Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. Some people may assume ED increases with age. The fact is that impotence and the inability to maintain an erection are not always age-related. Aging doesn’t necessarily mean you’re doomed to develop ED indefinitely. Age can raise the risk for ED, but there are ways to treat it. Learn more about the risks and treatment options.
Male sexual arousal may seem simple, but it depends on a precise, complex sequence of events inside the body. The brain activates nerves in the penis to relax muscles in the spongy tissues that run the length of the penis. When these muscles relax, blood can flow in from arteries to fill open spaces in the spongy tissue.
Increased blood pressure expands the penis. Membranes around the spongy tissue sustain the erection. Anything interrupting this sequence can cause the inability to have or keep an erection long enough for sexual intercourse.
ED is often associated with getting older. Although ED’s frequency does increase with age, it’s treatable regardless of your age and isn’t as inevitable as you might think. According to the National Institutes of Health, only 4 percent of men in their 50s and 17 percent of men in their 60s experience total inability to have an erection. In fact, ED can have many causes not associated with aging.
Physical causes of ED abound. Any one of these can disrupt the delicate sequence of physiological changes that produces an erection:
- heart disease, high blood pressure (hypertension), or high cholesterol
- low testosterone
- enlarged prostate
- sleep disorders (such as sleep apnea)
- multiple sclerosis
- Parkinson’s disease
The hormone testosterone affects a person’s sex drive and energy levels, which govern arousal impulses to the brain. Diabetes can also damage the nerves that signal increased blood flow to the genital area. According to the American Diabetes Association, a man with type 2 diabetes is twice as likely to have low testosterone compared to a man that does not have diabetes. Your doctor can test for diabetic nerve damage and low testosterone. Also, any constriction of blood flow from heart disease and artery blockages would hamper an erection.
ED is not necessarily related to age or chronic illnesses. Other common causes include:
- alcohol consumption
- tobacco use
- prescription medications
Alcohol, tobacco, and certain medications can also cause ED. Alcohol slows nerve communications within the brain, which can affect arousal signals and physical coordination. Tobacco not only restricts blood flow, but can lead to serious diseases that may further impair sexual function.
Medicines can also affect people differently. A drug that decreases sexual performance in one person might not in another. Common types of drugs that may lead to impotence include:
- calcium channel blockers
- high blood pressure medications
- hormone therapy
- depression medications
Psychological and emotional stressors can also inhibit sexual arousal. Nervous about tomorrow’s sales presentation at work? Depressed about a parent’s death? Angry or hurt by arguments with your spouse? Any of these can interfere with your feelings of sexual desire. Plus, not having or sustaining an erection — even once, for any reason — can spiral into greater anxiety and perhaps doubts about your sexual abilities and self-esteem.
The good news is that you can control most of the physical and emotional causes of ED we’ve reviewed here. For example, you can:
- lose weight
- quit smoking
- try to improve your relationship with your sexual partner
- choose less stressful responses to work challenges
Such strategies might take a little research and trial and error to discover what works best for you. Be sure to talk to your doctor to address physical or medication causes of your ED.
The risk for ED can increase with age because of naturally decreasing levels of testosterone. Still, testosterone and age aren’t the sole factors in achieving an erection. Most causes of ED aren’t directly related to age, but rather other underlying medical issues. Your doctor can determine the cause of ED with a blood test and physical and psychosocial exams. There may even be more than one underlying cause. Once the problem is properly identified, ED may be treated so you can lead a happier, healthier life.