Talking about erectile dysfunction (ED) can be one of the most difficult conversations to start, but it’s also one of the most important. Whether it’s with a doctor, therapist, partner, or someone you’re casually seeing, opening up about ED is a powerful first step toward reclaiming your confidence and enjoying a more satisfying sex life. I know this because I’ve worked with hundreds of men in your shoes.

Let me walk you through how to talk about ED with the people who matter most in your life. These tips are designed to help you feel prepared, stay confident, and get the support you need.

Starting the Conversation with Your Doctor

When men first bring up ED with their doctor, I feel exposed. Even if it’s uncomfortable, stick with it. That conversation may end up being the turning point for you. If you’re experiencing ED, your doctor can help you uncover potential causes—whether it’s related to atherosclerosis, high blood pressure, or something else that’s affecting your blood flow. They’re trained to handle these issues without judgment, so don’t let fear hold you back.

Here’s how to make the most of your appointment:

1. Be Honest About What’s Happening
   Share exactly what’s going on. Are you struggling to get or maintain an erection? Are you experiencing premature ejaculation? The more specific you are, the better they can help.
2. Discuss Lifestyle Factors
   Give a full account of your medical history. Talk about things like your diet, exercise, supplements you take, and whether you smoke or drink. These are all tied to vascular health and can influence your ED. If stress or anxiety is a factor, mention that too. If you’re taking antidepressants or other mental health medication, make sure you mention it. Many can cause ED symptoms.
3. Advocate for Yourself
   Many health conditions can cause ED. Ask for testing to see if low testosterone, or other hormonal issues could be causing your issues.
4. Ask About Treatment Options
   Don’t hesitate to ask about medications like sildenafil or tadalafil. These treatments are effective for many men, but it’s important to discuss potential side effects and ensure they’re safe given your overall health—especially if you have conditions like heart disease.

Remember, your doctor’s goal is to help you find the causes of ED—not judge you. By speaking up, you’re taking a big step toward improving your health.

Working Through ED with a Therapist

When I started practicing sex therapy, I was surprised at how much mental health was tied to ED. Stress, performance anxiety, and even unresolved emotional issues all get in the way. An AASECT certified sex therapist can help you untangle those barriers and give you tools to move forward.

Here’s how to approach the topic in therapy:

1. Be Open About How ED Makes You Feel
   Share how sexual performance issues affect your self-esteem, relationships, or overall sense of well-being. This is your space to talk freely.
2. Explore Emotional Triggers
   For many men, ED is linked to stress or past experiences and an unregulated nervous system. A therapist skilled in erectile dysfunction treatment can help you identify these patterns and work through them.
3. Practice New Coping Strategies
   Techniques like mindfulness, thought-stopping, or even breathing exercises can help you stay present and reduce anxiety in the bedroom, leading to improved erectile function.

Therapy isn’t just about “fixing” ED—it’s about building confidence and emotional resilience, which has a positive ripple effect on every area of your life.

Talking About ED with a Long-Term Partner

When men tell their partners about struggles with ED, they are nervous about how they’ll react. Would they think I wasn’t attracted to them? Would they feel disappointed? But what I’ve found in my work with men was the opposite. Being open brought men closer to their partners and turned what felt like a personal battle into something they could tackle as a team.

Here’s how to start the conversation with your partner:

1. Choose the Right Moment
   Avoid talking about erection problems in the heat of the moment or during intimacy. Instead, bring it up when you’re both relaxed and can focus on the conversation.
2. Be Honest, but Reassuring
   Acknowledge the issue without making it about them. Try saying something like, “I’ve been having some challenges with erections, and I want you to know it’s not about attraction. I’m working on it, but I’d love your support.”
3. Focus on Connection
   Use this as an opportunity to explore other ways to connect physically and emotionally. Try non penetrative sexual activity. Focus on foreplay, intimacy, and enjoying each other without pressure.
4. Ask for Patience and Understanding
   Let them know you’re doing your part to address it and that their support means a lot to you.

Being vulnerable with a partner isn’t easy, but it can lead to greater intimacy and understanding. Plus, knowing they’re in your corner can make a world of difference.

Addressing ED in Casual Sex Situations

Navigating ED during casual sex requires a different approach. You might not want to dive into a deep conversation with someone you just met, but that doesn’t mean you can’t address it. Being upfront and keeping things light works best.

Here’s how I handle it:

1. Be Honest but Brief
   A simple, “Hey, just so you know, I sometimes have trouble staying hard, but I’m all about making sure we have fun,” sets expectations without making it a big deal.
2. Shift the Focus to Pleasure
   ED doesn’t mean intimacy has to stop. If you find yourself having trouble in the heat of the moment, focus on other types of sexual pleasure. Oral sex, mutual masturbation, or exploring new sensations together can sometimes help you get out of your head and back into your body (and ensure your partner enjoys the experience as well).
3. Stay Confident
   Confidence is key. ED doesn’t define you, and showing that you’re comfortable with yourself will put your partner at ease.

Casual sex doesn’t have to be perfect—it’s about enjoying the moment. Being honest and open sets the tone for a positive experience.

Why Talking About ED Is Worth It

If I’ve learned anything from my work with men, it’s that talking about ED is a game-changer. It’s not easy, but the rewards are worth it. Opening up to your doctor, therapist, or partner can lead to better health, deeper connections, and more satisfying intimacy.

Avoiding the conversation doesn’t solve the problem—it just prolongs it. By taking that first step and starting the dialogue, you’re taking control of your life and your happiness.

So, if you’re struggling with ED, don’t keep it to yourself. Reach out to the people who can help—whether it’s a professional, a partner, or someone you trust. You’re not alone in this, and the path to a better sex life starts with a single conversation.

Talking about ED isn’t just about fixing a problem; it’s about opening doors—to better health, stronger relationships, and a more fulfilling life. Start the conversation today. You’ve got this. If you want help addressing ED issues in your life, schedule a consultation today to see if working with me could help.