Erectile Dysfunction

Many men would like a stronger erection. Firm erections are one way that a man rates his sexual prowess. Unfortunately, many men harbor unrealistic sexual expectations and are thus prone to self-criticism. For example, a weakening erection is a natural consequence of aging. And it is normal for a man to have difficulty with his erection on occasion.

That being said, did you know that erectile dysfunction (ED) is considered by many to be the most common male sexual dysfunction? One research study identified this as the the most frequently cited reason men gave for not being sexually active.

ED is defined as the inability to attain or maintain an erection sufficient for satisfactory sexual performance. Just how common is ED? Currently 30 million men in the US struggle with it. The prevalence of ED increases with age. For example, physicians are sometimes taught the 50/60/70 rule. That is, 50% of men in their 50s have ED, 60% of men in their 60s, and 70% of men in their 70s. This averages out to about 40% of men in all age groups.

Even though most men with ED do not seek treatment, it can have serious consequences for a man and his sexual partner. For example, ED can impact a mans sense of himself as a sexual being, and it can hurt his partners self esteem. In men with age-related ED, his partner may very likely be experiencing her own age-related sexual concerns, such as vaginal atrophy and dryness. Her sexual challenges may thus compound his erectile issues. Likewise, ED can lead to other disorders, such as low libido in a man or his partner, or premature ejaculation. And once a man becomes anxious about erectile challenges, he can easily develop performance anxiety which only makes his erection more difficult to attain. Similarly, some men are generally anxious about sex, and this anxiety can cause ED. Thus there are many ways that ED can quickly become entrenched as a mans typical sexual response.

What about treatment? Thankfully, there is a lot a man can do to strengthen his erection. Like all sexual concerns, ED can be caused by psychological, medical, relationship, or lifestyle issues. So, the first step is to determine what is causing your ED so you can decide your best course of action. Recent research shows that ED is frequently correlated with significant medical concerns. Because of that, all men with erectile issues should first consult a physician preferably a urologist. Be aware that ED is often a warning sign for cardiovascular disease. A man can have symptoms of ED two to five years before other medical tests indicate such issues! In addition, diabetes, thyroid issues, and medications such as anti-depressants and calcium channel blockers may be to blame. While Viagra or similar medications are many mens first choice for treatment, these medicines actually fail about 40% of the men who try them. Thus many men are well-served by also addressing lifestyle, emotional, and relationship issues. Regarding lifestyle issues, research suggests that a Mediterranean diet can be helpful for men with erectile issues, as can regular exercise. And of course, dont smoke even those only exposed to second-hand smoke appear to be at higher risk for developing ED than non-smokers! Of course, depression and relationship issues can cause ED, so seeing a therapist may be helpful in this regard. In addition, making love is so much more than penile-vaginal intercourse, and sex therapy can help you increase your sexual repertoire.
In sum, the good news is that while ED is common, there are many treatments available. But remember that while physical sexual response tends to decline with age, your heart and your mind are still your most important sex organs! About the Author: Dr Marianne Brandon is a clinical psychologist and sex therapist in Annapolis, MD. She is author of Monogamy: the Untold Story, and co-author of Reclaiming Desire: 4 keys for Finding Your Lost Libido. You can learn more about her work at
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