Erectile dysfunction and premature ejaculation
Both erectile dysfunction and premature ejaculation (PE) are totally normal when they happen occasionally. Sometimes your body just isn’t at its best, or there’s a lot on your mind. When they happen repeatedly, though, it can be frustrating and talking to a doctor is a good first step in getting treatment.
So what’s the difference between erectile dysfunction and premature ejaculation? ED is defined as the inability to get or maintain an erection that’s hard enough for sex. PE, on the other hand, means your penis is erect but ejaculation happens much faster than you want. There’s no rule for how long a man should last before ejaculation but if you’re feeling unsatisfied, it’s time to find a solution.
While these two conditions might sound like opposites, they can indeed go together. We’ll discuss some physical and psychological causes of both conditions as well as how they can be treated, individually and together.
Can ED cause premature ejaculation?
Yes, erectile dysfunction can cause premature ejaculation. This generally happens because of a “use it while you’ve got it” mentality — if you know you have difficulty sustaining an erection, and you manage to get one, it’s understandable that you’d want to ejaculate before you lose it. Sussing out whether you also have ED can help a doctor determine what kind of treatment you need for premature ejaculation.
How about premature ejaculations causing ED?
It’s more likely that something is going on that’s causing both ED and PE. For example, stress or anxiety over your relationship or sex life can make it difficult to get an erection and, once you do get one, can lead to premature or even delayed ejaculation. Or, on the physical side, prostate problems can cause both erectile dysfunction and premature ejaculation.
The stress of one sexual problem can lead to dysfunction in other areas of sex as well. Psychologically, it’s possible that someone who has premature ejaculation may become nervous about pleasing their partner and can develop psychological erectile dysfunction as a result.
Are there treatments that address both problems?
There are a few premature ejaculation products that could also help with erectile dysfunction, but whether they’ll work for you can depend on why you have either condition. The ED medication sildenafil (Viagra) has been trialed for PE to promising results. It’s not licensed solely for this use but could help you avoid premature ejaculation if you experience both conditions.
Antidepressants are another option. Studies show that paroxetine (Aropax) is the most-effective SSRI for controlling premature ejaculation, and could also help erectile dysfunction with a psychological cause like depression or anxiety. Dapoxetine (Priligy) is a type of medication that’s traditionally used in depression, but is licensed for premature ejaculation, and available from a doctor on prescription.
Speaking to a doctor can help you determine the cause of your erectile dysfunction and premature ejaculation, which will go far towards getting you the treatment you need. It’s possible you’ll only need to take one pill to last longer in bed.
Is there a link between ED and delayed ejaculation?
Delayed ejaculation covers two things: taking a long time to ejaculate and not being able to ejaculate at all. So how long does it take to ejaculate? Generally speaking, if you can’t ejaculate about 50% of the time you have sex, or it takes you 30-60 minutes to ejaculate, you’re experiencing delayed ejaculation.
Slow ejaculation can be caused by a number of things, some of which can also be causes of erectile dysfunction — diabetes, for example. There are also medications which can make it difficult to get an erection and hard to ejaculate, like SSRI antidepressants. Psychological links exist, too. If you’re experiencing delayed ejaculation, you might lose your erection if you get distracted or too tired.
So while neither condition means you’re bound to experience the other, links do exist. Talking to a doctor and figuring out what’s causing your issues can help narrow down what treatment you need.
Erectile dysfunction and loss of libido
Erectile dysfunction occurs when you’re not able to get and keep an erection that’s hard enough for sex. ED can be caused by something physical (like diabetes) or something mental (like stress). In either case, though, you’re aroused and interested in sex.
Libido is your interest in sex, so it’s almost the opposite problem. The equipment is working, but you don’t want to use it. Because humans are incredibly complex, though, it’s possible to have low libido and yet want to want to have sex.
There are a few things that can cause both erectile dysfunction and low libido to happen at the same time. Both are a possible side effect of some SSRI antidepressants. Low testosterone levels can also lead to ED and low libido.
Talking to a doctor can help you pinpoint what’s going on and what you need to treat it. Viagra, for example, should help ED with a physical cause and might help ED with a psychological cause. It’s unlikely to help with libido issues, though, because you need to be aroused for the medication to work.
Can ED cause loss of libido?
There’s not a physical link between erectile dysfunction and low libido, but there might be a psychological one. Some men find that their sex drive naturally lowers when they avoid sex for a period of time. If you’re experiencing ED, it’s possible that psychological stress could lead to not having sex which could eventually manifest as low desire.
Can low sex drive lead to ED?
It can be difficult to get an erection when you’re not in the mood. Strictly speaking, though, this isn’t textbook erectile dysfunction. The true definition of ED is when someone is sexually aroused but can’t get an erection.
Is there a single treatment for both?
If you’re experiencing a sudden disinterest in sex or the inability to get an erection, talk to a doctor and see what your options are. Depending on the cause of your ED and low libido, different treatments might be recommended. For example, if you’re experiencing sexual dysfunction as a side effect of an antidepressant, the doctor can help you figure out a different dosage of the antidepressant and prescribe Viagra. Or, you could try treating the low sex drive first, which could lead to you getting aroused more easily.
There’s no single treatment that specializes in treating both erectile dysfunction and low libido. Supplements of the hormone DHEA (dehydroepiandrosterone) have been studied for their ability to increase libido and help with ED — the latter being more successful than the former — but DHEA is restricted in Australia because there are risks associated with taking it.
ED and Peyronie's disease (PD)
Peyronie’s disease (PD) is a condition where the penis isn’t straight. While some curve to your erection is normal, Peyronie’s happens when too much scar tissue builds up on your penis. This could be the result of an injury, or from another cause. Peyronie’s disease symptoms also include pain while having an erection.
Can Peyronie’s cause ED?
Peyronie’s disease can make having sex difficult or uncomfortable. It can also make it painful to get or maintain an erection, resulting in erectile dysfunction. There are a few ways in which Peyronie’s can cause erectile dysfunction. One is psychological: the pain or discomfort associated with PD can lead to psychological ED. The scar tissue can make it more difficult for an erection to occur by weakening muscle tissue in the penis or impairing blood flow. And it’s also thought that Peyronie’s disease may be hereditary.
How is Peyronie’s treated?
There are multiple treatments for Peyronie’s disease, but not all men who have the condition need them. If your Peyronie’s doesn’t cause pain or erectile dysfunction, it’s ok to leave it untreated. Sometimes, it can even go away on its own.
Non-surgical options for treating Peyronie’s disease include medicines like Viagra, which can help PD and ED at once but should be used with caution, as they can increase the risk of priapism. Although Viagra can sometimes be prescribed without an in-person appointment, it’s best to see your doctor if you plan to take it for Peyronie’s.
Traction therapy, where traction devices are worn on the penis, can also help with Peyronie’s disease. Traction therapy can be done after surgery or by itself. A traction device called RestoreX has been approved for Peyronie’s disease by the TGA.
If your Peyronie’s is severe, surgery might be your best option. PD surgery works by removing the scar tissue, straightening the penis, removing part of the penis to balance out the curvature or implanting a straightening device.