I'm pretty sure that last line got some laughs in theaters and probably from quite a few real-life pharma reps who have sold similar drugs.  Although "male enhancement" drugs are only available by prescription, companies like Pfizer have been successful at advertising their products directly to consumers.  To this day, it is impossible to watch a NFL football game and not be bombarded with such commercials. 

I find these commercials ridiculous.  They're insulting to men and what they imply about us.  Like the one showing the happy middle-aged couple reclining in side-by-side bathtubs in the middle of an open field.  Every time I see that particular commercial, I throw my hands up in disbelief.  What is a bathtub doing out in the middle of a field?  And where did they get all that water to fill it?  That guy doesn't have E.D. at all, he's just exhausted from lugging all those buckets of water around.

Erectile dysfunction, or E.D. as it is commonly referred, has become a multi-billion dollar industry that continues to grow. The companies that manufacture Viagra, Cialis, and Levitra have successfully created advertising campaigns convincing us men that we should be able to get it up whenever and wherever we want (including in a bathtub in the middle of an open field). I don't know about you but I'm pretty sure I would have a hard time performing sexually if I was asked to do so in a bathtub in the middle of nowhere.

In reality, identifying and treating E.D. is rarely as effortless as popping a pill. In fact, in some cases such drugs can be counter-indicated and medically dangerous. It can also be costly. If you're hoping to have male-enhance sex twice a week, your bill for an entire year could cost as much as $1500 (there are no generic versions at this point). Furthermore, you may be throwing your money away since these drugs fail to work for about half the men that take them according to experts at Cornell University's Weill Medical Center.

As it turns out, there are other, often more effective, treatments for E.D. and some of them are far more cost-effective than the brand-named pills advertised on television. It is important to keep in mind that in many cases, there is an underlying medical condition for the disorder, like diabetes or hypertension. In fact, in younger men, erection problems are often the first symptom of cardiovascular disease. By adopting healthier habits, you may be able to improve your overall health and, in the process, restore your libido. In one medical study that appeared in the Journal of Sexual Medicine, researchers found that men could improve their erections by losing weight, improving their diet and exercising more frequently (As an aside, when I went to verify the aforementioned journal citation, what did I see flashing at the top of the journal's website? You guessed it, an advertisement for Viagra!  Have these companies no shame?)

Sometimes, however, the causes of E.D. are not physical in nature but rather psychological. Interpersonal difficulties can often manifest themselves in sexual symptoms. In my clinical experience, couples who cannot talk openly to each other often times have problems with sexual intimacy. In particular, men who have trouble communicating their feelings may find it difficult to share with their partner any anxieties about their sexual performance. In these circumstances, counseling can be very helpful for both you and your partner.

If you or your partner are experiencing sexual difficulties, consider consulting a mental health professional who specializes in the treatment of sexual concerns.

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Tyger Latham, Psy.D. is a licensed clinical psychologist practicing in Washington, DC.  He counsels individuals and couples and has a particular interest in sexual trauma, gender development, and LGBT concerns.  His blog, Therapy Matters, explores the art and science of psychotherapy.