About half of men over the age of 40 experience some degree of erectile dysfunction (ED). And with ED affecting five to 10 percent of men under 40, it can happen sooner than you might expect.
ED is defined as the inability to maintain a firm erection. There are many possible causes’anything that affects circulation to the penis, male hormone levels or psychological health can have an impact. Smoking, for instance, which is associated with hardening of the arteries, doubles the risk, and obesity and lack of exercise can also be factors. Men are more likely to have erection problems if they have diabetes, high cholesterol or low testosterone. Medications, including some prescribed to treat hypertension or an enlarged prostate, are implicated in one quarter of ED cases.
It’s not all in his head
‘It used to be thought that a lot of ED was psychological. We now think that’s quite uncommon,’ says Dr. Laurence Klotz, urologist and president of the Canadian Urological Association. Although anxiety, depression and stress can contribute to it, they may simply be worsening an existing problem.
The heart connection
Researchers are also learning more about the connection between ED and heart health. New studies show erection problems can be the earliest sign of coronary heart disease. A Mayo Clinic study tracked 1,400 men over 10 years and found that not only were those with ED more likely to develop heart disease, but this risk was higher if men were under 50 when they developed ED. ‘Among the youngest men, it was about twice as likely,’ says researcher Jennifer St. Sauver.
PDE-5 inhibitors such as Viagra (sildenafil citrate), Cialis (tadalafil) and Levitra (vardenafil) stop the enzyme PDE-5 from reducing the blood flow necessary for an erection. Self-injected medications, including alprostadil and papaverine, increase blood flow to the penis. Other treatments include hormone replacement therapy, psychotherapy, and lifestyle changes such as exercise and quitting smoking.
According to the experts, your partner is more likely to seek treatment if you are supportive and able to talk about it. Just don’t bring it up right after sex has failed, says Edmonton human sexuality expert Brian Parker. But what if he feels he’s failing you sexually? Show him he can satisfy you without an erection, Parker says. ‘There are things couples can do that are sexual but not intercourse.’ Tempted to back off because his lack of erection makes you feel undesirable? That will only make matters worse. ‘Men have sexual egos,’ says Parker. ‘You need to reassure your partner of how much you love him.’ You could also consider counselling.
This article was originally titled "Failure to launch," in the September 2009 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health.