As the first private step in tackling an issue he has been silently living with for months or years, a man often looks for an online course on erectile dysfunction.

One of the most common questions men bring to a sexual health professional is: Should I take medication, or should I try therapy? It would seem that the question has a binary answer, as if there is a right answer for all men, but the honest clinical answer is more complex than either answer alone.

Most men with erectile dysfunction know the feeling: You’re in the midst of a sexual experience, and then you suddenly aren’t part of it anymore.

An erection is a parasympathetic event, which requires that the body be in a state of relative calm, when blood vessels relax and blood flow increases to the penis under the control of the parasympathetic branch of the autonomic nervous system.

Most men who sign up for an online course to help with erectile dysfunction do so with one quiet hope: that the material will be enough to fix the problem. They read the content, see how it relates to them, and then wait for something to happen.

Mindfulness for sexual health is gaining clinical support as a treatment for ED. Learn how present-moment awareness breaks the anxiety cycle that drives erectile dysfunction.

You probably searched late at night. You’ve thought about your diet, blood flow, and testosterone levels, and maybe even thought about what might be wrong.

It starts with a thought that flashes through your mind: “Is this going to happen tonight?” For a lot of men, that little bit of doubt starts a cycle that makes them angry.

For many men, the first time an erection doesn’t go according to plan, the internal monologue is immediate and catastrophic.