Two cousins suffered with erectile dysfunction for years. When they finally opened up to each other, everything changed. Now they’re on a mission to help others
Marie-Claire Chappet
Sunday February 14 2021, The Sunday Times
Can you get it up?” is not a question I often ask my male friends. In fact, the subject has never, so to speak, arisen. Asking a man about his erectile performance is a no-no, a taboo, a conversation killer.
So it was unusual to find myself on a video call with two attractive, confident, millennial men, the cousins Angus Barge, 30, and Xander Gilbert, 31, unabashedly telling me about their erectile dysfunction (ED). For a long time they both suffered in silence, not knowing the other was going through the same thing. Every time they searched online they became frustrated by the lack of available information to help young men like them. They didn’t feel that it was a serious enough medical problem to go to the doctor and not an extreme enough psychological one to see a therapist.
“I was 27 when I first had a problem,” says Barge. “I went home with a girl one night and nothing happened. I just put it down to booze, but then the next morning it didn’t work again. I thought it was a bit more worrying, but tried not to let it bother me. A week later I went on a date with her and it happened when I was sober. I just remember being so scared, not knowing what had gone on.”
Then one day 2018 Barge was on a long car journey with his cousin. The moment felt right for him to confess. “I don’t know why! It was one of those times when you know your mouth is moving and you’re wondering why you’re speaking.” What followed was what he calls “the longest silence of my life”, until Gilbert responded by saying: “Me too.” By the time they parked the car at the end of the journey, they had shared everything about their ED that for years they had been unable to talk about. “We soon realised we wanted to encourage other guys to open up about this too.”
They started reading academic studies. One, from King’s College London, estimated that up to half of men under 50 have suffered from ED. Rates have more than doubled over the past 25 years. The reasons for this form “a complex connected web of causes”, says Peter Saddington, a sex and relationships counsellor at Relate. “Too much alcohol, lifestyle choices, obesity. We’ve also grown more sedentary, with cars and the ease of modern life, and exercise is so important. It releases endorphins, which promote healthy sexuality.” ED is also becoming a problem for younger men — 30 per cent will experience it before they turn 30 and three quarters of men who suffer will not get treated.
The numbers are worrying because the condition can be more than just a sexual hindrance.“It can serve as a predictive factor for the diagnosis of underlying issues such as low testosterone, vascular disorders, diabetes or heart disease,” explains the psychotherapist Sarah Calvert. “If you are suffering from ED, it’s crucial that in the first instance you have a medical check-up.”
After two years of research by the cousins, they quit their jobs in the City and, in the summer of 2020, launched Mojo, a website offering holistic advice and practical help to men with ED. The site features more than 50 professionals, from pelvic health physiotherapists and psychosexual therapists to clinical psychologists and nutritionists.
“One of the first times I had sex it was with a girl who I perceived to be more experienced than me,” Gilbert says. “I was a teenager and I thought, OK, I have to put on a good show here. I felt as though she knew what was going on and I didn’t. I thought I had to ‘perform’ and then, of course, the complete opposite happened …”
This early sexual experience became formative. “The issue stayed with me for years after that — long into my twenties,” he says. “It has made dating and getting into relationships much more difficult because the thought is always there: what if it happens again? You feel judged at the beginning of a relationship and feel pressure to perform.”
Gilbert uses the word “perform” countless times — they both do. It is unsurprising. We often understand sex as being entirely down to a man’s “performance”, as though he receives top billing and women are the support act. That’s a hell of a lot of pressure.
It is difficult to find an equivalent problem for women. Today women speak openly, and without shame, about orgasms, even if it is often about the lack of them. Lily Allen sings about them, Phoebe Waller-Bridge writes about them, whole chunks of Netflix are devoted to them. ED is still taboo. “You are filled with a fear that the message will get out that you can’t perform,” Barge says, “that you are a lesser man, a weaker man somehow.”
It took years after his problems first emerged for Barge to learn what was really going on down there. During training for a cycling race three years ago, he had crushed blood vessels in his genitals. In the 12 weeks it took to mend, it transformed from a biological issue to a mental one. “I had the problem regularly for a year after the initial injury — the psychological damage was done. Even though the blood vessels had healed, it had planted a seed of doubt in my mind.”
