to see the doctor to lower blood pressure so they can get back to enjoying a healthy sex life. While the medication may serve to lower their blood pressure and help them feel much better overall, it may also prevent them from having a satisfying sex life.

Unfortunately, it only takes one negative sexual experience to create an anxious state of mind. Once experienced, fears of an inability to form an erection again can cause one to avoid sex all together. We tend to mitigate just how negative of an effect not being sexual can have on a person. These anxieties can cause extra strain on a relationship, and on a person’s well being overall. So what is one to do? Be honest with your doctor. Share your concerns about your sexual dissatisfaction and don’t wait until symptoms send you to the ER. If you feel your doctor isn’t listening, shop around until you find a doctor who will. Remember, they work for you, not the other way around.

There are a few medications that can help to lower blood pressure that do not have erectile side effects but they are not right for everyone. Discuss with your doctor if any of these medications would be right for you.

These can include ACE inhibitors, alpha-blockers, calcium channel blockers, ARBs

Additionally, while it may seem counterintuitive, focus on enjoying sensual pleasure with yourself or a partner without the goal of an erection or orgasm. Many times we can become so focused on the end goal that we forget to find pleasure in the moment. By focusing on the sensual pleasures that do not include needing an erection, it is easier to relax. There are many ways to enjoy being sexual with a partner that don’t require the use of an erect penis. Don’t underestimate the pleasure that can be experienced manually and/or orally. While anxiety about performance may not completely fall away, it can certainly be reduced.

Many have found seeking out a sexual health professional to be helpful. Thankfully the internet has made it easier to narrow down specialists of all sorts. A sexologist, sex coach, sexological bodyworker, or sexual surrogate may have just the right insight and tools to help you get back to being your full, happy, sexual, self.

Dr. Laurie Bennett-Cook is a clinical sexologist with a private practice in Salt Lake City and is also the director of Sex Positive Utah, a social group that hosts discussions and workshops on sexuality, gender, relationship configurations, boundaries and consent. She can be reached at DrLaurieBennettCook@gmail.com