What is Erectile Dysfunction? Erectile Dysfunction is also known as ED or impotence and affects over 150 million men worldwide. This number is expected to double by 2025. While Erectile Dysfunction is most common in men between the ages of 40-70 years of age, it can happen at any age and may occur for a number of varied reasons.

This week, LetsGetChecked is joined by Michael J. Russer, prostate cancer survivor, author at The Good Men Project and TedX speaker. Today Michael is living with erectile dysfunction, however he views his current state of being as a blessing as opposed to a burder.

In honour of Prostate Cancer Awareness Month, Michael joins LetsGetChecked to provide insights into what it feels like emotionally and physically to live with impotence and to offer insight into how impotence can spark a whole new world when it comes to intimacy with your partner.


What Is Erectile Dysfunction?

Erectile Dysfunction is defined as the recurrent inability to acheive or maintain an erection during sexual intercourse. The term erectile dysfunction is an umbrella phrase that can differentiate between impotence and other variables that may interfere with intercourse such as injuries, drug use, health issues, or nerve disorders that may hinder the ability of blood flow to reach the tip of the penis.

Loss of libido, pre-mature or delayed ejaculation, dry orgasms and a total inability to orgasm is also associated with erectile dysfunction.

Dr. Robert Mordkin Explains Erectile Dysfunction

What Are The Symptoms Of Erectile Dysfunction?

If you are reading this article, you are probably concerned about some common signs and symptoms of erectile dysfunction that may be presenting within your day to day life.

Here are some signs that you or your partner may have erectile dysfunction:

  • Inability to achieve an erection
  • Inability to maintain an erection
  • Anorgasmia: failure to become aroused after a sufficient level of stimulation from yourself or your partner
  • Lowered sex drive
  • Premature ejaculation
  • Delayed ejaculation
  • Dry orgams
  • Inability to ejaculate


What Is The Connection Between Erectile Dsyfunction And Prostate Cancer?

There is no direct link between erectile dysfunction and prostate cancer itself. It is the treatment for prostate cancer that may result in partial or complete erectile dysfunction. These treatments include:

Radiation Therapy

Radiation therapy or radiotherapy is a treatment that uses ionizing radiation to kill malignant cancer cells and decrease the size of tumours. Radiation is also used in small doses during X-rays. Radiation therapy for cancer is either administered through a machine that expels beams in the localized area of cancer, or is injected into the body at the source of cancer in solid or liquid form.

It is not fully known how radiation therapy can cause erectile dysfunction, however, it is hypothesized that it may block blood flow to your penis, lower testosterone levels or damage nerves in your pelvis. Erectile Dysfunction, as caused by radiation therapy is a gradual process that may begin 6 months after treatment.


A prostatectomy describes the surgical removal of all parts of the prostate gland. A prostatectomy may need to be carried out for a number of reasons including urinary retention, and cancers of the pelvis including prostate cancer.

While doctors use specialized techniques to avoid nerve damage, it is possible to face erectile dysfunction as a consequence of the surgery. It is common to experience erectile dysfunction immediately after the surgery. "Dry orgasms" are also a common consequence in which penetrative sex is possible, but it is not possible to ejaculate.

Hormone Therapy

Hormone therapy also known as Androgen Deprivation Therapy or ADT is used to to decrease the level of androgens (male hormones) in the body in an effort to stop them from affecting prostate cancer cells.

One of the functions of androgens is to stimulate the prostate cancer cells to grow. A leading side effect of ADT is a lowered sex drive, however, it may also cause erectile dysfunction in some instances. Erectile dysfunction may begin 2-4 weeks into treatment.

This week, LetsGetChecked is joined by Michael J. Russer who was diagnosed with prostate cancer in 2011. Michael says that "cancer was big in my family", so he wanted to get the cancer removed in whatever method was available to him and as quickly as possible.

Michael received radiation therapy and beat the prostate cancer. Erectile dysfunction was left in its wake. Michael talks of the importance of getting screened for prostate cancer and states that many men don't get checked because they don't want to know. Today, Michael lives with impotence and he is here to share his insights with the LetsGetChecked community so they can better know the signs and symptoms of prostate cancer as well as erectile dysfunction.

Living With Erectile Dysfunction: Michael J. Russer


What was the root cause of your impotence?

I was diagnosed with prostate cancer in october 2011 and while the biopsy came back fairly mild, I have a family history of cancer, I lost five members of my direct family to cancer, it's is a big thing in my family. While their cases weren’t prostate cancer, the outcome wasn’t good for them. The biopsy didn’t shine a light on just how aggressive my cancer was so I said take it out.

