Z Headshot

How experiencing E.D. led me to create Roman.

By Zachariah Reitano, co-founder, and CEO of Ro.

When I tell people I co-founded a men’s health company that helps treat men who experience erectile dysfunction, they’re often not sure how to react. I can see their mind churning. Why men’s health? Why erectile dysfunction? Why you?

Frankly, I don’t blame them. On the surface, I appear to be a healthy 27 year-old male trying to solve a problem they associate with older men. Based on what is commonly (mis)understood about the topic, their surprise is understandable.

However, their reaction — which is based on so much misinformation — has only served as a potent reminder of why our work is so important.

When I was 17, I experienced erectile dysfunction (ED) for the first time.

It was unusual for someone my age to have difficulty getting an erection, especially since it had a medical and not a psychological cause. Yet, in more ways than I knew, what I would experience in the following year happens all too frequently to men at every age.

I was confused and frustrated. Something was wrong and I knew it. It‘s hard to talk about erectile dysfunction at any age and I realized that there was not a single person with whom I could speak about it other than my father (hang in there with me).

I was lucky. My dad, Dr. Michael Reitano, was a physician and an expert in sexual health. That was a lucky break, one few people get. Growing up, very few things were off limits at the dinner table. One day I mustered up the courage and finally brought it up (and when I say ‘finally’ I mean as long as a boy can wait when something might be wrong with his penis).

My dad asked me a few questions (“Are you depressed? Stressed? Using drugs?”) but after a few minutes, he reassured me that I shouldn’t worry—we could fix this. Still, I’d seen that look on his face before when my sister was ill. He was concerned.

The next time we were exercising together, he came up and said, “Hey Z, can I take your pulse?” I stuck out my arm and he held my wrist and closed his eyes. I assumed he was just counting away as I kept running. I had kept my pace slow thinking it would help him count, but it seemed like forever, so I decide to kick it up a notch.

After about 10 minutes, he asked me to step off the treadmill. There was that face again. He stayed calm — he is well-trained — but he knew something wasn’t right. He scheduled a stress test for the following week. (In a stress test, you exercise in front a physician as they monitor your heart; the treadmill gets steeper and faster every three minutes.)

I remember walking into the doctor’s office and passing a waiting room full of men in their 50’s and 60’s. Looking back on it now, I should have suspected it was a bad sign that men who had as many years left as I had lived were taking the same test. Anyway, at the time, I felt pretty confident I was going to crush it. It’s amazing how naive you are at 17.

The stress test starts. I hop on the treadmill and start walking. Minute 3 hits and I’m doing great. Minute 6 passes by and I’m having a good time. Naive and cocky. Minute 9 and I am barely breaking a sweat. Minute 12 and I kick it just to show off. Dumb move. The last thing I saw was the EKG monitor go nuts and the last thing I remember hearing was my doctor yell for help. My heart stopped. I collapsed and zipped off the treadmill.

They brought me back. Before I knew it, I was in the hospital for an ablation procedure to burn the parts of my heart that were causing it to do something it shouldn’t.

Fortunately, my heart was fixed. Unfortunately, my experience with ED was not yet.

E.D. An indicator of my heart condition, a side effect of my medication.

Flash forward almost a decade. I started to experience heart symptoms again. It was like deja vu. I saw doctor after doctor. I had lab tests, wore a Holter monitor for weeks, and even managed to finish a stress test standing upright.

After all those doctors appointments, I had some good news: I wouldn’t need another procedure. The bad news was that I was prescribed heart medication with an all-too-familiar side effect: erectile dysfunction.

I thought to myself, “You’ve got to be kidding me.”

It was almost funny. I remember the moment the doctor told me. It was reminiscent of one of those silly movie scenes where one character says something that takes the other back and everything after is just a dull drone. I had an expert physician by my side every step of the way, the best care you can imagine, read everything there is to know about my heart condition and ED, and I still felt overwhelmed.

I should have been listening to my doctor. We were talking about my heart after all. But my mind was elsewhere.

