Erectile dysfunction can be a sensitive subject for many men.  Notions of masculinity and virility are often tied to sexual performance, and anything that threatens that can naturally lead to feelings of embarrassment, shame, and even anger.  Yet, it’s vital to talk about erectile dysfunction or any erectile issues if you are going to deal with them and treat them.  They can also be a symptom of underlying health problems and serve as an early warning for serious diseases and conditions. That should definitely be the foundation of a discussion with your doctor or healthcare professional.

The main theme here is that erectile dysfunction is a medical problem, either physiological, psychological, or both, and can usually be treated effectively.  There’s no reason to suffer in silence, even as you get older, and ED becomes more commonplace.  Treat it seriously as a medical problem, and engage with your doctor, as well as your partner or spouse, and address the issue directly.  We’ll explain the ‘hows’ and ‘whys’ of erectile dysfunction, including why it is more common with age, and look at some of the treatment in our guide below.  That will give you a starting point for further researching the issue on your own and framing meaningful conversations between you, your partner, and your doctor.  

The Causes Of Erectile Dysfunction

There are many diverse causes of erectile dysfunction, which can loosely be broken up into physiological and/or psychological causes.  A single factor can result in erectile dysfunction, as can multiple factors working together.  Every individual is unique, and their response to diseases, illnesses, health problems, aging, and related phenomena are also unique.  What may trigger ED in one person may not in another. So, it’s important to seek professional medical advice to get at the root cause of erectile dysfunction for you and your situation.

With that said, the following are some of the common causes of ED:

• Heart or circulation problems, including clogged arteries, high cholesterol, heart disease, and blood pressure issues
• Physical trauma or damage to nerves, arteries, or veins in the groin
• Performance anxiety
• Psychological conditions such as anxiety, depression, OCD, PTSD, and other mood disorders
• Age-related decreases in sensitivity and circulation
• Emotional or relationship-related issues
• Medication side-effects
• Side-effects of bodily changes, scarring, or damage resulting from surgeries or treatments (e.g., prostate cancer treatment)
• Decreased levels of testosterone in the body due to aging
• A symptom of other diseases and illnesses, such as diabetes, stroke, or cognitive problems

The good news is that most of the root causes of erectile dysfunction are treatable, or at the very least, there are treatments that will restore erectile dysfunction in most men.  At the same time, since the root causes of many cases of erectile dysfunction can be a more serious health problem, which often requires treatment in and of itself, erectile dysfunction (not including isolated incidents, which is normal for most men) should never be ignored. 

Talk To Your Partner

Perhaps even more important than talking to your doctor about erectile dysfunction, at least in the short term, is talking to your partner.  As with any sexual health problem (and most health problems in general), they impact not only you but also your partner or spouse.  Frank, open, and honest communication can make it far easier to seek treatment from a doctor or healthcare professional. 

It also helps avoid adding extra stress, shame, or psychological burdens into a relationship, which can exacerbate organic causes of erectile dysfunction.  Rather than leaving your partner to think there’s something wrong with them or that you don’t find them attractive anymore, or just don’t want to be intimate any more – be honest and open.  Not only will it help them understand and preserve your relationship, but it may provide you a newfound strength to deal with your problems with your doctor. 

Fast Facts About Erectile Dysfunction

The rates of erectile dysfunction among the entire male population range from 5 to 15%, depending on age.  In general, however, the rates increase significantly with age, with an approximate correlation of 10% per decade (e.g., 50% of men in their 50s experience some persistent erectile dysfunction) (Kubin et al., 2003).  As mentioned above, isolated incidents of erectile dysfunction can occur even in youth and aren’t a cause for concern.  But persistent difficulty in attaining or maintaining an erection sufficient for sexual activity is formally erectile dysfunction, and worth discussing with your doctor.

Many men realize that, as they age, due to reduced testosterone levels and other related body changes, they may find it becomes more difficult to become aroused than during their teens or twenties.  The characteristic, fullness, and longevity of erections may also become less pronounced.  This is normal and doesn’t exactly constitute erectile dysfunction.  Only when it becomes an obstacle to satisfactory sexual penetration and intercourse does it rise to the formal definition of erectile dysfunction.  With that said, some treatments for ED can be effective at reversing or improving the natural bodily changes that impact arousal and erectile function, even absent formal erectile dysfunction diagnoses. 

