Category: What causes erectile dysfunction?

Porn Can Contribute to Erectile Dysfunction

It’s the conclusion that many articles, websites, and recent conversations have come to: When young men deal with ED, pornography is sometimes the culprit.

As a medical clinic, the question we ask is always the same: What do the facts say? Does science have the answer to the question “Can porn really cause erectile dysfunction?”

Let’s find out.

How Much Do We Really Know About Erectile Dysfunction in Young Men?

It’s true that erectile dysfunction is an issue for younger men. A 2013 study found that about 1 in 4 men experiencing ED are under the age of 40.

Is this number an increase? Unfortunately, little data from previous generations exists to make a true comparison.

Some earlier takes on this subject (such as a Kinsey study in 1948) suggest that ED used to be less common in young men, but these studies are rare and use methods which differ greatly from those we use today, making it hard to conclude one way or the other.

While we do not know the extent of an “increase” in instances of ED, recent data shows that it is a prevalent issue for young men today. But could porn be the reason? Can porn really cause erectile dysfunction?

How Does Pornography Affect the Brain?

Studies have found that the reward centres of the brain respond actively to pornography. Individuals whose reward centres are particularly triggered by these images respond to pornography the same way a drug addict’s brain would respond to a substance.

Some believe that frequent exposure to pornography trains the reward centres in the brain to respond only to increasingly graphic images which do not mimic real-life sexuality, making it difficult to become excited during intimate encounters.

Not so fast, neurologist Dr. Simone Kühn notes in a 2013 Telegraph article about her study on the subject. At this point in the research “It’s not clear whether watching porn leads to brain changes or whether people born with certain brain types watch more porn.”

More recent studies show that healthy young men with a porn addiction experience less ED while using porn than during sex with a partner. See this 2021 study A web-based survey of men with “problematic” pornography consumption concluded that “prevalence of ED in young men is alarmingly high, and the results of this study suggest a significant association with problematic pornography consumption.”

What Are Some Reasons For Erectile Dysfunction in Young Men?

While the consumption of pornography has increased since the advent of the internet, other changes have also taken place in the last quarter century which could also affect male sexual health.

Young people have seen a rise in instances of high blood pressure, diabetes, obesity, and other health problems associated with ED. Stress has also increased among young people, and attention spans are growing shorter. For young men experiencing erectile difficulties, these risk factors should all be considered by a doctor.

What Can Young Men Do To Treat ED?

Yes, the brain can be impacted by pornography. And yes, the brain is one of many factors considered when treating erectile dysfunction. But there is no conclusive evidence linking the two. While it may be worth considering for some individuals with certain brain types, every man is different. Potential causes for erectile dysfunction in young men vary greatly.

Before running to a doctor for a quick-fix prescription or trying to self-diagnose the reasons for your ED, see a men’s health specialist for an evaluation. Doctors who specifically treat erectile dysfunction are experts in physiological and psychological risk factors and will take your whole health into consideration when creating a treatment plan.

If you live close to Toronto and the GTA, FullMast Clinics are a great resource for any man dealing with ED. To get started, contact us online or call 1-844-500-1177.

11/11/2016
SONICWAVE Treatments for Erectile Dysfunction Resulting from Radical Prostatectomy

Initial caution… then Good News.

The medical community has been cautious about treating erectile dysfunction caused by radical prostatectomy for understandable reasons. The nerve that runs through the prostate gland is delicate and easily damaged by the surgery and further disturbance by low-intensity extracorporeal shock wave therapy (LI-ESWT) – SONICWAVE as we term it – could potentially cause further damage. Therefore we began by recommending that we delay SONICWAVE treatment for at least a year after the surgery.

Three clinical trials (see links below) run over the last few years have shown there is no reason to delay treatment. Early treatment gives better results. SONICWAVE therapy promotes nerve regeneration along with improved sexual function.

Prostate treatments that don’t involve surgery respond more quickly to SONICWAVE and improvements are experienced in 6 – 8 weeks. After a radical prostatectomy, as long as the nerve has been largely preserved, the improvements can take longer.

What is the Best Timing for SONICWAVE Treatment?

There is no harm in starting treatment right after the prostate surgery. We suggest waiting until you have recovered from discomfort and are able to exercise normally.

