Is Erectile Dysfunction a Deal Breaker? What to Do

Is erectile dysfunction (ED) a deal breaker in a relationship? The honest answer is: Not always–and for many couples, it isn’t.

Whether you’re dating, in a committed relationship, or married, erectile dysfunction can create frustration and distance if it’s not properly handled. But it doesn’t automatically mean the end of intimacy in the relationship.

In many cases, whether ED becomes a deal breaker depends on the level of communication, mutual understanding, and the partners’ willingness to address it.

In this article, you will learn what partners really think about the impact of erectile dysfunction on their relationship, when it can be a serious problem, and how couples can successfully handle it in their relationship.

What is Erectile Dysfunction

Erectile dysfunction (ED) is a condition in which a man cannot get or keep an erection firm enough to have satisfying sex.^[1]National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Erectile dysfunction (ED). U.S. Department of Health and Human Services. … Continue reading It is commonly referred to as “impotence”, although impotence can sometimes be mistakenly used to describe other conditions such as infertility or premature ejaculation.

Erectile dysfunction is a problem of penile erection that can affect sexual performance, ejaculation, and fertility. This is possibly why impotence, synonymous with erectile dysfunction, is often mistakenly used to describe infertility and premature ejaculation.

ED can range from being able to get an erection sometimes but not every time, to being able to get an erection that does not last long enough for sex, to being unable to get an erection at any time.^[2]Ibid. National Institute of Diabetes and Digestive and Kidney Diseases (2024)

Erectile Dysfunction Statistics

Here are some interesting erectile dysfunction statistics:

• As of 2024, 52% of men in the US between 40 and 70 years of age have erectile dysfunction.
• At least 30 to 50 million men in the US and at least 150 million men globally are estimated to have ED.
• There may be an underestimation of global ED statistics due to challenges such as reporting bias, cultural, and social factors.
• ED prevalence increases by 10% for each decade after age 40. Approximately 40% of men are affected at age 40, while 70% report having ED by age 70.
• The overall prevalence of ED is 52% of men.
• ED is strongly associated with comorbidities such as diabetes, hypogonadism, and cardiovascular disease. Over 30% to 50% of men with hypertension experience erectile dysfunction (ED).^[3]Abuhay, D. A., Gela, Y. Y., & Getu, A. A. (2021). Prevalence of Erectile Dysfunction and Associated Factors among Hypertensive Patients Attending Governmental Health Institutions in Gondar City, … Continue reading^[4]Nunes, K. P., Labazi, H., & Webb, R. C. (2012). New insights into hypertension-associated erectile dysfunction. Current opinion in nephrology and hypertension, 21(2), 163–170. … Continue reading
• Every 1 in 10 men has had erectile dysfunction at some point in their lifetime.
• Estimates suggest that erectile dysfunction will affect 322 million men worldwide by 2025.

What Causes Erectile Dysfunction?

Erectile dysfunction can have several underlying causes. These could be physical, psychological, or lifestyle-related. Understanding the cause of erectile dysfunction is important for couples to deal with it.

The cause of ED can also be classified as modifiable and non-modifiable factors. While modifiable causes like psychological and lifestyle-related causes can be addressed via behavioral and non-medical interventions, non-modifiable factors like age, genetics, or underlying disease may require medical management.

A. Physical (Organic) Causes: Related to organic conditions affecting nerve stimulation, or blood flow to the cavernosal smooth muscle of the penis.

• Vascular diseases – Hypertension, atherosclerosis, diabetes, or heart disease.
• Neurological conditions – multiple sclerosis, spinal cord injuries, or neuropathy.
• Hormonal imbalances – low testosterone or thyroid issues.
• Medications – antihypertensives (e.g., thiazides), antidepressants, or drugs affecting libido.
• Age.

B. Psychological Causes: Emotional issues affecting arousal and libido.

• Stress, anxiety, or depression.
• Performance anxiety or relationship issues.
• Past trauma or psychological conditions.

C. Lifestyle-Related Causes: This includes behaviors that affect erection and its sustenance.

• Excessive alcohol consumption or smoking.
• Obesity and poor diet.
• Sedentary lifestyle.

What Women Really Think About ED

Several women were asked on Reddit if ED is a deal breaker or if they would love and respect a man with ED or PE. Here were their responses.

If I started dating a guy and I really liked him and I found out he had ED/PE, I would still date him and it wouldn’t make me think less of him or change my feelings. But I would encourage him to talk to his doctor and see about methods to help his problems.

Sex is important to me, so I couldn’t be with a guy who suffered persistently with those conditions. I don’t see what being rich has to do with that though. And aren’t people supposed to be physically attracted to their SO’s?

“I’d never say anything, but I’d be pretty disappointed. If I wasn’t overly interested in you to begin with it would be a deal breaker. Intercourse is my favorite part of sex, and the longer the better.”

If I’m not attracted to him, no. If I am, I could. Sex doesn’t create love. If he can’t compensate in the bedroom though, I wouldn’t be inclined to be committed to him.

I’ve loved a man with erectile dysfunction before. It was really, really difficult. I’m honestly not sure if I could do it again. It took a huge toll on our relationship because he was completely unwilling to even talk about.

Maybe if there could be an open conversation about the issue, and he was still willing to satisfy me in other ways, it could be possible. But I’d just rather not even bother.

Some women don’t view ED as a deal breaker in their relationship, while others do. What is more important is the couple’s openness to communicate their intimacy needs and seek solutions together.

When ED Becomes a Deal Breaker in a Relationship

If erectile dysfunction is not always a deal breaker in romantic relationships, when does it become a deal breaker? Most couples can navigate ED successfully with adequate communication, mutual understanding, and appropriate treatment.

