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 aren’t always age-related. Aging doesn’t necessarily mean you’re doomed to develop ED indefinitely. While age can raise the risk for ED, 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 result in 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 and isn’t as inevitable as you might think. According to Johns Hopkins Medicine, it’s estimated that 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.

There are many physical causes of ED. Any one of these can disrupt the sequence of physiological changes that produces an erection:

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 isn’t necessarily related to age or chronic illnesses. Other common causes include:

Alcohol slows nerve communications within the brain and throughout the body, 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.

Medications 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:

Psychological and emotional stressors can also inhibit sexual arousal. Nervous about tomorrow’s sales presentation at work? Grieving 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. For example, you can:

  • lose weight
  • quit smoking
  • try to improve your relationship with your sexual partner
  • practice healthy responses to stress

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 can be treated so you can lead a happier, healthier life.