5 Tips For Managing Erectile Functioning Issues

It is likely that all of you reading this right now have consumed an erectile dysfunction advertisement in the past month — they’re everywhere from subway platforms to billboards and TV commercials. An older, cisgender man was likely displayed struggling with intimacy and suddenly able to reconnect after being prescribed medicine like Viagra or Cialis. This depiction is a tiny scratch on the surface around the topic of erectile functioning. 

There is a deep-rooted shame for many cisgender men who experience issues with erections — often because masculinity is directly linked to the ability to get an erection and have penetrative sex. Unpacking these shame imbued ideas allows us to not only give space for cis men to expand their sexual experiences but allows trans people in the dialogue around how to move through sexual functioning issues, as not all people with penises are men and not all men have a penis.

This statement is the groundwork for understanding how expansive sexual expression can be for people with penises. Popular culture has many of us working from the understanding that penises are crotch rockets meant to hammer into bodily holes for pleasure. That is an incredibly harmful and toxic belief not only for people with penises but their partners. While sexuality for people with penises is largely taught as one-dimensional — it is quite the opposite.

Re-understanding penises as a body part which can experience many different forms of pleasurable touch invites a dialogue around erectile functioning that begins to decrease shame and dysphoria. 

There are so many reasons beyond aging why someone might experience erectile functioning issues like premature ejaculation or difficulty obtaining/maintaining an erection. Some other reasons people experience erectile functioning changes could include trans women and non-binary people taking hormone replacement therapy (HRT), high blood pressure, diabetes, heart disease damage, depression, anxiety, stress, or relationship tension. 

Here are 5 options for managing erectile functioning changes:

Sex toys 

Erectile functioning issues are caused by the lack of blood flow into the penis during arousal — which is directly impacted by the blood vessels ability to hold blood flow in the penis for an erection. A cock ring is a toy that can help do the work of the blood vessels when you need an extra boost. They are a silicone, rubber, or metal ring that sits at the base of the penis and wraps around the testicles — some have two parts to separately wrap around the penis and testicles. It’s up to you the type of cock ring you prefer. Using a bit of lube can help get the toy on and adjusted comfortably. This is a great option for people who are able to get a partial erection but not keep it for long — the cock ring constricts the blood in the shaft of the penis and keeps it there for an extended erection. They can also be used alongside a pump or ED vacuum which pulls blood into the penis for an erection. 

Moving through erectile functioning issues largely depends on whether or not you desire an erection during sex. Vibrators aren’t just for people with vulvas — integrating toys into solo and partnered sex can help increase pleasure and decrease performance anxiety. The Enby is a gender-neutral vibrator which has many functions. Redefining sex outside of penetration and opening conversation with your partner(s) about how you want to experience pleasure is a great starting point for working through any sexual shifts or stressors. 

Explore different kinds of play

There are so many ways to play and experience pleasure without an erection but it’s hard to imagine that when our sex education is so phallocentric. It’s also true that a boner is not an indicator of interest or consent to have sex. When we view hard penises as automatically sexual, we forget how important communication is in understanding someone’s body and how they like to have sex. An erection doesn’t equal consent nor does it mean that a person prefers penetrative sex to other forms of sex. And a soft penis is not an indicator that sexy time isn’t going to happen or that your lover isn’t interested. It’s simply an invitation to explore one another’s bodies with curiosity and communicate about desires.

The glans (or tip of the penis) is much like the clitoris and can be orally stimulated in similar ways. This is the most sensitive and nerve-packed part of the penis which can be sucked on, licked, lubed up and manually stimulated while a penis is erect or soft. The frenulum is the area about an inch long on the underside of the penis leading up to the tip which can feel great to play with, along with the corona which is the rim of the tip of the penis. All of that is a great surface area to explore with different strokes, sensations, pressures, and stimulations whether the penis is hard or soft. Penises may need a little extra lubricant to experience this intensely pleasurable sensitivity. 

The term muffing is used to describe to manually penetrating people with biological penises by “tucking” the testes/scrotum upwards into the inguinal canals to create two canals perfect for manual penetration. Both the ilioinguinal and genitofemoral nerves live within these canals, which is what creates such a pleasurable experience. This technique can seem quite complicated at first but becomes easier after some practice (either on your body or your partners). 

Taking care of your body

Erectile functioning is directly linked to blood flow so maintaining a healthy heart is key. The term “healthy” is a loaded one — so take time to define that for yourself. It could mean eating foods that bring you pleasure while integrating healthy heart foods like leafy greens, berries, and fish that increase nitric oxide. Making sure you’re getting enough sleep and doing some physical movement throughout the day is also important. These small shifts in daily routine can immensely help erectile health. Kegel exercises have also been known to give people with penises more control over their erections if you struggle with premature ejaculation. They help strengthen the pelvic floor muscles, especially when integrated into your daily routine. 

Hormone therapy or medication

For some people struggling with erectile functioning issues, medication might be the right path to go down. Consulting a doctor before starting any treatment is important to figure out what will work best for your body. Some people use testosterone topical creams, medication injected into the penis, or pills like Viagra that increase nitric oxide in the blood vessels. 

Sex therapy 

Sexuality is holistic — meaning mental health can directly impact your sexual experiences. If you’re struggling with anxiety, depression, stress, or relationship tension finding professional support can help you work through these hard moments. Sex therapists are specifically trained to guide people at the intersection of sex and mental health. Be gentle with yourself as you create space to heal. 

Blog authors all hold positions at the Gender & Sexuality Therapy Center (G&STC). For more information about our therapists and services please contact us.