The best results are obtained when SONICWAVE treatments are started within one year of the surgery. Erectile tissues degrade without periodic tumescence (half erection). In other words it is beneficial to regain at least some erectile function within months of prostate surgery.

What About Clinical Studies?

Our first hand experiences with patients provide the confidence for us to recommend SONICWAVE to treat erectile dysfunction after radical prostatectomy. Additionally, here are clinical studies that explore efficacy:

Low-intensity extracorporeal shock wave therapy for erectile dysfunction after radical prostatectomy: a review of preclinical studies – 2018

A prospective randomized placebo controlled study evaluating the effect of Low-intensity Extracorporeal Shockwave Therapy (LI-ESWT) in men with erectile dysfunction following radical prostatectomy – 2019

Low-intensity extracorporeal shockwave therapy in the treatment of erectile dysfunction following radical prostatectomy: a critical review – 2019

Erectile Dysfunction after Radical Prostatectomy: Low-Intensity Extracorporeal Shockwave Therapy (LIESWT) Plays a Role?

Effect of penile rehabilitation with low intensity extracorporeal shock wave therapy on erectile function recovery following robot-assisted laparoscopic prostatectomy – Aug 2020

Erectile Dysfunction A Prospective Randomized Placebo-Controlled Study Evaluating the Effect of Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Men With Erectile Dysfunction Following Radical Prostatectomy – June 2021

If You Have Had Prostate Surgery and suffering from Erectile Dysfunction Book an Appointment with One of our Physicians

23/09/2016
Yes, bike riding may cause erectile dysfunction and how to avoid it

After 12 years riding the same bike seat, on average of 20 kms a day, George began to notice gradual erectile dysfunction issues in the past five years. “My first thought was that it was related to cycling.” He didn’t experience numbness, as a precursor, but instead, it just wasn’t working in the bedroom.

His story is common. In fact, hardly a day goes by that Duke’s Cycle in Toronto doesn’t have a customer come in asking for a new seat. “Numbness is a common problem, but they don’t often go into more detail than that,” says Lisa Stockus, a sales representative.

In 1997 a study from the Massachusetts Male Aging study, which looked at over 1,700 recreational riders between the ages of 40 and 70, blamed cycling for erectile dysfunction. One of the authors, Dr. Irwin Goldstein, proclaimed: “there are only two kinds of male cyclists – those who are impotent and those who will be impotent.”

Since that study, the following research is saying that instead of ditching the bike, find a new saddle instead. There is hope for riders who want to have healthy and active sex lives.

What is happening down there?

Your penis doesn’t have to be directly on the saddle to feel the effects of numbness. In fact, the soft tissue area between the anus and the penis, the perineum, is loaded with blood vessels and nerves. The erectile tissue extends from the tip of the penis back towards the anus. If riders are resting their body weight on this area, and not your sit bones located in your glutes, then the blood flow is not only restricted, the vessels can collapse, or worse, build up scar tissue that can block blood flow needed for an erection.

The sit bones, or ischial tuberosities, have no organs, and the nerves and arteries are surrounded by the fat and muscle of your bum, therefore we can sit for hours without pain.

But, the research is revealing that yes, cycling will cause numbness, and yes this can lead to erectile dysfunction. The MMAS study revealed that spending three hours or more a week on the saddle carries a risk ratio of 1.72 (anything over 1.5 is defined as a health risk) of long term arterial damage.

And while the research since the studies in the early 2000s haven’t produced any new findings, more research has been done on saddles and ways to mitigate the numbness and pressure on the perineum.

Not everyone who rides will experience numbness or ED. But as the creator of Spongy, a dual seat saddle that removes the pressure from the perineum, Jeff Dixon says, “It’s like a smoker—you might not get cancer, but it’s a risk. With cycling, it’s the same thing, unless you remove the risk: the traditional saddle.”

Saddles that are designed to spread the pressure to the buttocks without a hard, narrow nose have been shown to alleviate the problem. After complaints and the health concerns of bicycling police officers who spend most of the day on a bike saddle, the National Institute for Occupational Safety and Health (NIOSH) conducted a study that looked at 91 police riders before using an alternative nose-less saddle.

“There were reports of genital numbness, but the sensitivity was removed and they found the erectile dysfunction was diminished,” says Steven Schrader, a reproductive health expert, and one of the study’s leading authors.

