Can tight underwear cause erectile dysfunction?

Before the discovery of Viagra — originally a heart drug — most people were unaware of erectile dysfunction as a medical condition. Today, television commercials hint that household chores can take a romantic turn with the help of a colorful little pill.

It may seem like an embarrassing and rare medical condition, but it’s actually quite common. An estimated 30 million men suffer from erectile dysfunction (ED) in the United States.

Increased awareness of ED may be responsible for the renewed popularity of boxer shorts, but is it true that tight underwear contributes to erectile dysfunction? Dr. Robert Eisenberg, a urologist affiliated with Sharp Grossmont Hospital, shares that while boxers or briefs have never been linked directly to ED, tight underwear is related to infertility, as it can interfere with the right temperature for good sperm maturation.

Intimacy important at all ages
“ED occurs when there is interest in sex, but the inability to achieve or maintain an erection,” says Dr. Eisenberg.

Although there are certainly more cases of ED in the 80-year-old population than in the 30-year-old population, ED is not a normal part of the aging process. Dr. Eisenberg says it is just as important to diagnose and treat this condition no matter what age.

“The idea that it is a natural part of aging implies that is should be accepted and not treated in older men,” he says. “The reality is that intimacy is just as important in an older couple as it is in a younger one, and treating ED allows that intimacy to continue.”

A European study found that roughly 2 percent of men in their 30s have ED, and this gradually increases to more than 50 percent of men over 80. “I tend to see men come to the office for ED in their 40s,” says Dr. Eisenberg. “But men with other diseases or health issues can show symptoms of ED at an earlier age.”

The health issues strongly related to erectile dysfunction include:

• Cardiovascular disease

• Smoking

• Hypertension

• Diabetes

• Common side effect of prostate cancer treatment

Other common ED myths
Dr. Eisenberg addresses three other issues commonly thought to contribute to ED:

Riding a bike
“There is evidence that a significant relationship exists between riding bikes and erectile dysfunction in men. While the exact mechanisms and connection are still being researched, a properly fitted bicycle, a riding style with a suitable seat position and an appropriate bicycle seat can help prevent impairment of erectile dysfunction.”

Lack of sexual attraction
Dr. Eisenberg confirms that while attraction to your partner is an important component to intimacy, it is not related to ED. “People often mistake ED and low sex drive, also known as a low libido. The two tend to have different causes and require different treatments.”

Emotional issues
“While sexual dysfunction can have a psychological component, erectile dysfunction is not due to a psychological issue.”
Dr. Eisenberg stresses the importance of being treated by a doctor who specializes in ED. “This doctor can offer all the treatment options available in order to find the one that is best suited for each individual patient’s needs.”