All of this is by way of saying that many men have to deal with erectile dysfunction at some point in their lives, and the incidence increase as they get older.  At the very least, most men have to deal with some changes in their sexual functioning as they age.  That’s all the more reason to engage with your partner, and then your doctor or healthcare provider on the topic – you’re by no means alone, and it’s the only way you’re going to be able to treat full-fledged erectile dysfunction successfully. 

Talk To A Doctor

It can be nerve-wracking and stressful at first, but talking to your doctor isn’t something to be afraid of or worry over.  They’re trained to deal with far more embarrassing things than erectile dysfunction, which, as we stated, impacts a large percentage of men, more and more as men get older.  They’re also sworn to confidentiality with patients, so you have nothing to fear about your “secret” getting out.  Honest, open dialogue, rather than euphemisms or skirting around the issue, is usually the best approach.

No matter which method you choose, it’s best to have your questions written down in advance since doctors’ appointments can often feel rushed (especially in traditional doctor’s office settings).  You can try introductory strategies to lead into the question, such as, “I’d like to talk about a men’s health issue,” or “I’m concerned I might have erectile dysfunction.”  It can help to rehearse your “opening line” or question in advance, to make it feel more natural and make you more comfortable.  You don’t want to let nerves or embarrassment get in the way, ruin your sex life, or potentially mask a more serious health problem. 

Treatment Options For Erectile Dysfunction

There are several effective treatments for erectile dysfunction today, depending on the root cause and other health factors.  Obviously, if erectile dysfunction is secondary to heart problems, diabetes, or similar, then treating or addressing those problems often alleviate sexual dysfunction, too.  Specific treatments just for erectile dysfunction itself include:

• Oral pills taken daily or shortly before sexual activity, such as Viagra, Cialis, Levitra, or generic versions of those medications.  They work by increasing blood flow to the penis, making it easier to achieve and maintain an erection. 
• For patients who don’t respond to oral ED medications, injections such as Tri-Mix and similar can be used to induce erections within a half-hour in the vast majority of men.  This is more reliable than a pill, though comes with additional risks, so it isn’t a first-line treatment.
• Psychological causes of erectile dysfunction can often be treated through therapy, medication, or a combination of both.  This also includes resolving emotional or relationship-based problems, so couples therapy or counseling may be in order.
• Erectile dysfunction that results as a side effect of medications can be dealt with through changing dosages or medications with the oversight of your doctor or healthcare provider. 
• Foreplay, incorporating sex toys, penis pumps, and other sex accessories can also take care of some level of erectile dysfunction or change to erectile function related to aging.

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Redefining Your Sex Life

It’s also worth noting that erections are not a requirement for every sexual interaction. Many older adults have perfectly fulfilling relationships, including sexual relationships, despite many handicaps, limitations, and problems, including erectile dysfunction.  In fact, many older couples report similar or greater satisfaction with their relationship than younger couples, despite a virtually non-existent sex life.  Whatever the case may be for you and your relationship, be sure to talk to your partner and your doctor so that you can address it directly and maximize your sexual relationship and function to your (and your partner’s) satisfaction.

Lifestyle And Other Tips To Deal With ED

Preventing erectile dysfunction, or taking steps to offset the effects of aging that may result in sexual function changes, is definitely worthwhile.  Rather than rely solely on medication, or wait until ED escalates from an intermittent to an ongoing problem, there are several lifestyle and related changes that men can make to improve their overall health and resultant sexual health. 

Exercise Regularly

Adults should get around 2-3 hours of moderate exercise per week, consistent with their physical abilities and health.  This will help to ensure maximum heart and respiratory health, which improves and maintains circulation and stamina and thus can play a significant role in erectile function.

