How ED Can Teach You To Have Great Sex

How ED Can Teach You To Have Great Sex

Erectile Dysfunction can be fixed.

Viagra and Cialis Get You Rock Hard, But They Can’t Change Your Life. These Ideas Can… 

by Mike Rosen


Of the 26 men on my current caseload as a sex and relationships therapist, 20 of them came to my office complaining of “erectile dysfunction.”  These men are united in the fear that they will never again have a fulfilling sex life.

Here’s the catch: most of these men aren’t suffering from ED nearly as much as they’re suffering from excessive expectations, and far from ruining their sex life these unpredictable erections hold the key to unlocking the hottest and most connected sex of their lives. 

These guys tell me things like “my dick and I aren’t on the same page” and “my cock doesn’t work.”   If this sounds like you, it’s important to realize the things you’re saying—all those midnight “oh you work now?” jabs and the mid-coital “where are you when I need you?”—aren’t weird or abnormal.

Over 40% of men report being dissatisfied with their sex lives, and almost every man (and their partners) have had trouble getting or maintaining an erection at some period in their lives. 

Your fears make sense, too. More than a receding hairline or dad bod, few things challenge the core of the man like an unresponsive penis. What once felt reliable now feels risky, and it starts to drive a wedge between you and your partner(s).

I get why you’re confused. You were told bills would be an issue, you knew there was nothing you could do to help the Knicks actually win a game, but this was supposed to be automatic, wasn’t it? Wasn’t that the whole problem with men? That they were too horny, too ready for sex, and too one-track-minded?

So, let’s set the record straight:  having an unpredictable erection doesn’t make you less of a man, you’re not resigned to being a sexual spectator for the rest of your life, and your dick isn’t “offline.” Far from it. Your cock has actually never been trying harder to reach you. It’s sending a very clear signal: please, please, please have better sex. 

What is Erectile Disorder?

Erectile disorder (we don’t call it erectile dysfunction anymore) is when you have trouble getting or staying hard for the duration of intercourse over a period of 6 months or more. We DO NOT give the diagnosis, however, if these unreliable erections can’t be better explained by relationship or life stressors. But you wouldn’t know that from watching television.

In 2015 alone, Cialis outspent ALL major pharmaceutical brands with $272 million in advertising. Viagra was a stiffy’s length behind at $232 million. That’s over $500,000,000 spent to convince you that any erection issue is a biomedical issue — and that’s just one year’s worth of ads. Assuming you’ve turned on a TV anytime since 2015 it follows that some of that advertising worked on you. 

There are, of course, medical explanations for erectile disorder: trauma or scar tissue, conditions that limit blood flow, and damaged nerves to name a few. A pill can often help with these issues, but not all ED is medical in origin. Part of the reason those ad spends were so successful (Viagra regularly brings in billions each year in sales) was that they didn’t have to work hard: most men have a tragically limited view of what sex can be.  American sex education is notoriously limited to biology, and glosses over subjects like intimacy, pleasure, and curiosity. Porn and mainstream media don’t exactly fill out the picture, so a lot of men (and women) separate sex from the rest of their lives. 

Viagra and Cialis fail men because they don’t change that paradigm.

Most guys take viagra, and still think they need to stick it in and cum as fast as possible before that little blue pill wears off. It doesn’t help them have better sex or feel more connected to their partner (40% of men are dissatisfied with the sex they’re having). It doesn’t help them understand the problem. And it sure as shit doesn’t work if they stop taking the pill (50% of men simply stop taking the medicine even if it’s working).

That’s because Viagra and Cialis can’t undo the conditioning that ED causes, nor do they ease performance anxiety or the concerns of “what if it doesn’t work this time?” In fact, pharmaceutical intervention has been shown to only be equally effective to psychotherapy, and most effective when combined. 

The majority of men I work with come in thinking that sex exists in a vacuum, and that it can be siloed off. They think their relationships are suffering because sex has become difficult, not the other way around.

This siloing is convenient. It allows them to skip the more complex work of self-exploration. They skip the stuff that really unlocks sex. They don’t think about what they want from sex because they don’t realize they have options. They don’t consider factors like safety, confidence, or even their own sexual preferences. 

If you wake up with a tent in your pants some days, or if you can get it up with some partners but not others, then it’s probably not just your biology that you’re coming up against. It’s your psychology, too.  It’s true. If you’re having a hard time getting hard, it’s unlikely that there’s an issue with erectile functioning. It’s much more likely that you have normal erectile functioning and excessive, misguided expectations.