All of my cancer treatment had a significant impact on my erectile function, ultimately impotence became permanent.

What was the first thing that went through your head when you found out you would need to deal with impotence?

I knew it was a possibility but it was particularly poignant given my circumstances. I had just ended a 26 year marriage. During the last 11 years, we stayed together for the kids, until they went to college. We stayed faithful but we were celibate for 11 years. You can imagine the irony and anger I felt when I knew that I was faced with permanent impotence.

I went through the stages of grief pretty quickly. I got over anger fast and I didn’t enter into a depression. At the time I was optimistic that there might be some sort of way to fix it.

What techniques did you use to tackle your erectile dysfunction?

I tried pretty much everything, from Reiki energy to acupressure, acupuncture and upper and lower colonics. I even tried hiring a shaman. I will never forget him dancing around amidst incense in a dark room, beating a drum. Each time he beat the drum, I nearly jumped out of my skin. I tried everything and remained hopeful.

“All of them said with all best intention, you’re going to get it back. I thought to myself, you have waited 11 years, I can wait some more.”


When you began to realize that there was a possibility that you wouldn’t be overcoming the physical impacts of erectile dysfunction, what were your next steps?

Jacqueline and I met a year after my diagnosis, the rest as they say is history. Today, we have a level of intimacy that most “normal people” cannot even fathom. When I knew that we were going to be more than friends, I remember trying so hard to make it work but it wasn’t going to be something that I could do, so I asked her to experiment with me.

From that moment, we broke a train of the natural way of things. When men get hard, there’s a sense of urgency, and I lost that but I gained the ability to be present.

“Our culture in a very genetic way makes us want to have intercourse, it's how we grow the species but it can also get in the way of much deeper levels of intimacy, especially along gender lines.”

From speaking at conferences and through the research that both you and Jacqueline carry out, what would you say is the largest discrepancy between how men and women perceive sex?

Michael: We were speaking at a conference and the topic was "Creating Intimacy In A Shutdown World". We asked the crowd how they defined intimacy. Men said sex, whereas women said kissing, hugging, warm feelings and the physical part too. Men put a bigger emphasis on intercourse whereas women define intimacy as what goes alongside sexual intercourse.

Jacqueline: Women need to be more honest and transparent about what they want. Faking orgasms is endemic in a long term relationships.

Michael: It’s true, I read this study recently that illustrates that 84% of women fake orgasms in long term relationships. There are two main reasons for this, one is to make their male partner feel good, and the other is to speed the process up. This behaviour goes back eons ago. We are still wired in a tribal way.

What are the three main things you need to bear in mind if you are trying to discover intimacy in a “non-traditional” way?

There are three things that are necessary:

  • Authenticity
    Showing up who you are.
  • Vulnerability
    The willingness to feel everything.
  • Willingness
    Being open and unafraid to tear down the barriers around the heart

Creating extraordinary intimacy in a shutdown world : TEDX Video Of Michael

What does erectile dysfunction feel like emotionally and physically?

I do not consider myself a victim of sexual dysfunction whatsoever, I am a happy camper. This isn't the same for everyone. I know men who have told their partners to go "find a real man".

I have also known men who have said they would rather die than be impotent and I think they are living in self imposed chains.

Jacqueline and I are living examples of what you can discover if you are open.

Today, we leave the word "performance" outside the bedroom and instead we want presence. Performance is an expectation and that will just become a self fulfiling prophecy, because if we use words like performance, we create pressure. "Presence" is without judgement, without distraction and is centred in the heart.

Jacqueline, what advice would you give as a partner to someone who experiences impotence?

When you're about to build a home, you need to build a strong foundation and emotional intimacy needs to build the foundation, the foundation can take whatever the weather.

Some couples have some deep wounding in place that needs to be addressed and healed before they can have any mutually fulfilling sexual relationship. This is best thing that ever happened in our relationship. When I met Michael, I was in the latter part of my menopause. I was done with penetrative sex at this point and he said why don't we experiment, I was totally ready to look at more creative ways to become intimate, and it was music in my ears. We just found ways that work for us. When we’re speaking to our clients, we tell them you're on an adventure, it's taking a bus but you don't know where this bus is taking you. Instead of having a guided tour, just take the ride, you are in for an adventure of your life.

Michael, what advice would you give to guys who have “sexual dysfunction”?

"I get you're angry, I get your down I get that you feel the loss. I felt all of those things, if you open yourself up to the possibility, you will see a silver lining you didn't even know existed."

You're not a victim, you don't have control over the circumstances but you have absolute total control of what you do with them.

Read: Do You Have Elevated PSA?