Ep. 405: The Truth About Erectile Dysfunction

Sex therapist Jessa Zimmerman interviews Johns Hopkins urologic surgeon and researcher Dr. Arthur Burnett about erectile dysfunction from a holistic biopsychosocial perspective. Burnett explains how erections work as a vascular function regulated by the nervous system, and how physical factors like hypertension, atherosclerosis, diabetes, cardiovascular disease, and nerve or hormone issues can interfere. They discuss how stress and performance anxiety can biologically affect erections via adrenaline, and how oral medications like Viagra and Cialis work by reducing a “brake” in the erection pathway, though effectiveness can change as overall health changes. Burnett emphasizes thorough assessment beyond quick prescriptions, including counseling when appropriate, and reviews a treatment ladder from lifestyle changes to oral meds, vacuum devices, penile injections, and penile implants, noting implants typically preserve sensation and can reduce anxiety when expectations are realistic.00:00 Show Introduction00:43 Meet Dr Arthur Burnett01:43 Why Study Erectile Dysfunction03:30 How Erections Work05:43 Physical Causes of ED06:56 Nerves Orgasm and Erection08:03 Holistic Assessment Approach10:56 Stress Anxiety and Viagra13:07 Mid Episode Substack Break13:47 When Therapy Helps15:12 Lifestyle Changes That Improve ED17:42 When to Use Medical Treatments18:55 When Pills Stop Working20:08 Second Line Treatment Options22:44 Considering Penile Implants24:09 Implant Sensation and Expectations26:52 Choosing the Right Urologist28:54 Where to Find Dr Burnett30:14 Closing and CreditsVisit Jessa's substack: https://www.intimacywithease.com/substackBio:Arthur L. “Bud” Burnett II, MD, MBA, FACS, is a globally recognized Johns Hopkins urologist, researcher, Viagra Pioneer and educator whose pioneering work in men’s health and erectile function has transformed care worldwide.Want to learn more about my sponsored charity? Charity: Water is committed to providing clean water to every human on the planet, 100% of your contribution will be used directly for water projects around the globe. You can learn more at https://www.bettersexpodcast.com/water.More info and resources:Secret Podcast for the Higher Desire Partner: https://www.intimacywithease.com/hdppodcastSecret Podcast for the Lower Desire Partner: https://www.intimacywithease.com/ldppodcastHow Big a Problem is Your Sex Life? Quiz – https://www.sexlifequiz.comThe Course – https://www.intimacywithease.com/iwecourseThe Book – https://www.sexwithoutstress.comAccess the Free webinar: Intimacy Made Easy: 3 Secrets to Bridging Libido Differences: https://intimacywithease.com/masterclassIntimacy with Ease is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit jessazimmerman.substack.com/subscribe