Unrealistic Expectations and Erectile Dysfunction

mark@centericc.com

Nov 22, 2025

Mark Goldberg LCMFT, CST

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Erectile Dysfunction Radio Podcast

Setting unrealistic expectations when dealing with erectile dysfunction can be a major issue for many men and their sexual partners. Setting reasonable goals to achieve and maintain erections is discussed on today’s episode of the Erectile Dysfunction Radio Podcast. We dedicate this podcast to educating and empowering men to address erectile dysfunction, improve confidence, and enhance the satisfaction in their relationships. This podcast is hosted by certified sex therapist, Mark Goldberg, LCMFT, CST.

Transcript of Episode 26 – Unrealistic Expectations and Erectile Dysfunction

Casey: Today we’ll be discussing why unreasonable expectations produce poor outcomes when it comes to erectile dysfunction. No matter what we are setting expectations for in life, in your opinion—are unrealistic expectations, just always going to lead to poor outcomes? Mark: This is an interesting question. I don’t think we can say unequivocally, unrealistic expectations are going to lead to poor outcomes, when we talk about outcomes, there are objective outcomes in life, there are many times that people will set high expectations for themselves and they will come pretty close to meeting those expectations. From an outsider’s perspective, from anybody looking in on this person’s life, they are going to see this person as being highly accomplished, a very successful person, and objectively, some of those outcomes really are pretty good. However, when people set high expectations for themselves, it can lead to feelings of disappointment and distress that are subjective to that person. As a quick example, I remember being asked this question in graduate school, if two people come and present themselves to you, one person comes and says, well, I’m only making a million dollars every month, but my cousin makes 10 million every month, and it’s causing me a lot of distress. Whereas there’s somebody who’s suffering with chronic illness but feels very whole and at peace in their life, who is in a tougher situation. That highlights the dilemma that we’re talking about in terms of objective outcomes. Many people would say a person making a million dollars every month is probably doing a lot better than somebody who’s struggling with chronic illness, but from a subjective perspective, the person who’s struggling with chronic illness may actually feel much more content with his or her life than the person who’s making a million dollars but is looking at other people who are making more. Casey: Got it. Thanks for that explanation. Why are unrealistic expectations problematic? Why is it an issue when it comes to overcoming ED? Mark: Like we have mentioned many times on this podcast, what we think directly impacts erections, directly impacts sexual function. If a person has a very high expectation of sexual performance or at least a perception of high expectations from a partner, it’s going to create that same distress that we were just mentioning previously. That distress can distract from pleasurable activities, stimulation, and it can impact the way we think about our partners. It can impact the way we think about ourselves when it comes to engaging in sexual activity, so how do we know what is unrealistic when it comes to dealing with erectile dysfunction? How do we define these expectations as unrealistic, like everything else that we’re talking about, it is not going to have an objective definition, no two men are the same, no two situations that they find themselves in are the same. For some men, a realistic expectation may be gaining and maintaining an erection multiple times throughout the day, whereas for other men, that’s not necessary for their lives and not really an expectation that they should have for themselves. This is going to be a very subjective measure in terms of what is considered realistic. When I work with men, and we’re trying to assess what is realistic, and what is unrealistic, that cannot be done outside of the context of their lives. There are however, some misconceptions that are out there that I do believe are unrealistic for any man. Some of those are that a man should be able to achieve an erection instantaneously, a man should be able to get an erection in every situation that he finds himself.

Mark Goldberg, LCMFT, CST; Podcast Host

These are what I consider to be objectively unrealistic, this is going to be unrealistic for any man at any stage of life, and helping men to set expectations to be realistic and to ultimately be focused on the realistic goals of what they want to do with that erection, I believe is very helpful and leads to much better outcomes. Casey: As a therapist, do you have any stories of how unreasonable expectations produced poor outcomes when it came to ED? Mark: I have many stories of unreasonable expectations that compound erectile dysfunction. I’ll remind our listeners that erectile dysfunction is not a single causality type of condition, there are multiple factors that contribute to erectile dysfunction, and there are multiple factors that contribute to the maintenance of erectile dysfunction. When we think about how unrealistic expectations lead to poor outcomes, we want to think about how do those unrealistic expectations also served to maintain erectile dysfunction, so this can happen in one of two areas primarily. One of those areas is unrealistic expectations that a man harbors about himself, and the other area is unrealistic expectations that a man’s partner harbors about what should be happening or should not be happening during the sexual encounter, so I can give an anecdote, story about each. I worked with a 22-year-old male at some point over the past couple of years who was struggling with erections in particular in a partnered setting, and he became very anxious and this led to him becoming really hyper-focused on how often he was getting an erection, the quality of the erection. By the time he came to see me, his goal and his expectation of self was that he would be able to gain and maintain an erection really at any hour of the day, whether he’s alone or whether he’s with a partner. The pressure that he was putting on himself compounded to the point that he really developed a performance anxiety all because he had set these really lofty goals because he had remembered that when he was 13 or 14, he was getting erections throughout the day, really without any control. And he held on to that as being the goal of what should be healthy for himself. That unrealistic expectation is actually what we discovered led to the maintenance of erectile dysfunction, even when he was with a partner, because he was so preoccupied and so worried that there was a problem with his erection. He couldn’t just focus on the experience in front of him. A second anecdotal story is something that I’ve seen across multiple men and couples that I have worked with, and that is when a partner internalizes the erectile dysfunction as something wrong in the relationship or something wrong most commonly with her and it can become very demanding that a man deliver an erection all of the time. A lot of times these unrealistic expectations come from memories of earlier experiences, so sometimes people will be in a relationship and they’ll be getting older, and I don’t mean getting into their 60s or 70s, this can happen even as people progress into their late 20s and early 30s. expectations and ed quote

Things don’t work quite the same way, and that’s normal and natural and should be expected, however, when people create expectations, they oftentimes compare that to previous experiences without taking into account that a number of years have passed since the last time they were with a different partner, and that unrealistic expectation can put undue pressure on a relationship and on the man who is already struggling with erections. Casey: Do you have any direct advice or general thoughts about how to set proper expectations for yourself when, or if, you are dealing with ED? Mark: The First thing that any man should be doing if they’re trying to set proper expectations is identify what your goal is, identify what the purpose of the erection is. For the vast majority of men, the purpose of an erection is for sexual activity and sexual pleasure. If you intend to engage in sexual activity once or twice a week, that’s when you need your erection, the fact that you’re not getting an erection in the middle of the day when you don’t need it, is not really that important. However, if you don’t set a realistic goal for yourself, it’s going to be really, really difficult to set proper expectations. That’s number one. Number two, I think it’s really important that men educate themselves about how erections actually work, what is reasonable to expect, how firm an erection should be, how often a man should be getting an erection, what type of factors get in the way of getting an erection. And go easy on yourself, set a realistic expectation that includes, if I’m stressed, I shouldn’t expect to get the same type of erection, it should not be nearly as firm. Maybe I won’t respond at all because my mind is preoccupied, if you’re transitioning between relationships, if you’re in a new relationship, be realistic about what you can expect of yourself as you are going through that transition. Goals and a realistic assessment of where you are in life, I believe, help set proper expectations and create a way to get out of the erectile dysfunction loop.

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Ready to talk to an ED expert? Erection IQ founder Mark Goldberg helps men resolve erectile dysfunction. He offers individual, one-on-one services to men throughout the world through a secure, telehealth platform. It’s 100% confidential. You can visit the Center for Intimacy, Connection and Change website to Schedule A Consultation with Mark.