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Erectile dysfunction (ED) is a serious problem, but many myths and misconceptions persist about the condition, says urologist Daniel Shoskes, MD. Men wonder if sitting on a hard bicycle seat can cause ED. They worry ED is caused by diet, a lack of sleep, or is simply part of getting older. They wonder if they’re the only ones with this issue.

1. Can the prescription drugs I take affect my ED?

Yes. More than 200 drugs may be associated with difficulty achieving an erection.

2. Is erectile dysfunction sometimes a psychological issue?

Yes. Often psychological factors are involved either in part or as the entire cause, of erectile dysfunction, especially in younger men.

3. Can tight underwear cause erectile dysfunction?

No. Causes of ED can be physical and/or psychological, but tight underwear is not among the causes of ED.

4. Is erectile dysfunction a normal part of getting older?

It’s common for erections to be more difficult to achieve with aging due to other diseases, but age alone is not a barrier to having sex. Generally, other factors may be involved. These may include vascular disease, diabetes, hypertension, and personal habits such as cigarette smoking.

5. Can a man get an erection whenever he wants?

No. This may be true of teenage boys, however, erections don’t occur as often as a man gets older. Hormones in a man’s body and other life changes may affect a man’s level of arousal. It may take longer for a man to achieve an erection and may require more direct stimulation and foreplay.

6. Can tobacco use, alcohol or illegal drug use bring about ED?

Yes. These substances can damage blood vessels and/or restrict blood flow to the penis, causing ED.

7. Is it true that most men never experience erectile dysfunction?

No. Most men experience ED at one time or another. Studies suggest that as many as 52% of men between the ages of 40 and 70 may have difficulty with erections.

8. Should a man seek treatment for recurring ED?

Yes. A man should seek medical advice and treatment if ED occurs more than half of the time.

9. Can the occasional riding of a bicycle result in ED?

This is controversial and some studies suggest that men who ride a lot may have compression of the pudendal nerve leading to erection issues. Bicycle riding, in moderation, does not affect erectile functioning. Men should take breaks when cycling long distances, however. A bike and seat that fit ergonomically with a man’s body can relieve discomfort associated with bicycling.

10. If a man suffers from ED, can it cause problems for his sexual partner too?

Yes. Both partners can suffer if impotence goes untreated. Failure to communicate and denial of the problem can lead to depression, anxiety, and lack of self-esteem for both partners.

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