“We determined that about 20 to 25% of their body weight was being put on the nose of the saddle. With the nose-less saddle you remove that weight on the soft tissue.” After the study, only three officers returned to the regular saddles.

This was the thinking behind one of the most unconventional, but popular bike seats available. The Spongy Wonder (made in New Brunswick) uses two platforms – one for each sit bone, without a nose.

Within the athletic cycling community, one brand of saddle stands out. The Power series of saddles from Specialized that shift body weight onto the sit bones avoiding putting pressure on the perineum.

As far as gel seats or cut outs, Schrader says to avoid both. Both alternatives only transfer the weight and put more pressure on the perineum.

The type of biking makes a difference

A 2004 study of 33 bikers revealed that a traditional sport race bike saddles, put twice the pressure on your perineum than other styles of bike saddles.
“Road cycling and cycle touring are big culprits, but it’s less about body position and more about the fact that it is a long time on the bike and in a position that is static and you don’t move around on the saddle,” says Andrew McGregor, the sports marketing sales rep for Specialized Bicycle Components.

“Triathletes are poster childs for this as they are in a fixed position while roadies (road cyclists) move around a bit; mountain bike (is the best scenario) because it is a dynamic sport where you’re up and down out of the saddle often.”

Measure your sit bones

Your weight has no bearing on the width of your sit bones, meaning, you can be heavier and have a smaller distance between your sit bones. Before finding a perfect fitting bike saddle, experts suggest getting a fitting and that begins with this all-important measurement.
A profile photo of a rider with a saddle too small for his sit bones reveals a curved spine and his body weight shifted forward. With a correctly fitting saddle, his back straightens and his weight shifts back onto his sit bones.

“If the saddle isn’t the right width, the body will always adapt to find a way – you might shift body by lifting one leg and shifting your bodyweight to adapt. It might cause back pain or travel up your arm. But this is all fixed with the right bike saddle,” says McGregor.

And when all else fails, McGregor says just lift your bum for some relief. “As soon as you get up problem resolved—even on a bad saddle.”

13/09/2016
Sex, Scams, and Science: Why You Deserve a Doc When Dealing with Erectile Dysfunction

Dealing with erectile dysfunction isn’t easy to talk about. Over-the-counter pills, online quick fixes, or even just ignoring it can seem easier than calling a men’s health clinic, especially if the challenge of getting and maintaining an erection is new to you.

We know. We get it. But you and your partner deserve to know what’s going on with your body. A doctor who specializes in erectile dysfunction can decipher the real reasons your penis isn’t performing. And that doesn’t just make the process of finding the right treatment quicker and easier–it could also save your life.

Erectile Dysfunction Can Be a Symptom of More Serious Problems

An erection occurs when the arteries in your penis receive signals from the brain to let more blood flow in. This process involves a lot of important parts of your body including the circulatory system, the nervous system, your pelvic muscles, and even your brain.

This means that when you experience challenges getting or maintaining an erection, the causes could involve many different and critical parts of your body.

That matters to a doctor, and it should matter to you. It matters that erectile dysfunction could signal high cholesterol, high blood pressure, or even diabetes. It matters, too, that you have options for dealing with erectile dysfunction. There are a variety of treatments available which take those underlying issues into account.

A specialist like Dr. Ron Mayer at Toronto men’s health clinic FullMast is trained to identify and treat the causes of erectile dysfunction. That’s good news not only for your sex life, but your well-being in general.

Getting Help for Erectile Dysfunction is Easier Than You Think

An erectile dysfunction specialist is just that: a specialist. Doctors at our men’s health clinic spend all day dealing with erectile dysfunction by talking to men and their partners and treating sexual health issues. That means they’re experts in not only treating ED, but in making sure people are comfortable with the process.

Don’t know anything about erectile dysfunction? We will walk you through any questions you have. Don’t want to take pills? We have great treatments that don’t involve medication. Need support navigating erectile dysfunction with your partner? We know just the person to help.

Going to a doctor for your erectile dysfunction not only helps you to improve your health, it opens up possibilities and resources for dealing with erectile dyfunction that you may not have even known existed before your visit.

Oh…and it works.