Did Barge see the young woman again? “Er … no.” He shifts uncomfortably in his seat, the first time in our conversation that he has seemed awkward. “I think self-preservation kicks in. You get in a flight-or-fight mode: you either want to stay and prove you can do it, or you never want to see her again, because you’re too embarrassed, too afraid it will keep happening.”
I feel for his poor date, not least because, years ago, I found myself in her situation with a previous partner. It left me thinking what many women feel in that moment: what on earth should I say to make it better? Often coupled with: is it me? “Men and women both say the wrong thing in the moment,” Barge says. “Men try to protect themselves by saying it’s never happened before. But unfortunately that just makes women feel like it’s their fault instead.”
“We advise ‘I feel …’ statements, rather than stating everything as fact,” Gilbert says. “ ‘I feel scared’ or ‘I feel confused’, rather than lying or pretending it doesn’t bother you when it does. For women it’s about being understanding, but also using ‘I feel’ statements. ‘I feel it’s me’ is a common fear — but one that will be immediately put to rest when you communicate openly.”
You might have thought Barge, in particular, would have been able to talk about ED. His mother, Dr Amanda Barge, is a sex therapist and is now among those experts who help Mojo’s men. But even that conversation proved difficult. The Barges’ situation is uncannily similar to the premise of the hit Netflix comedy Sex Education. In the show, a teenage boy, Otis Milburn, is painfully awkward around the subject of girls and sex, and is unable to masturbate, a fact he hides from his mother — a sex therapist — played by Gillian Anderson.
Barge’s reluctance to use his own in-house expert changed with Mojo. “I think she felt quite emotional when I told her,” he says. “She was very happy I felt confident enough finally to confide.” Theirs is a more open relationship these days. “I did have a user tell me he loved the voice of the woman doing the masturbation tutorials,” Barge says. “Which was my mother.” He reddens. “You should have seen the sexual ornaments around my house growing up.”
Dr Barge herself is nothing but proud of her son’s achievements, particularly for his bravery in the face of such a taboo topic. “We live in a strange world, where one of the most prevalent and common problems a man faces in his sexual life is also one that makes him feel so isolated and alone,” she says. “Mojo is so acutely needed.”
As I speak to more of the in-house experts, common themes emerge. There is a lack of robust sexual education in schools, as well as a lack of information, and spread of disinformation, online. In their eyes there is a huge deficit in available resources.
When you type “help with erectile dysfunction” into a search engine, you find a host of confusing and contradictory results, all of which are drowned out by endless adverts for Viagra. “What these [pharmaceutical] campaigns do is to put young guys in a cycle of dependency,” Gilbert says. “Viagra helps only with blood flow, it won’t get to the root of the problem, which is so often psychological. So then we get users saying they feel broken because ‘even Viagra didn’t work’.” That can feel even worse than the initial shame.
A year-long membership of Mojo will set you back £4.17 a month. One tablet of Viagra costs about £5. To the founders, popping a pill is a misleadingly easy fix, and one that they feel strongly should not be relied upon. Would it be like taking ibuprofen for chronic back pain when you probably need to see a chiropractor? “Absolutely,” says Barge. “The Viagra route — to me it just doesn’t feel right.”
Instead the site provides one-to-one counselling sessions, coaching videos, mindful meditation and CBT focused around the issue. It also instructs on various exercises to de-escalate the mental pressure users are often putting on themselves. One encourages users to get accustomed to their penis in — how to put this? — its resting state, thus diminishing its power to cause stress or negative connotations.
The site also teaches Kegel exercises — yes, men, you too should think about strengthening your pelvic floor. For some men, however, a weakness in this area could have psychological as well as physical roots. If the underlying cause of your ED is mental, you may be suffering from a “seized pelvic floor”, for which a therapeutic treatment would be recommended over a physical exercise, which could on its own make the condition worse.
