When Erections Falter: The Silent Health Warning Men Can’t Afford to Ignore

Unreliable erections affect roughly half of all men over 50. It’s a significant issue that almost nobody talks about openly, except perhaps a handful of urologists on YouTube, a few sex therapists, and me. And it’s worse than that: a recent study found that around a quarter of men who experience erectile difficulties would rather stay silent than speak to a healthcare professional about it.

That silence is potentially life threatening.

I’ve lost two partners over the space of twenty years to chronic illness. In both cases, erectile dysfunction was the first sign that something was seriously wrong. Whether the cause is psychological or physiological, ED is often the body’s earliest warning signal of a more significant health issue such as cardiovascular problems, diabetes, hormonal imbalance. It needs to be taken seriously, not endured quietly, with shame or ignorance.

And yet when I’ve spoken to men for whom this is a real and present issue, the conversation nearly almost always arrives at the same place: how do I let my partner know this has nothing to do with her?

Because I understand that fear completely. I was there myself, in my younger years. When I was with a man whose body wasn’t responding in the way I expected, my first instinct wasn’t concern for him, it was a very particular kind of self-doubt. He must not fancy me. I must not be attractive enough. His body is telling me something his mouth won’t say. It became entirely about me, my own ego, my insecurity.

But here’s what I know now that I didn’t know then: unreliable erections are rarely caused by a man not desiring his partner. In fact, no man with whom I’ve spoken on this topic has ever mentioned this, in fact entirely the opposite. And while I suspect for a few men this may occasionally be true, it’s the exception, not the rule. The far more likely explanations such anxiety, medication, vascular health, hormones, sheer exhaustion, have nothing to do with how attractive you are or how much he wants you. The two things have been conflated for so long that it takes a conscious effort to separate them. Believe me when I tell you - a man’s unreliable erection almost always has nothing to do with YOU.

Talking about erections is not easy. So much of how men understand themselves - their vitality, their status, their identity as a lover - is tied to whether their cock works reliably. And even though statistics consistently show that the majority of women don’t reach orgasm through penetrative sex alone, penetration remains the gold standard to which most men aspire. When an erection is unreliable, or absent altogether, the instinct tends to be one of three things: ignore it, apologise, or disengage entirely.

None of those options will improve your relationship or your ability to achieve an erection. Here’s what will…