Alternatives to a visit to your doctor, like over-the-counter pills, don’t have a great track record. While they may work for some, success can be short-lived. That’s because these band-aid solutions don’t address the core health issues at play with your erectile dysfunction.

Erectile dysfunction is a common issue, and seeking treatment from a specialist is the smartest way to address it. Your sex life, your body, and your health deserve a holistic, informed approach which only an erectile dysfunction specialist can provide.

Schedule your consultation with the FullMast Men’s Health Clinic in Toronto or Vancouver, or call 1-844-500-1177 for more information.

19/08/2016
8 Questions With FullMast’s Chief Medical Officer Dr. Ron Mayer

1-Hello, Dr. Mayer. Thank you for sitting down with me today. Would you mind discussing the main issues that come up most often in your clinic?

Well, primarily, men come into the FullMast clinic for erectile issues and questions about testosterone therapy. When a man comes into our office, and he’s around 45 years old and he presents with erectile issues, the first thing I have to think about is cardiovascular illness. Men who present with early-onset erectile dysfunction will most often have cardiovascular issues such as hypertension and high cholesterol.

2. As FullMast’s Chief Medical Officer, what are some concerns you’ve noticed when patients come into your office? How have you been able to address these?

I’ve noticed that some patients are reticent to come into a clinic where there are other men who are sitting around in the waiting room. They’re not necessarily ashamed, but there is still stigma around sexual health and erectile issues. In order to combat this, we manage our consultations according to a specific protocol. The consultations are an hour long. When a patient comes in for his consultation, the previous patient has already left. We have one treatment room. Our main concern is the comfort of the patient. We want to ensure privacy and confidentiality as much as possible.

3. What are some questions men should ask their doctors during their annual physical?

Annual physicals are not recommended for men until they’re 50 years old. Before 50 years of age it should be once every two years. During these annual checkups, they should ask for a colonoscopy, a rectal (prostate) exam, which involves the detection of PSA, the prostate-specific antigen. Certainly as a man gets older, he should ask about exercise and weight loss, especially if he is overweight or obese. Most physicians don’t talk to men about those issues. Even a slightly overweight man who doesn’t get that much exercise will present with signs of erectile dysfunction. The most common manifestations of ED are cardiovascular issues, hypertension, high cholesterol, and high blood sugar.

4. Do issues of mental health ever arise during these consultations?

Yes, these issues come up quite often. Men who are low on testosterone often come in slightly blue and with less energy. Sometimes, we have a conversation about the use of antidepressants. As part of the assessment, we also evaluate psychogenic causes of erectile dysfunction especially if the man is in his early thirties. Often times the causes are not organic but psychogenic. But keep in mind, psychogenic causes may also occur in men in their fifties as well.

5. Does fitness or nutrition ever come up during a consultation?

One of the first things we talk about is exercise. I usually ask them, ‘Do you walk?’ Walking is a good way to start becoming active. I recommend they measure the steps they take every day. There are many phone apps out there to help them keep track of the number of steps they take. I would recommend 1,000 steps per day, or 100 steps per minute to get their heart rate up.

Vitamin D is also important especially in the wintertime: 5,000 units per day along with magnesium. A trick I tell them is when to start and when to stop: if they go outside at noontime, and their shadow is longer than their height, take the vitamin D, but if at noontime, their shadow is shorter than height, don’t take it that day. I would also recommend lots of unsaturated fats, which can be found in olive oil, avocado, and walnuts (which contain arginine, a precursor for nitric oxide, which assists in producing a fully erect penis).

6. Do most men who come into your office have some type of support network?

They do, but it’s mostly support from their partner, especially because their partner is equally affected by these erectile challenges. They often come into the clinic with their partners. Men usually don’t like to talk about these issues with other people like friends or family members. Hopefully over time people will see sexual health as being another facet of overall health, but today, many men are still worried about how people perceive their masculinity. They don’t want to be questioned by their buddies or their friends. I’ve noticed men don’t joke about these issues until they’re in their seventies. In the1990s when Viagra come out, men became more open to discussing sexual health. It opened up the lines of communication; the commercials were humorous, and men felt more comfortable talking about it.

7. What age group do you see most often at the clinic?

The range is anywhere between 20-80 years old. Usually, younger patients have erectile issues that stem from psychogenic issues rather than men in their fifties and beyond. Younger men also have concerns with premature ejaculation.

