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Last medical review: March 19, 2026
What is ED (Erectile Dysfunction)? A condition in which a sufficient erection cannot be obtained, or an erection cannot be maintained, during sexual activity. It includes not only complete inability to achieve an erection but also insufficient hardness and loss of erection mid-intercourse. An estimated 11.3 million or more adult Japanese men are believed to suffer from ED, and it is not uncommon even among men in their 20s and 30s. A partners understanding and support are key to successful treatment.
Table of Contents
When you suspect your boyfriend may have ED (erectile dysfunction), are you struggling alone, unsure of how to respond as a partner, with no one to confide in?
ED is on the rise across all age groups, and roughly 1 in 3 adult Japanese men experience concerns related to ED. It is by no means caused by a lack of attractiveness on your part.
In this article, under medical supervision, we explain the correct knowledge about ED, specific ways a partner can respond, treatment options, and approaches to deepen your relationship as a couple.
ED does not refer only to complete inability to achieve an erection. Insufficient hardness, losing the erection mid-intercourse even after penetration (mid-intercourse softening), or being unable to achieve an erection only in certain situations are all included in ED.
One or two failures alone do not necessarily indicate ED, but if the following conditions persist repeatedly (generally for more than 3 months), ED is a possibility.
| Checkpoint | Specific Condition |
| Erection hardness | Not hard enough for penetration; clearly less hard than before |
| Erection duration | Loses the erection mid-intercourse after penetration (mid-intercourse softening) |
| Erection timing | No erection despite sexual arousal; fewer morning erections |
| Psychological changes | Has started avoiding sex; reluctant about sexual activity |
| Symptoms in specific situations | Can achieve an erection alone but not when with a partner |
Even if some items apply, there is no need to panic. In most cases, ED can be improved with appropriate treatment.
ED has a significant emotional impact not only on the man himself but also on his partner. Understanding each others feelings is the first step toward resolving the issue while maintaining a healthy relationship.
ED is an issue deeply tied to a mans pride. Many men feel personally responsible for not achieving an erection as desired and lose confidence as a result.
| Main Feelings of Men with ED | Common Behaviors |
| – Wounded sense of masculine self-esteem – Anxiety about not being able to satisfy a partner – Resistance to relying on medication or medical care – The dilemma of having sexual desire but not getting an erection |
– Actively considers treatment and seeks consultation – Discloses symptoms but avoids hospitals – Denies the ED and runs away from the problem – Avoids sex itself, leading to a sexless relationship – Resorts to self-styled remedies (supplements, working out, etc.) |
Many women facing a partner with ED end up thinking, Maybe Im not attractive enough? or Maybe his feelings have cooled. Feeling turned off or frustrated is a natural emotion, and there is no need to blame yourself.
| Situation | Examples of Main Feelings/Behaviors |
| Right after learning about the ED | – Feels down, wondering if shes the cause – Doubts whether his love has faded; becomes anxious |
| When a sexless period continues | – Loneliness from losing the connection as a couple – Doesnt know how to bring it up |
| When the man is reluctant to take action | – Frustration: He only thinks about himself – Begins to reconsider the relationship itself |
| When the man is proactive about treatment | – Reassurance from working toward a solution together – A positive desire to support him |
ED occurs independently of a partners attractiveness or affection. There are many causes of ED, including stress, lifestyle, chronic illness, aging, and psychological pressure. There is absolutely no need to assume that its because Im not attractive or hes gotten tired of me.
In fact, when a partner blames herself and becomes despondent, the man may feel even more pressure, creating a vicious cycle that worsens ED. The most important thing is for both of you to share the recognition that ED is a couples issue and is no ones fault.
The following responses to a man with ED can worsen his symptoms and create rifts in the relationship.
| What Not to Do | Why Its Harmful |
| Blame him, mock him, or tease him | Wounds his pride and increases psychological pressure, worsening the ED |
| Pressure him with Hurry up and get better | Anxiety and pressure are the biggest enemies of psychogenic ED |
| Dismiss it as no big deal | Denies his suffering and shuts down opportunities for honest conversation |
| Force sexual activity | Strengthens fear of failure and may lead him to avoid sex altogether |
| Compare him to other men | Deeply wounds his self-esteem and can break the relationship |
| Reveal his ED on social media or to friends | A privacy violation that destroys trust |
With a partners understanding and support, the rate of ED improvement increases significantly. Tackle the issue together at a comfortable pace using the following 5 steps.