Your perceived weakness is about to become your greatest weapon. 

How To Fix Unpredictable Erections—And Have the Best Sex You’ve Ever Had

Alright, here’s the part you’ve been waiting for. It’s a step-by-step guide to helping your little Stella get its groove back. This doesn’t all unfold in a straight line, but these are some of the actions you can take to start addressing ED. 

I know this is scary and weird. I know this seems insurmountable. That’s why the single most important thing you can do is humanize this. Nothing you’re experiencing is alien. Nothing you’re experiencing is your fault. What you’re going through is normal and even expected. You have to just keep reminding yourself of what’s real and what isn’t. Our society and culture are practically designed to block you from intimacy. So this isn’t about you “not being able to fix yourself.” It’s way bigger than that. Ok, here we go…


If you’re struggling with erections, you’re probably looking at every sexual encounter as an exam. That’s putting way too much pressure on a few inches of flesh. If you’re going to have a shot at healing this then you have to take sex entirely off the table for a little while. Porn, too. Yeah, even the photos. Yes, even the ones you thought you deleted. All of this “omg am I hard or am I not hard” doesn’t leave a whole lot of room for joy and fun.

Ultimately, ED is a couple’s issue and not an individual’s. But how do you tell your partner about this? Just be honest. Make it about both of you. Your partner can play a major role in this healing. In fact, partners can be one of the best tools in your toolkit. Try something like, “Hey, I want to get back to having incredible sex with you. I want to connect with you without anxiety, and I never want you to think that you’re not enough for me. As part of that process, I need to take sex off the table for a little while. I want to explore other ways of pleasing you…are you willing to help me?”  They’re going to have feelings about this. Hear them out, but be firm.


Your “regular” life is connected to your sex life. I’m sorry. I know you don’t want to hear that, but you can’t silo it off anymore. Maybe that worked when you were a teenager and got hard every time Britney Spears came on the radio, but life changes, hun, and your body isn’t immune to what’s going on around you.

It’s time to look deeper at what’s actually happening for you psychologically when you switch on that D’angelo playlist. You’re going to want a journal for this. A good therapist who is grounded in sexuality could also be invaluable. 

Look for powerful patterns.

  • Study the game film of your entire sex life. List all the times getting a hard-on wasn’t difficult. What did those moments/partners/situations have in common? Were your partners strangers or long-term commitments?  Were you at your own home or theirs? Were they blonde or brunette? What was going on in your life at that time? Were you financially secure? How did you feel about your own body and fitness? What was your family life like?  Did you like your life? 
  • Do the same for all the times when getting a hard-on was difficult. 
  • Go through these lists and look for patterns. Maybe you have a hard time getting hard in long-term relationships. Maybe you realize that all the times you’ve struggled with erections have been in the 6 months following a death event or changing jobs. Maybe you only get aroused when the Yankees are in the playoffs. Whatever the pattern might be, it’s important to know it and take actions to address any associated distress. 

Fantasize better.

Most men haven’t really thought about what they want sexually beyond a few porn fantasies.  Also, most men only rely on one or two senses during sex even though they have five. You don’t have to be like most men. List all the things you enjoy or are curious about sexually on one side of the page. Eventually, knowing these things will allow you to explore more with your partner(s).

  • Do you like cuddling? Do you like moving slow or fast? Lights on or off? What are some of the things you’ve always wanted to try? 
  • Write the list of things you DON’T enjoy. Maybe you don’t actually like getting head, maybe you’ve never really been into dirty talk. These are good things to know. 
  • Use these lists to write out as many “ideal sex scenarios” as you can. Then copy that list into a new document. Under each one write a few steps you’d need to take to make those dreams come true. (e.g. “ask my partner” “attend therapy to work out some stress” “introduce myself to the girl at the gym” “buy some handcuffs”) 

Life pressures.

  • You want to keep sex separate from the rest of your life. You want to seal it off because that would keep it safe and manageable, and because that’s what our society does. Culturally in the West, we have developed a way of thinking about sex as if it’s some other part of life, like there’s life and then there’s sex, but that’s not true. 
  • Conduct an honest appraisal of the type of stress you’re under in the rest of your life…Look at how/when this stress started relative to your struggles in the bedroom. How does your partner’s response to your sexuality make you feel? Are you worried about losing him/her/them if you can’t get it up? The stress you’re feeling in your relationship, your job, or around your father’s health could be the source of all of this. 

