When men experience erectile dysfunction (ED), the first assumption is often that something is physically wrong.

Maybe it's low testosterone. Maybe it's blood flow. Maybe it's age. Maybe something isn't working the way it should.

And sometimes there is a medical contributor. That's why a medical assessment is an important part of evaluating erectile dysfunction.

But erections don't happen in isolation from the rest of you.

Your nervous system, stress levels, relationships, beliefs about sex, past experiences, expectations, attention, and ability to relax can all influence erectile function.

In Part 1 of this series, I spoke with urologist Dr. Chris Bitcon about the medical considerations associated with erectile dysfunction.

For Part 2, I sat down with Justin Paulson, a registered clinical counsellor, couples counsellor, and clinical sexologist who works extensively with sexual concerns, including erectile dysfunction and performance anxiety.

Erectile function depends on communication between multiple systems in the body, including:

• The brain

• The nervous system

• Blood vessels

• Hormones

• Emotional health

• The pelvic floor muscles

In a recent conversation with Kelowna-based urologist, Dr. Chris Bitcon, we explored the medical side of erectile dysfunction (ED), how erections actually work, and why ED is rarely caused by just one thing.