Eat A Balanced, Healthy Diet

Obesity and obesity-related health conditions are one of the main contributors to increasing rates of erectile dysfunction.  Diets modeled on the Mediterranean-style diet, which are rich in fruits and vegetables, lean proteins, and healthy fats, while low in carbs, processed food, and red meat, are often the most effective for overall health and sexual health alike.  They can also help to ensure you get sufficient nutrients, vitamins, and minerals in your diet for optimal body functioning and allow you to drop any extra weight that you may accumulate as your metabolism slows with age.

Consider Taking Vitamin Supplements Or Specific Anti-Aging Supplement Products

These can work to ensure your body gets the fuel it needs to perform and offset some of the changes resulting from aging, such as lower levels of testosterone production.  Those changes in hormones can play a significant role in erectile dysfunction, and many high-quality supplements can help to reverse or offset that hormone loss naturally.

Get Plenty Of Quality Sleep, About 8 Hours Per Night

Lack of sleep, tiredness, and fatigue often can lead to erectile dysfunction or sexual health issues.

Medication Side-Effects

Consult your doctor about the medications you are taking, and review side effects – if they include erectile dysfunction, talk to your doctor about changing medications or dosages.

Cut Out Stress

Practice mindfulness and meditation and other strategies to reduce stress and distraction in your life.  That can be a major cause of psychologically-induced erectile dysfunction or erectile problems, especially when combined with emotional or relationship issues.

Don’t Neglect Mental Health

Seek professional therapy or help for psychological conditions, even if they are unrelated to sexual function since they can easily spill over into causing sexual issues.

Stop Smoking And Drinking

If you smoke, stop as soon as you can.  Decrease alcohol intake or cut alcohol out entirely.  These two vices can have dramatic health effects, directly impacting circulation and blood flow, and therefore erectile function. 

Frequently Asked Questions

Is Erectile Dysfunction Permanent?

In the vast majority of cases, erectile dysfunction is not permanent.  When a health condition causes it, taking care of that health condition can often restore normal erectile function.  Age-related decreases in function can be offset with the various treatments and lifestyle methods/habits discussed in this guide.  In some limited number of cases, however, erectile dysfunction can be permanent.  This is often the case when physical trauma or surgeries damage the tissues of the penis or the arteries and veins that make up the blood supply to the penis.  In these cases, further surgical intervention or other options may need to be considered to overcome erectile dysfunction.  For most men, however, erectile dysfunction is temporary, caused by psychological or physiological problems that are reversible or treatable. 

Is Erectile Dysfunction A Sign Of Heart Disease?

Most erectile dysfunction that men experience is not a sign or symptom of heart disease.  However, one of the signs and symptoms of heart disease, considered an early warning sign, is erectile dysfunction.  That’s all the more reason to discuss erectile dysfunction with your doctor, so that appropriate tests and diagnostics can be completed.  It might just save your life…and your love life!

Can You Take ED Meds If You Have Heart Problems?

Many erectile dysfunction treatments are suitable for patients with a variety of heart problems.  However, discussion with your doctor or healthcare provider is highly recommended.  They will be able to evaluate your existing health problems, medications, and risk factors, and prescribe the kind of erectile dysfunction treatment that is the safest given your unique profile.  Just because a treatment may be safe for your heart does not mean you are healthy enough for sexual activity, regardless of your erectile function, so as always, the best approach is to speak with a trained medical professional for a more definitive answer to this question. 

Concluding Thoughts

Erectile dysfunction is more common than you may think.  If you are experiencing regular erectile dysfunction or other sexual health problems, the first thing to do is talk to your partner.  Once you’re on the same page, seek professional help – through therapists, psychiatrists, or medical doctors – or a combination of all of the above – depending on the nature of your problem.  Seeking medical help from a doctor or healthcare provider. 

DISCLAIMER

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.

References:

• Kubin M, Wagner G, Fugl-Meyer AR. Epidemiology of erectile dysfunction. Int J Impot Res. 2003;15(1):63-71. https://www.nature.com/articles/3900949
• Lakin, M & Wood, H. (2018). Erectile dysfunction. Cleveland Clinic Center for Continuing Education. Retrieved from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/

Medically reviewed by Leann Poston M.D. on 9/21/2020

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