8. Dr. Mayer, thank you for your time today. Before we say goodbye, is there anything else you would like to add?

Oh, that’s not a problem at all. Thank you. Yes, so I have noticed that many therapies nowadays focus on medications such as Viagra and Cialis, but there are many non-medicinal therapies and procedures out there. In fact, medications tend to wear off over time. FullMast has pioneered the first new and Health Canada approved treatment for erectile dysfunction called SONICWAVE, which is a non-surgical, non-medicinal therapy that uses high-frequency vibrations to stimulate nerve function, cell regeneration, and increase blood flow to the penis.

If a man has diabetes or has had prostate surgery or who presents with neurogenic issues, we’re going to recommend both SONICWAVE and Viberect. Viberect is another vibration technology that helps the secretion of nitric oxide. We believe in multimodal therapies so we also recommend pelvic floor exercises to strengthen the muscles that are responsible for maintaining blood flow and rigidity in the penis.

Overall, we’re here to help men handle the sensitive issue of erectile challenges by providing the best care possible at our clinic. We also want to open up the conversation about men’s sexual health and about maintaining sexual activity as men age. Myself and sexologist Dr. Stephen de Wit will be presenting at an upcoming talk on August 2nd to discuss these key topics in men’s sexual health.

10/06/2016
What is the Main Cause of Erectile Dysfunction?
What does it take for a man to have a good erection? This is a question that plagues many men who are trying to overcome sexual challenges. When I say a “good” erection, I mean an erection that is satisfying for both yourself and your partner. For many of our patients in Toronto, Vancouver, and other parts of Canada, achieving a “good” erection is a daily challenge

When seeking to resolve this issue, it is a good idea for men to understand the main cause of erectile dysfunction as well as being aware of risk factors and other contributing causes. A thorough diagnosis that recognizes the underlying reason for sexual difficulties will help you find the best treatments for your erectile issues.

What is the most common cause of erectile dysfunction?

The best way to understand erectile dysfunction is to take a look at what’s happening inside your body, especially where blood flow is concerned. This is because an erection involves blood flowing to the penis. This process allows the penis to become hard. For this reason, the main cause of erectile dysfunction is something called endothelial dysfunction.

The endothelium is the lining on the inside of your blood vessels. They are important in regulating four things:
1. Vascular tone: the extent to which your blood vessels constrict or dilate
2. Cellular adhesion: the process whereby cells interact and attach to a surface
3. Thromboresistance: the resistance of a blood vessel to thrombus formation, a thrombus being a stationary blood clot along the wall of a blood vessel
4. Vessel wall inflammation: blood vessels become swollen in response to injury, infection, or illness
The endothelium is what causes vasodilation of the vessels in the penis, resulting in a full erection. So, in essence, the main cause for erectile dysfunction from a biological perspective is damage to the endothelium. Any form of chronic inflammation caused by hypertension, diabetes, high cholesterol, obesity, gout, and other inflammatory conditions can harm this function.

Here’s how it works: When we get excited, either through touch or visual stimulation, messages are sent to the endothelium of the penis to release a substance known as nitric oxide (NO). This chemical is responsible for vasodilation by accumulating something called cGMP. This nucleotide relaxes the blood vessels and allows blood to flow into the penis. When there is damage to the endothelium, there is less nitric oxide, which results in a non-fully erect penis. This is how drugs like Cialis or Viagra work. They prevent the breakdown of cGMP, which allows nitric oxide to be continually be released over a longer duration of time.

How can I prevent erectile dysfunction?

Now that we’ve identified the main cause of erectile dysfunction, it’s time to work backwards to determine a resolution.

To prevent or minimize erectile dysfunction, you must first start caring for your cardiovascular health. Believe it or not, common advice for reducing the risk of heart attacks and strokes is the very same guidance that can help you prevent ED. This is because same conditions that cause heart disease can cause erectile dysfunction. Consistent exercise, managing your weight by watching what you eat, and keeping your blood pressure in check are all important parts of many successful erectile dysfunction treatment plans. These simple changes may go a long way in helping you combat and overcome erectile dysfunction.