Then, on the walk home from the doctor’s office, my dad (who is also a physician and was there for the results of my test) looked at me and said a few simple words: “Don’t worry. We’ll take care of it.” He knew what I was worried about. He had seen over thirty thousand patients over the course of his career and knew just what to say. He had helped me overcome this challenge once before. It worked. Once I trusted that my daily life would be okay, I was put at ease. I was actually able to start thinking about my heart.

When the present was no longer a concern, I could finally focus on the future.

That seems fairly obvious. But, somewhere, somehow, it has been lost in healthcare. If someone is 30 lbs overweight and is experiencing erectile dysfunction, a physician sees diabetes, heart disease, high blood pressure or high cholesterol — and it’s completely understandable. They are worried about their patient’s future. But, a patient cannot see tomorrow if something is consuming them today. If they cannot be intimate with their partner, they aren’t going to be able to be concerned about some blood pressure number that is 18 points too high. This idea is one of the key insights on which Ro was founded.

At Ro, we meet patients at eye level. We help solve what matters most to our members in the present so they can focus on their future.

Erectile Dysfunction: A check engine light for a guy’s body.

As funny as it might sound, the strength of a guy’s erection is one of the greatest barometers of his overall health. To get an erection, a lot of systems in your body have to be working together in perfect harmony. For starters, your hormones must be released on demand, your arteries need to carry blood to the penis with perfect efficiency, your nervous system must transmit its signals without a hitch, and your mind and body need to be in sync.

That’s a lot to ask on-demand and in pressure situations.

But, it’s also more than that. The blood vessels of your penis are relatively small, which means that they reveal any change in their ability to do their job, compared to the larger blood vessels in your heart.

So when someone’s experiencing Erectile Dysfunction, it’s very similar to the check engine light in your car going off. It’s a sign that something is wrong, but you don’t exactly know what.

That’s why, if you’re experiencing erectile dysfunction or a diminished erection, it’s so important to talk to a doctor. Because E.D. can often be the first sign of a far more serious underlying condition. In my case, it was the first sign of an underlying heart condition. But it can also be a sign of diabetes, heart disease, high blood pressure or high cholesterol. It’s commonly associated with obesity and depression. Or it could be the result of poor lifestyle habits, like drinking too much, smoking, being stressed or not getting enough sleep.

52% of guys over the age of 40, and 26% under 40, experience erectile dysfunction

One of the most surprising things I learned while going through this experience was just how common this condition is. Over 52% of men will experience some form of ED. And unlike the stereotype, it’s not just guys over 60.

It turns out 20% of men in their 20s, 30% in their 30s, 40% in their 40s, and so on, experience ED.

It’s approximately 30 million men. To put that number in context, it’s the same number of people with diabetes. This is not a coincidence.

But if so many people experience the issue, why don’t you hear more about it?

Stigmas are lethal

The stigma is real. Only 18–30% of men who experience ED receive treatment.

Meaning the embarrassment and stigma surrounding ED is causing approximately 24 million men to cover up their check engine light and ignore the earliest possible sign that something much worse might be brewing.

And so what happens is people just wait until less embarrassing, more obvious and more severe symptoms reveal themselves. By then it’s often much harder to take control of your overall health.

Or occasionally, men try to solve the problem without talking to a doctor.

Studies show that 80% of all Viagra purchased online is counterfeit and contains things like printer ink, paint, and floor wax. Imagine the situation you would have to be in for you to put that in your body, for you to feel that this is your “best” option.

We need to change the narrative

When you hear about E.D. or Viagra, I do not want you to think about sex. I want you to think about PTSD, Diabetes, Heart Disease, High Cholesterol, High Blood Pressure, Obesity, and Depression.

I want you to think of the leading causes of death in the United States. And then I want you to think of what happens when we create a culture that mocks the management of the earliest possible sign of something far more dangerous.

To this day, I cannot imagine what would have happened if I didn’t have a physician as a father, if I didn’t have someone who created an environment where I felt comfortable expressing what I’m sharing with you today.

That’s why we created Roman. To make sure that embarrassment and stigma never prevented anyone from seeing a doctor and being intimate with their partner.

The very fact that you’re here reading this right now means you’re taking a courageous step in the right direction. If you’re experiencing E.D., you don’t have to live with it. We’ll be here to help you overcome this health challenge. Follow the link below to talk with a doctor. And let’s take care of it.