“How a person understands and relates to themselves and their sexual difficulty is a core aspect of how they address it,” explains one of Mojo’s resident experts, the clinical psychologist Dr Roberta Babb. “The mind has an extraordinary and powerful relationship with the body. Psychological and emotional barriers that contribute to the occurrence of ED can include anything from stress and tiredness to extremely low self-worth.”
Her Mojo colleague Silva Neves, a psychosexual and relationship therapist, says there are two forms of ED: global (organic causes such as Barge’s crushed blood vessels as well as other underlying health issues) and situational. “If erection problems are ‘situational’, meaning they happen only in certain situations and not others, it is most likely psychological,” he says. “Typically these men will report erection problems with a sexual partner but not masturbating on their own. This indicates a problem with sexual anxiety, fearing they won’t be good enough lovers to their partner.” Global issues should be seen by a GP or specialist, but situational issues require more therapeutic, psychological assistance.
A way to tackle this, Neves suggests, is to make sex less “penis-centered”. The leading man must become the understudy. “Learning to be pleasure-centred rather than performance-focused is the key to better erection,” he says. “Men should remember that many other parts of their body can be used to give and receive pleasure.”
One of the site’s most significant services is its ability to provide remote diagnosis — something that makes it both pandemic-friendly and, crucially, man-friendly. Many men are unaccustomed to discussing the middle ground between physical and psychological issues with a professional. “Men don’t speak to the doctor about anything,” says Barge. “And we don’t speak to each other or confide in one another the way women do. That leads to so many problems beyond erectile dysfunction. Men can be totally consumed by an issue like this. It makes them feel so alone.”
Many younger Mojo subscribers cite heightened anxieties caused by the unrealistic expectations of freely available porn and what Gilbert describes as the “disposable marketplace” of dating apps. “You always feel like you’re in competition,” he says of online dating. “There is this pressure that you are being compared with someone else.”
There are three pornography sites that get more global traffic than either Amazon or Netflix. There is an entire course on Mojo dedicated to it, described as a pioneering look at the links between porn and ED, examining if a dependence on porn for erections is affecting physiological dysfunction when it comes to real-life sex.
Sarah Calvert has seen in her own practice that this dependency can go some way to explaining the surge of ED in recent years. “There are two pathways to arousal, the brain and the body,” she says. “Responding to one’s own sexual needs primarily through the brain — online pornography, for example — can translate into erectile dysfunction when having sex with a partner because the body can become desensitised. Our sexual arousal may become conditioned to respond in a way that may not translate well to non-digi sex.”
“But I don’t think we should demonise porn,” Barge says. “It is only an issue if you have a really unhealthy relationship with it.” It is rarely the sole cause of ED, “but porn does create unrealistic expectations of who you should be having sex with, what your body and penis should look like, how long you should last and — of course — how instantly you can get it up.”
Users can share their experiences on the Mojo community forum, many of them for the very first time. The age range is from 16 to 60. “We had a user in his fifties who burst into tears during a coaching session because we were the first people he had ever opened up to about this,” Barge says. “That’s over 30 years of suffering in silence. We also had a 19-year-old who hadn’t had an erection in two years because of a bad break-up. Again, we were the very first people he had ever told and now, thanks to talking about it and getting help, he is having erections again. That really is the main message. It is really powerful to talk about it.”
Barge is now a certified counsellor who runs sessions on the site, as does Gilbert, who leaves our interview ten minutes early to “teach an erection coaching session”.
“We’ve had some sniggers and the odd comment from our old colleagues in the City,” says Barge. “A few ex-girlfriends have also popped up to say a few cheeky things.” What is it like to date while publicly discussing the success of your erections, I ask. While Gilbert is in a long-term relationship, Barge was single until recently, and still on dating apps when Mojo launched.
“Dating and telling someone that you run an erectile dysfunction company was quite hilarious. I enjoyed it,” he grins. “Honestly, I think a lot of girls are intrigued to see whether the product works”.
- 11.7 million men in the UK are estimated to have experienced erectile dysfunction, and 2.5 million have given up on sex as a result
- 50% of men under the age of 50 are estimated to have suffered from erectile dysfunction, according to a 2019 study
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