Having accurate knowledge about ED reduces anxiety and misunderstanding and enables an appropriate response. There is also a lot of information men themselves are unaware of, so it can be effective for the woman to take the lead and gather information together.
The timing of the conversation about ED matters. Absolutely avoid talking during or immediately after sex; bring it up in a relaxed everyday setting. Words of empathy such as Because I care about you, I want to think this through together are important.
Physical affection that does not focus on penetration promotes the release of oxytocin, which reduces anxiety and stress, and provides psychological reassurance. Holding hands, hugging, and giving massages – maintaining intimacy while reducing the pressure of sexual intercourse – can become a turning point for ED improvement.
Lifestyle improvements not only have a direct effect on ED, but the sense of were tackling this together also has a positive psychological impact.
| Improvement Area | Specific Actions |
| Exercise | Aerobic exercise (walking, jogging, etc.) at least 3 times per week. Effective for improving blood flow |
| Diet | Actively consume zinc (oysters, beef), citrulline (watermelon), and antioxidant foods (vegetables, fruits) |
| Sleep | Get 7-8 hours of sufficient sleep. Sleep deprivation can lower testosterone |
| Quit smoking | Smoking constricts blood vessels and is a direct cause of ED |
| Alcohol | Avoid heavy drinking. Small amounts can ease tension, but large amounts impair erections |
The most important thing is to consult a specialist early. When used correctly, ED medications can produce a high improvement rate. For boyfriends who feel embarrassed to go to a hospital, we recommend suggesting online consultations. He can be examined by a physician from home via smartphone, and ED medications can be delivered to his door.
ED is rarely caused by a single factor; mixed-type ED, in which physical and psychological factors are intertwined, accounts for the majority of cases.
In recent years, due to the rise in lifestyle-related diseases and the impact of a stressful society, ED has been increasing among younger men. The estimated number of ED patients in Japan is more than 11.3 million.
| Age Group | Lacks Confidence in Erectile Function | Insufficient Erection Interfered with Intercourse |
| 20s | Approx. 34-40% | Approx. 33-40% |
| 30s | Approx. 46-50% | Approx. 45-50% |
| 40s | Approx. 61-65% | Approx. 59-65% |
| 50s | Approx. 74-80% | Approx. 72-80% |
| 60+ | Approx. 83-85% | Approx. 80-85% |
*Source: Based on data from the Viagra 10th Anniversary Survey (Mpac, 2009), with estimates incorporating recent trends
| Category | Cause | Characteristics |
| Organic ED | Vascular/nerve abnormalities, aging, diabetes, hypertension, etc. | Physical causes. Common in those 40 and older |
| Psychogenic ED | Stress, anxiety, trauma, past failure experiences | Psychological causes. Common in those in their 20s and 30s |
| Mixed-type ED | Both physical and psychological factors | The most common pattern |
| Drug-induced ED | Side effects of antihypertensives, antidepressants, etc. | May improve by changing or reducing medication |
Psychogenic ED is particularly on the rise among younger generations. In addition to work pressure and relationship-related stress, excessive dependence on pornography has been pointed out as a cause of reduced sexual sensitivity in some cases.
Most cases of ED can be improved with appropriate treatment.
| Medication | sildenafil (Viagra) | vardenafil (Levitra) | tadalafil (Cialis) |
| Onset of effect | Approx. 30 min – 1 hour | Approx. 15 – 30 min | Approx. 1 – 3 hours |
| Duration | Approx. 4 – 5 hours | Approx. 5 – 10 hours | Approx. 24 – 36 hours |
| Effect of food | Strongly affected | Slightly affected | Minimally affected |
| Characteristics | Longest history with extensive clinical record | Highly fast-acting | Long duration; less need to time around the dose |
All of these medications have a strong safety profile when used under a physicians prescription, and generic versions are now available, lowering the cost barrier as well.