While ED is a common condition, it becomes a potential deal breaker under the following conditions:

• Lack of communication: Avoiding open communication about the problem can increase misunderstanding or resentment.
• Abusive behavior: ED may be associated with frustration, embarrassment, or blame, which can lead to other problems in the relationship.
• Dismissiveness: ED can be a deal breaker when the partner’s needs are dismissed or entirely ignored.
• Refusal to seek medical help: Refusal to seek medical help for any reason can make ED a deal breaker in a relationship.
• Differences in intimacy needs: If one’s partner has high sexual needs that cannot be met through other forms of intimacy (e.g., cuddling or kissing), chronic ED can lead to severe frustration.

Treatment Options for Erectile Dysfunction

Due to the impact of ED on romantic relationships, there is an ongoing search for effective treatments and solutions. The good news is that several treatment options are currently available.

The treatment of erectile dysfunction involves medical treatment, lifestyle changes, and emotional support, or a combination of these. The following treatment options can significantly improve sexual function and relationship satisfaction in couples with ED:

1. Medical Treatments

Some drugs used in the treatment of ED include the following:

• PDE-5 inhibitors: This class of drugs is known as phosphodiesterase 5 (PDE-5) inhibitors because they block PDE-5 and cause increased blood flow to the penis for longer and stronger erections. Examples include Sildenafil (e.g., Viagra® and Revatio®), Tadalafil (Cialis®), Avanafil (Stendra®), and Vardenafil.
• Testosterone therapy: Testosterone is the major hormone for erection and libido in men. When ED is caused by low testosterone, testosterone therapy could be used to treat this condition.
• Treatment of underlying conditions (hypertension and diabetes): Antihypertensives and anti-diabetic medications can be effectively used to treat ED when it is caused by these conditions. Examples of effective anti-hypertensives for ED include α-receptor blockers like Finasteride and Tamsulosin.

These medications or any other with similar effects should be used under medical supervision. Several products are being marketed for the treatment of ED. Verify their safety and tested efficacy before trying them out.

2. Lifestyle Modifications

Lifestyle modifications can also significantly improve the symptoms of ED, alone or in combination with medications. These behavioral changes address some common physical causes of ED not directly related to disease.

• Reduce alcohol or smoking
• Regular physical exercise
• Maintain a healthy weight
• Improve sleep and stress recovery
• Avoid binge-watching pornographic content, which affects one’s perception of sexual pleasure.

3. Psychological & Relationship Support

In the absence of organic or physical causes of ED, a relationship therapist, a sexologist, or a psychologist can help address the psychological causes of ED. A relationship therapist can also help improve communication and reduce anxiety related to poor sexual performance from ED.

Remember that ED is not always a deal breaker, and for many, it isn’t. Willingness to communicate and seek support is what makes the difference.

4. Couples Approach

Erectile dysfunction is often regarded as a “couple’s disease” because it affects both partners. Thus, it requires a couple-centred approach. With open communication, couples can find lasting solutions together, explore other forms of intimacy, and reduce performance pressure in the relationship.

On this couple’s approach, James Hotaling, MD, a urologist at University of Utah Health, says, “Putting yourself in your partner’s shoes is a great first step to tackling ED as a couple.”

“Putting yourself in your partner’s shoes is a great first step to tackling ED as a couple. Many men with ED feel they’ve lost self-confidence inside and outside of the bedroom, which can lead to anxiety and depression. Acknowledge your partner’s struggle and be supportive.”

Be prepared for a conversation. Think about when and where you can have the conversation with your partner–the bedroom might be a great place if you can get some privacy there. Schedule the discussion at other times, not during or immediately after sexual intimacy. Remind your partner that you’re in this together and that ED is treatable.

5. Advanced Medical Treatments

Medications and lifestyle modifications are the usual first-line options, and they work in 60% of men. In other cases, the following advanced treatments may be required.^[5]University of Utah Health. (2020, October 7). How to deal with erectile dysfunction in a relationship. https://healthcare.utah.edu/healthfeed/2020/10/how-deal-erectile-dysfunction-relationship

• Penile vacuum pump: A vacuum pump is applied over the penis, and when pumped, it pulls blood into the penis. After that, you then place a special ring over the base of the penis to keep it erect until after sex.
• Injection therapy: This involves self-injecting medication directly into the penis–typically alprostadil (PDE-5 inhibitor), papaverine, or phentolamine (non-selective α-adrenergic receptor blocker similar to tamsulosin). These help relax muscles and expand penile blood vessels for an erection, and are typically done about 5 to 15 minutes before you want an erection.
• Penile implants: These are inflatable or malleable cylinders placed in the penis by a urologic surgeon to treat severe erectile dysfunction when other treatments fail. They allow for natural-feeling and on-demand erections. The procedure takes around 4-6 weeks to recover from, with over 95% satisfaction rates, and provides a permanent solution that can last an average of 12-15 years.

Consult a medical doctor or urological surgeon before getting these done. They will discuss the cost, precautions, and procedure with you for effectiveness and safety.

Final Words

Erectile dysfunction is not an automatic deal breaker in a relationship. It can be challenging, but with a combination of medical treatments, lifestyle changes, and emotional support, couples can navigate it.

In many cases, the real issue isn’t ED itself, but how both partners respond to it. Lack of communication, frustration, dismissiveness, and avoidance can result in serious problems from ED, but with openness, communication, and mutual understanding, couples can successfully deal with erectile dysfunction.

If you or your partner is experiencing erectile dysfunction, address it early, seek professional help, and importantly, be honest about it. At the end of the day, a strong relationship is not built on perfection, but on connection, trust, and effort.