Once upon a time, problems in the bedroom stayed in the bedroom. Today, sexual difficulties have come out in the open thanks to drug commercials, advances in treatments, and expert endorsements. Impotence, now commonly called erectile dysfunction or ED, is no longer a hushed-up diagnosis, and for good reason. It’s treatable at any age, and many men who seek treatment are returning to normal sexual activity.
Doctors define ED as the consistent inability to obtain or maintain an erection sufficient for sexual intercourse. It’s more common than many people realize, affecting somewhere between 15 and 30 million American men. It’s more prevalent with age. According to the National Kidney and Urologic Diseases Information Clearinghouse, about 5 percent of 40-year-old men experience ED, but for 65-year-old men that number jumps to 15 to 25 percent.
And even more of men have an occasional problem achieving an erection. “If men are honest, every one of them will tell you they’ve experienced impotence at least one time in their lives,” says Neil Baum, M.D. “Not every intimate encounter is a ‘10.’ It can be devastating when ED occurs,” he says. “A man’s whole concept of his masculinity may be undermined.”
Until the early 1970s, experts thought underlying problems in the psyche caused most erection problems. Today, the medical community recognizes that medications, lifestyle choices, or injuries are some of the most common erectile dysfunction causes. Here’s what our experts advise for responding to erectile dysfunction.
“As a man gets older, it may take a longer period of genital stimulation to get an erection,” says Dr. Baum. “For men ages 18 to 20, an erection may take a few seconds. In your thirties and forties, maybe a minute or two. But if a 60-year-old doesn’t get an erection after a minute or two, that doesn’t mean he’s impotent. It just takes longer.” The time period between ejaculation and your next erection tends to increase with age. In some men ages 60 to 70, it may take a whole day or longer to regain an erection. “It’s a normal consequence of aging,” says Dr. Baum.
Prescription drugs might be at the root of the problem. Or it might be that over-the-counter antihistamine, diuretic, heart medication, medication for high blood pressure, or sedative you’re using. Realize, of course, that not every individual reacts to medications the same way. Drug-induced ED is most common in men older than 50, says Dr. Baum, with almost 100 drugs identified as potential causes of erectile dysfunction. If you suspect your medication, consult your doctor or pharmacist and ask about changing the dosage or switching to a different drug. Do not, however, attempt to do this on your own.
Shakespeare was right when he said in Macbeth that alcohol provokes desire but takes away the performance. This happens because alcohol is a nervous system depressant. It inhibits your reflexes, creating a state that’s the opposite of arousal. Even two drinks during cocktail hour can be a cause for concern. Over time, too much alcohol can cause hormonal imbalances. “Chronic alcohol abuse can cause nerve and liver damage,” says Dr. Baum. Liver damage results in an excessive amount of female hormones in men. Without the right proportion of testosterone to other hormones, you won’t achieve normal erections.
The penis is a vascular organ, says Irwin Goldstein, M.D. The same things that clog your arteries also affect bloodflow to the penis. In fact, he says, all men over age 38 have some narrowing of the arteries to the penis. So watch what you eat. “High cholesterol is probably one of the leading causes of ED in this country,” says Dr. Goldstein. “It appears to affect erectile tissue.”
Studies show that nicotine can be a blood vessel constrictor, says Dr. Baum. In a study at the University of Texas, researchers had a group of nonsmoking men chew gum with nicotine or a placebo gum. Those who chewed the nicotine gum had a 23 percent reduction in sexual arousal compared with the group who chewed the placebo gum.
Studies show that men who are overweight are more likely to have difficulties maintaining an erection. If you are at least 20 percent heavier than your ideal weight, think about taking off a few pounds. Consider karate or a weight training program. Not only will a fitter body lessen the likelihood of ED, but it will also boost self-confidence. The better a man feels about his body, the better he’ll feel for “the event,” says Dr. Goldstein.