Note: It has not been medically proven that energy drinks or supplements alone can cure ED. Spending time and money on unsubstantiated folk remedies may delay improvement.
In recent years, online consultations that allow examination by a physician via smartphone or PC have become widespread. Since ED treatment is primarily based on medical interview, it pairs well with online consultations, and ED medications can be delivered to your home, easing the burden of clinic visits and concerns about privacy.
The way a partner should respond varies depending on how the boyfriend is dealing with his ED.
If he has already visited a clinic or started online consultations or lifestyle improvements, actively cooperating and watching over him provides significant support. However, if he is relying solely on supplements or strength training, share accurate information so that he also considers seeing a specialist or using ED medications.
For men who say its embarrassing to take medication, it can be effective to suggest the option of an online consultation. Researching the cost and the consultation process in concrete terms and showing him can also help reduce his hesitation.
Some men avoid the topic of ED altogether. The key approach is to first establish strong communication between the two of you, deepen the relationship, and then draw out his true feelings. If he still refuses to open up over a long period, you may need to consider whether to continue the relationship.
There is no need to immediately decide to break up just because of ED.
| What to Confirm Before Considering a Breakup | Signs the Relationship May Be Difficult to Continue |
| – Have the two of you discussed ED thoroughly? – Have you suggested consulting a specialist? – Have you tried to understand his feelings and situation? – Have you honestly conveyed your own feelings? |
– No matter how often you talk, he refuses to face it – He continues to ignore your feelings and your hopes for the future – He flatly refuses any treatment or improvement effort – Your own mental and physical health is being damaged |
What matters is not the ED itself, but whether the two of you can face it together.
Dont forget to take care of your own mental health too. If you are feeling stressed for a long time because of your partners ED, it is important to also consult a trusted friend or a professional counselor.
A. No, ED occurs independently of a partners attractiveness. There are many possible causes, including stress, lifestyle, psychological factors, and physical illness, so there is absolutely no need to blame yourself.
A. Yes, it is not uncommon. Among younger men, psychogenic ED is common, and work-related stress can be a trigger. Some data show that more than 30% of men in their 20s have concerns about ED.
A. Most cases of ED are treatable. ED medications (sildenafil [Viagra], tadalafil [Cialis], vardenafil [Levitra], etc.) have high efficacy rates, and lifestyle improvements and counseling are also effective.
A. Avoid bringing it up during or immediately after sex; bring it up in a relaxed everyday setting. Telling him that an online consultation allows him to consult from home makes it easier for him to take action.
A. They have a strong safety profile when used under a physicians prescription. Mild, temporary side effects such as headache and flushing may occur, but serious side effects are rare.
A. Yes, partners may accompany him. In the case of online consultations, you can also share the screen at home and consult together.
A. Mild ED can sometimes improve with lifestyle changes alone. For moderate or severe cases, the combined use of ED medications is recommended.
A. It is not heartless. What matters is not ED itself, but whether the two of you can face it together. If, despite thorough discussion, things do not improve, prioritizing your own happiness is your right.
ED (erectile dysfunction) is not a rare condition; it can readily occur even in men in their 20s and 30s. Men themselves often postpone taking action due to pride or embarrassment, but if left untreated, it may progress into a sexless relationship or create cracks in the relationship with a partner.
To summarize the key points of this article, the three things that matter most as a partner are:
If you approach ED with the attitude that it is a couples issue, you can effectively use options like ED medications and online consultations to move toward a solution more smoothly. It may even become an opportunity to deepen your relationship.
Limited Time Offer: Online Consultation Only – First-Time Tadalafil (Generic Cialis) 10 Tablets for 5,000 yen (clinic-designated brand)
*Limited quantities and duration; this offer may end without prior notice
Mens Care Clinic Medical Team
Specialty: Mens Health, ED Treatment, AGA Treatment
*This article was created under medical supervision, but please consult a specialist for individual symptoms.
*Last medical review: March 19, 2026
ED
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