Step Three: LET’S GET IT ON

Now that you’ve looked at the social and psychological side of things it’s time to get physical again.

Engorge your concepts of pleasure.

  • The greatest mistake most men make is thinking that sex is about orgasm. That’s depressingly limited. Unless you’re only having sex to procreate, sex is about pleasure. Cumming is pleasurable, yes, but sacrificing all other forms of pleasure for the orgasm isn’t doing anyone any favors.
  • What is pleasure? Good question. Grab a tissue and run it gently over the back of your hand. That feel good? That’s pleasure. Turn on an ASMR video on youtube with headphones in. That feel good? Pleasure. What could sex look like for you if it wasn’t all about cumming?

Practice pleasing your pleasure parts with Sensate Focus.

You’ve spent your whole life focusing on dick-centered pleasure… The rest of your body has nerves, too. Sensate focus is about pleasure without “sex.” At this stage, you’re just exploring. You’re not trying to get hard. So don’t sweat it. 

  • Without touching your genitals, run hands along your body, have your partner blindfold you and kiss your neck and thighs… just FEEL. This is not about getting an erection. It’s about sensation. So even if you do get hard, keep going with the exercise. Do not try to have sex.
  • Practice vocalizing when something feels good, if you want more of something, or if it’s unpleasant.
  • Try a night of penetration-free touch. Have you ever just let your partner kiss your chest for 5 minutes? Not intense enough? Have them pour hot, body-friendly wax on your inner thigh. Need more intensity? Research impact play and breath play. 
  • After a few sessions like this, if you’re starting to feel less pressure when it comes to playtime, you can introduce genital touch. Again, this isn’t about getting hard. And don’t let this turn into sex. It’s about feeling.

Man up / Man down, not man overboard

When you’re dealing with unpredictable erections one of the most challenging parts is the fear that takes over when you start losing your erection. This exercise will help teach you how to be present in those moments, how to retrain your attention, and how to stop beating yourself up.

  • Whether on your own or with your partner, practice getting hard, and actually practice losing your erection. Stimulate yourself until you’re erect and then just stop. Let it go down. Notice which parts of your body are lit up with pleasure. Feel your heartbeat. Learn what it’s like for your cock to go down without it being an emergency.
  • Repeat the cycle a few times. Don’t try to bring yourself to orgasm.
  • You’ll likely notice that soon you can go through many rounds of this. Your partner might even find it really hot to participate or watch.
  • Like sensate focus, this is about body awareness and pleasure without destination or shame.


  • Go forth with a pleasure mindset. Think about all those things you realized you NEED to enjoy sex. Ask for all those things you wrote that you wanted. Speak up if you don’t like something. Ask your partner about what they like.
  • It makes sense that you want to give your partner the best orgasm they’ve ever had. But what if you also gave them the best head they’ve ever had? Or filled their (or your) role play fantasy? Test out foreplay, fingers, mouths, toys, sounds, smells, and tastes.
  • Introduce penetration slowly. Just for a few seconds or minutes at first. Remember, you have so many tricks and tools to please your partner if your erection goes down.
  • If penetration happens, that’s great, but by that time you’ll have experienced so much pleasure it’ll be the cherry on top and not the whole damn experience. If you lose your erection, laugh, grab a toy, and keep going. It’s fine. You’re still an incredible partner, a talented lover, and very very much still a man.
  • Gambescia, N., Weeks, G. R., & Hertlein, K. M. (2015). A clinician’s guide to systemic sex therapy (2nd ed.). Routledge.
  • Kleinplatz, P. J. (2004). Beyond sexual mechanics and hydraulics: Humanizing the discourse surrounding erectile dysfunction. Journal of Humanistic Psychology, 44(2), 215–242.
  • Simopoulos, E. F., & Trinidad, A. C. (2013). Male erectile dysfunction: Integrating psychopharmacology and psychotherapy. General Hospital Psychiatry, 35(1), 33–38.
  • Velten, J., & Margraf, J. (2017). Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships. PLOS ONE, 12(2), e0172855.
  • Wentzell, E. (2017). How did erectile dysfunction become “Natural”? A review of the critical social scientific literature on medical treatment for male sexual dysfunction. The Journal of Sex Research, 54(4–5), 486–506.


Which Statement Best Applies To You?

Click the button below.