Identifying your personal risk factors for erectile dysfunction

Whether you have just started experiencing erectile dysfunction or have been working to manage it for a long time, chances are endothelial dysfunction is at the root of the issue. But what is causing it and how can you resolve it? This main cause of erectile dysfunction shows many warning signs and has many associated risk factors. Take a look at the list below to see how many apply to you.

Behaviours and Conditions that Put Men at a Higher Risk for Erectile Dysfunction Include:
- A family or personal history of heart disease
- Type two diabetes and prediabetes (read more about this risk factor )
- Inflammatory conditions
- Obesity
- High blood pressure
- High cholesterol
- An inactive lifestyle (for example, working a desk job and not regularly getting exercise)
- An unhealthy diet
- Smoking
- Taking medications related to blood flow (these may be required for your health, but considering current prescriptions is a good idea when trying to understand the causes of your ED)
There are many benefits to addressing these issues. Along with helping treat ED, these lifestyle changes can prevent a man’s likelihood of developing heart disease. Since heart disease is one of the leading causes of death in Canadian men, this is good news. I often include lifestyle change recommendations into the erectile dysfunction treatment plans I develop for patients in Toronto and Vancouver.

Is my cardiovascular health the only thing that can cause ED?

Blood flow and heart health are the main cause of erectile dysfunction, but there are other causes of erectile dysfunction which may be at play in a man’s individual situation. While these factors may restrict blood flow, they do not necessarily relate back to a person’s heart health or lifestyle. These can include:
- A history of prostate issues, particularly if a man has undergone a prostatectomy
- Penile injuries and damage to the tissue within the penis (this can be sustained through sexual injury, car accidents, and more)
- Numbness or a lack of sensation in the penis (research shows that excessive bike riding can have this result for some men over time)
- Neurological issues that affect the brain’s ability to communicate with the reproductive system. This can include Alzheimer’s disease, Parkinson’s disease, tumours, epilepsy, and multiple sclerosis.
- Use of drugs that affect the central nervous system, including depressants (Xanax, Valium, alcohol etc), or stimulants (cocaine, amphetamines)
- Use of various other drugs that may influence reproductive processes, such as cancer chemotherapy medications or synthetic hormones
- Psychological, emotional or relationship issues
At Men’s Health Clinics like FullMast, a doctor will ask questions about all these risk factors in order to determine the causes of your individual ED issues. While the main cause of erectile dysfunction is always considered, these factors may also play a role.

Why does erectile dysfunction become more common as we age?

While ED can strike at any age, statistics demonstrate a considerable increase in erectile dysfunction (ED) with increasing age: up to 75% of men who are 75 years of age or older suffer from erectile dysfunction. So what happens to men as they age? Why does it become more difficult to have an erection and why are erections not as hard or long-lasting as they once were? Perhaps most importantly, can erectile dysfunction be prevented as we age and can the downward progression be altered? The answer to both these questions is a resounding “yes.”

Many people I meet in my Vancouver and Toronto erectile dysfunction clinics ask me about the relationship between age and ED, stating that it was “so much simpler” when they were young. The truth is that the process of getting an erection was never simple for your body, even if it once occurred without much visible effort. A complex chain of biological processes must occur to produce an erection. This includes psychogenic, neurogenic, vascular, hormonal, and muscular events. An interruption to these processes can get in the way of getting an erection. As we age, there is an increased likelihood of us experiencing health issues related to erectile dysfunction, particularly heart health which is the main cause of erectile dysfunction. By keeping an eye on a man’s overall health, we can often prevent, minimize, or treat his erectile issues.

Why does erectile dysfunction matter for Canadian men?

Sexual health can play into a person’s personal health, self-esteem, and well-being. It can also have an influence on the health of romantic relationships. Evidence shows that many couples prefer sexual intercourse where the male partner has a fully erect penis. Also, many couples report missing the feelings of excitement and pleasure that come from this particular form of intercourse. They also report a happier sense of “coupling” when sexual intercourse is enjoyable for both partners. A man with a non-erect penis may still have an orgasm and ejaculate during sexual intercourse, but for many men and for many couples, this may not be enough.

If you are a Canadian man seeking more information about the possible causes and treatments for your erectile dysfunction, contact us today for a free and fully confidential consultation.
02/06/2016
Physical reasons for erectile dysfunction

Here is a calculator that is based on data from the European Journal of Urology.

Learn about other causes of erectile dysfunction.

04/12/2015