Erectile dysfunction is the inability to get and maintain an erection firm enough for satisfactory sexual performance. An isolated incident of ED is normal and is common; however, approximately 18 million U.S. men have more persistent symptoms.
Though the incidence increases with age and is more common in men over 40, ED can affect men in their 20s and 30s. In fact, researchers found that ED affects 8% of men in their 20s and 11% of men in their 30s.
Risk factors, such as poor diet, excessive alcohol use, smoking, and lack of exercise, increase the risk of developing ED. Therefore, taking steps earlier in life can help reduce the risk.
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According to the Massachusetts Male Aging study, one of the largest studies ever focused on men’s health, over half of men aged 40 to 70 had at least some degree of ED. Depending on risk factors, men may experience ED at different periods in their life, either sporadically or continuously.
In a health care professionals (HCP) study that questioned almost 32,000 men between the ages of 53 and 90 about sexual function, physical activity, body weight, smoking, medical conditions, and medication use, researchers found:
In a National Health and Nutrition Examination Study (NHANES) in which just over 2,000 men were surveyed, about 5% of men 20 to 39 years old experienced ED compared to 70% of men over the age of 70. In addition, almost nine in ten men with ED had cardiovascular disease or a major risk factor for cardiovascular diseases such as high blood pressure, diabetes, high blood lipids or cholesterol.
The HCP study results showed a strong link between age and ED. Fewer than 2% of men with ED reported that it started before the age of 40, and 4% said it started between 40 and 49. There was a sharp increase in the percentage of men experiencing ED after the age of 50: 26% of men aged 50 to 59 and 40% of men aged 60 to 69.
For men under age 60 who had a comorbid health condition, the risk of ED was double that of healthy men. The greatest difference in the rate of ED between men with a comorbid condition and healthy men was in men between the ages of 65 and 79.
In a study of Turkish men that questioned over 2,700 men:
Though getting an erection is a complex process involving the nervous, endocrine, and cardiovascular systems, the common denominator for most physical problems causing ED is damage to small blood vessels, which can decrease blood flow into the penis. As men age, they are more likely to have cardiovascular disease, which increases their risk of ED. In more than 90% of men over age 40 with ED, a physical cause would explain their ED symptoms.
Physical Causes of ED:
Psychological Causes of ED:
There are several risk factors for ED, including:
Optimizing these modifiable risk factors can decrease the risk of ED. In fact, of the men surveyed in this study, men who exercised frequently have a one-third lower risk of ED when compared to those who did not exercise.
You can ask yourself several questions to help you and your doctor determine whether you have ED.
Some of these questions may indicate a potential physical cause of ED, such as decreased testosterone levels. To better understand your risk factors for ED, your doctor may suggest a hormone panel or series of lab tests to check your testosterone and other hormone levels.
There are many reversible causes of ED, many treatable causes of ED, as well as a few irreversible causes. Regardless of whether there is a cure for ED, there are many options to improve your symptoms.
Let’s start with the many reversible causes of ED. Medications and lifestyle factors can increase the risk of ED. However, making the following changes in your life (if they apply) is a great way to improve the chances that ED can be cured.
There are many treatment options for ED. They can be classified into medications, penile injections, vacuum devices, and surgery.
Medications can be used to restore testosterone levels or to increase blood flow into the penis. Men with hypogonadism, who have symptoms such as low libido, may need testosterone replacement therapy to resolve their symptoms.
PDE5 inhibitors are medications used to increase nitric oxide, which dilates blood vessels and increases blood flow into the penis.
Examples of PDE5 inhibitors include:
Each medication has its own risk and benefit profile and, depending on the circumstances, may be the best medicine for erectile dysfunction.
Approximately 30% of men who have tried oral ED medications report that they did not work well for them. For these men, penile injections may be a good option. Injectable ED medications trigger increased blood flow into the penis. Unlike oral ED medications, they do not require sexual stimulation to work. Trimix injections are a combination of three medications that work synergistically to increase blood flow into the penis.
Vacuum devices involve putting a tube over the penis and sealing it at the base. The vacuum pump pulls blood into the penis as air is sucked out of the tube. Once an erection is attained, a ring is placed at the base of the penis to keep blood in the penis.
When all other options have been exhausted, there are surgical options to consider, such as a surgically implanted penile prosthetic.
Other than moderating alcohol use and stopping smoking, having a healthy diet and engaging in regular physical exercise is the best preventative measure for ED. The Mediterranean diet and other similar diets are packed with antioxidants and vitamins along with lean sources of proteins and healthy fats. Since the incidence of ED increases over the age of 40, consider making some or all of these 11 dietary changes every man should make after the age of 40.
Though the rate of ED increases with age, it affects a significant number of younger men. The healthcare professionals at Invigor Medical can help you determine whether you have ED and discuss potential diagnostic and treatment options with you.
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While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.