What are some causes of erectile dysfunction?

Sexuality and health are connected in many different ways. Promiscuous and unprotected sex can, of course, be distinctly haz­ardous. It has been shown that in general, carnality and longevity go together.

There are several possible explanations for this. It is sug­gested that it may be that sex promotes good health by, for example, stimulating the release of growth hormone. An alternative explan­ation is that as we get older, it is only the healthier elderly people who are still capable of having sex. In fact, both these explanations are probably partially true.

Undoubtedly, however, general health affects sexual appetite and performance. And undoubtedly, also, the incidence of erect­ile dysfunction — it affects 1 in 3 men at the age of 40, 2 in 3 men by the age of 70, and 3 million men in the UK in total — tells us that the majority of middle-aged and elderly men are not particu­larly healthy.

This is pretty much in line with American data that shows that, by the time we enter our sixth decade, 5 out of 6 of us will have the symptoms of one or more of the chronic degenerative dis­eases.

Causes of Erectile Dysfunction

Erectile dysfunction is not always, however, a sign of an under­lying disease. It can have many causes. It is often linked with anxiety arising from the misconception that sexual activity must lead to penetrative intercourse and ejaculation. When this expec­tation is unmet, many men consider the sexual act a failure — and men with this expectation are particularly vulnerable to anxieties and self-fulfilling prophesies of failure. Sexual counselling is the most appropriate form of treatment in these cases; and can often alleviate problems due to anxiety, stress and marital conflict.

Impotence is also a common side-effect of many drugs, includ­ing medicines such as anti-hypertensives, hormones, anti­depressants, tranquillisers, and some cold and flu remedies, and recreational drugs such as alcohol, tobacco, heroin and cocaine. In medical cases a change of prescription may sometimes be suffi­cient to cure the problem. Where recreational drug use is involved, rehabilitation or other support is indicated.

In middle-aged and elderly men, however, most cases of erec­tile dysfunction have an organic cause, specifically vascular disease and neurological disease. If either the blood vessels that supply the penis or the nerves that connect to it are below par, an erection is difficult or impossible to achieve and maintain. As dia­betes damages both blood vessels and nerves, and the condition is increasing at an alarming rate, it is hardly surprising that impo­tence in ageing men is an increasingly common problem — and that prescription and grey’ sales of Viagra and its competitors, Cialis and Levitra, are doing well.