Ah, erectile dysfunction – the elephant in the bedroom that no one wants to talk about but nearly everyone has an opinion on.  As a urologist and sexual health expert, it never ceases to surprise me how little men know about their hard-ons.  But how can I blame them with so much misinformation out there about what constitutes normal erectile function and the myths that continue to propagate about ED? Now in practice for nearly 10 years, I’ve heard it all when it comes to erections: from the mildly amusing to the downright absurd.  Well, it’s time to clear the air, bust some myths, and get real about ED. 

What follows is a list of common myths I hear from my patients almost every day.  It’s my hope that when you finish reading, you’ll have a better understanding of erections and be able to accurately distinguish between ED fact and fiction.

Myth 1: ED is rare. 

This myth may be the most damaging of them all.  Men who experience erectile dysfunction often think they’re alone, which compounds the shame they may feel and discourages them from seeking help.  Let’s set the record straight: ED is neither rare nor something to be embarrassed about. The numbers don’t lie: around 30 million men in the United States deal with erectile dysfunction.  Globally, that number skyrockets into the hundreds of millions.  Estimates of the prevalence of ED range from 9% to 40% of men by age 40, and generally increase by 10% with each decade thereafter.  It’s estimated that 1 in 4 men will experience ED at some point in their life.

The condition of ED is as common as it is misunderstood, but the perception of rarity stems from the fact that men just don’t talk about it.  For many men, ED feels like a blow to their masculinity.  Society places so much emphasis on sexual performance as a marker of male identity that struggling with it can feel like failing at something fundamental.  This toxic narrative is not only untrue but also incredibly harmful. This stigma is perpetuated by unrealistic portrayals of male virility in pop culture.  Think about it: movies and TV shows depict men as always ready, always capable, and never facing challenges in the bedroom.  Reality? Not so much.  Life is messy, bodies are unpredictable, and nobody operates at 100% all the time.

Myth 2: ED only happens to older men.

If I had a nickel for every time I heard this, I’d have retired on a beach by now.  This myth might be one of the biggest barriers preventing younger men from recognizing and addressing ED.  The cultural stereotype is clear: ED is something that only happens after a man retires, starts wearing loafers with socks, and has a cabinet full of medications.  But the truth is ED does not discriminate by age.

While it’s true that ED becomes more common with age – about 40% of men over 40 and 70% of men over 70 experience it – younger men are far from being immune.  Research shows that 1 in 4 men seeking treatment for ED are under 40. Yes, you read that right: a quarter of all men who consult a doctor about ED are young, often in their 20s or 30s. And some younger men may experience ED even before their first sexual encounters.  This means ED isn’t just about aging – it’s about a variety of physical, psychological, and lifestyle factors that can strike at any point in life.

Myth 3:  If you can get morning wood, you don’t have ED. 

This myth is one of the more persistent misunderstandings about erectile dysfunction.  It seems logical on the surface: if your equipment is functioning in the morning, it must work fine all the time.  But the human body is far more complex than that.  Morning erections, or nocturnal penile tumescence (NPT) if you want to impress at your next trivia night, don’t tell the whole story.  

Morning wood is a natural and healthy phenomenon that occurs during rapid eye movement (REM) sleep.  While you’re snoozing, your brain cycles through different sleep stages, and during REM, your body relaxes while certain autonomic functions, like erections, are stimulated.  Morning erections are driven by the parasympathetic nervous system (aka your body’s "rest and digest" system), which works independently of your conscious thought. These erections aren’t necessarily triggered by arousal – they’re more of a biological systems check, ensuring everything is in working order. Here’s the good news: if you’re regularly waking up with an erection, it’s a sign that the basic mechanics (blood flow and nerve function) are likely intact.  Morning erections are a useful indicator of your body’s physical capability, but they’re not the full picture.  ED is a complex issue influenced by physical, psychological, and relational factors.  So, if you’re struggling with ED but still waking up with morning wood, don’t dismiss the problem.  This can sometimes be a clue that psychological factors like stress, anxiety, and relationship dynamics may be affecting your ability to get and stay hard when it really counts.

Myth 4: ED is always a psychological problem. 

When erectile dysfunction rears its unwelcome head (pun intended), people often jump to the conclusion that the problem is psychological.  And while it’s true that mental health plays a role in some cases, the idea that ED is always a psychological issue is a damaging oversimplification. This myth not only prevents men from seeking the right treatment but can also trivialize what may be a serious underlying medical condition.While psychological factors like stress, anxiety, or depression can certainly contribute to ED, they’re not the whole picture. Physical issues – like blood flow problems, nerve damage, or hormonal imbalances – often play a role as well.  Erectile dysfunction is a multifaceted issue that rarely has a single cause.  By dismissing it as "just a psychological problem," or something that’s “only in your head,” you risk overlooking serious physical conditions, stigmatizing mental health struggles, and creating unnecessary shame.  The truth is that ED often involves both the mind and body – and both deserve attention and care. Remember, ED isn’t a character flaw or something you need to endure in silence.  It’s a medical issue, and with the right support, it’s almost always treatable.  Whether the root cause is in your blood vessels, your brain, or both, help is available – so don’t let this myth stand in the way of getting back to a fulfilling, confident sex life.

Myth 5: ED is a natural part of aging. 

