The Fundamentals of Sex

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Like other body systems, penises need certain circumstances to function effectively.

Even small amounts of alcohol can undermine erections.

It's easy to get ED medications, but using them can reinforce the narrative of personal inadequacy.

It's all over the internet, health podcasts, and even the New York Times: Half of all men over 40 “will suffer from erectile dysfunction at some point.”

And indeed, every week, individuals and couples come to my office talking about “ED.” Unfortunately, professionals and lay people alike use the term to describe anyone who can’t get an erection when he wants to—even just once.

This, of course, implies that penises should behave like ATMs—ready to do business 24/7, rain or shine. But that’s not how penises (or any other body part) are designed.

Like eyes, ears, and stomachs, penises need a special set of conditions to do what their owners (or their owners’ partners) want them to do. Those conditions can involve emotions, environmental issues, or features of another person. If one of those isn’t quite right, even the healthiest penis will stubbornly stay small and soft and quite calm.

Too many physicians prescribe erection drugs without inquiring about the situations in which a man wants to get erect. If you’re with someone you can’t stand, feel terribly guilty, are afraid of unwanted pregnancy, or are in a big rush, all the Viagra in the world may not help. That’s what often leads docs to send patients my way.

So here are common situations in which people expect an erection and often don’t get one. These are examples of unrealistic expectations, not ED.

How much? As far........

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