When it comes to ED, one of the most pervasive myths is the idea that it’s an inevitable consequence of aging.  Sure, many bodily processes slow down as we age – hair grays, joints creak, and the metabolism that once allowed you to eat an entire pizza without consequences disappears.  But equating ED with a “normal” part of aging is misleading.  While ED becomes more common with age, it’s not an unavoidable rite of passage – nor should it be ignored or dismissed.

The aging process alone doesn’t cause ED; rather, the health issues that often accompany aging, such as cardiovascular disease, diabetes, and low testosterone, are often the real culprits.  By viewing ED as a treatable condition rather than an unavoidable consequence of getting older, you can take control of your sexual health and improve your quality of life. Age might bring wisdom, but it doesn’t have to bring an end to intimacy.  So, if ED is getting in the way, remember: you’re never “too old” to seek help, and there’s always hope for a better, healthier tomorrow – in and out of the bedroom.

Myth 6: ED is caused by watching porn. 

Ah, the age-old scapegoat: porn. Over the years, there’s been no shortage of sensational headlines blaming pornography for every bedroom woe imaginable, including erectile dysfunction. While some of these claims are rooted in kernels of truth, the idea that watching porn causes ED is not entirely accurate – nor is it the epidemic some alarmists make it out to be. This misconception stems largely from the concept of “porn-induced erectile dysfunction” (PIED), which suggests that frequent exposure to pornography desensitizes the brain to normal sexual arousal, making it difficult for men to achieve or maintain an erection during real-life sexual encounters.  Proponents argue that porn creates unrealistic expectations about sex, leading men to struggle with intimacy when reality doesn’t measure up.

The rise of high-speed internet and endless streams of adult content has amplified these concerns but the data on porn and ED are mixed.  Some studies report links between frequent porn use and sexual difficulties, while others find no significant impact.  Many researchers believe that the way an individual engages with porn – their mindset, frequency of use, and emotional health – is far more important than the mere act of watching it.  A 2015 study published in The Journal of Sexual Medicine found no direct link between porn use and erectile dysfunction but highlighted that men who reported sexual problems were more likely to be dealing with other issues like relationship dissatisfaction, poor communication, or mental health struggles.

Myth 7: ED medications always work like magic. 

ED medications, like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil), have earned a bit of a mythical reputation.  Thanks to advertisements featuring confident men sailing off into the sunset or returning from the pharmacy with a wink, many people believe these little pills are an automatic ticket to a rock-solid erection anytime, anywhere.  While ED medications can be incredibly effective, the idea that they work like magic for everyone is oversimplified and, frankly, quite misleading.

ED medications like the ones I just mentioned belong to a class of drugs called PDE5 inhibitors.  These drugs block the enzyme phosphodiesterase type 5 (PDE5), which breaks down a chemical called cyclic GMP.  Cyclic GMP helps relax the smooth muscles in blood vessels, allowing for increased blood flow to the penis.  More blood flow = better chance of achieving and maintaining an erection. PDE5 inhibitors can be life-changing for many men, but they don’t work for everyone. Studies show they’re effective in about 70-80% of cases, which is impressive but not universal. Moreover, different medications work better for different people.  If one doesn’t work, you may want to consider talking to your doctor about trying another or adjusting your dose.  And remember, these medications don’t trigger an erection the moment they hit your bloodstream.  Foreplay, arousal, and sexual stimulation are still necessary for the magic to happen. They also work best when paired with a healthy lifestyle.

Myth 8: ED Has Nothing to Do with Your Overall Health. 

Erectile dysfunction might seem like an isolated problem confined to your sex life, but this myth couldn’t be further from the truth.  In reality, ED is often a window into your overall health.  The canary in the proverbial coal mine.  Many men don’t realize they have high blood pressure, diabetes, or heart disease until they experience erectile difficulties.  In this sense, ED can be an early warning system, prompting you to address potential problems before they become more severe.

Erectile dysfunction clearly isn’t just a “bedroom issue.”  Ignoring ED means potentially overlooking serious medical conditions like heart disease, diabetes, hypertension or hormonal imbalances.  The good news?  By addressing the underlying causes of ED, you’re not just improving your sexual health – you’re investing in a healthier, longer, and more fulfilling life.

Final Thoughts: The Bigger Picture of ED and Sexual Health

Erectile dysfunction is one of those topics that’s often approached with a mix of embarrassment, confusion, and a lot of misinformation.  It’s no surprise that myths about ED are rampant – from misconceptions about its causes to unrealistic expectations about treatments.  But here’s the thing: while ED is a common and frustrating issue, it’s also highly treatable, and the real challenge lies in dispelling these myths and understanding what’s really going on with your body.

What sets ED apart from many other conditions is that it’s a highly visible issue – there’s no denying when things aren’t functioning as they should.  But that visibility is also what makes it an opportunity: a chance to get ahead of potential health issues, take control of your well-being, and have open, honest conversations about something that affects so many men.  So, if you're struggling with ED, don’t settle for quick fixes or try to push through it alone.  Address the root causes, seek professional help, and take charge of your health.  You deserve it, and your future self will thank you.

In the end, the path to better sexual health is just that – a path.  It’s not always straight, but with the right mindset, support, and information, you’ll get there.  ED might be common, but it doesn’t have to be permanent.  And maybe the biggest takeaway from our discussion today is that ED isn’t just about not being able to get it up; it’s about taking a deeper look at your body and mind, and addressing what might be lurking beneath the surface.