Erectile dysfunction (impotence)

Middle age

Common causes in this age group are overwork, stress, guilt and bereavement (ED often happens when a widowed man tries to form a new sexual relationship). A few cases are due to diabetes.

Post-middle age

In this group of men, ED gets commoner with increasing age. Nonetheless, 70 per cent of all 70-year-olds are sexually potent.

It is now clear that in a very high proportion of cases, the problem is due to deterioration in the blood vessels that carry blood into the penis. Research being carried out in 2007 suggests that in addition there may often be deterioration in the arteries of the brain or the heart. Therefore older men with ED should take care to protect themselves against strokes and heart attacks – for example by keeping their blood pressure and cholesterol down.

You may be surprised to see that I have not listed 'lack of hormones' as a common cause of ED. In fact, lack of male hormone is pretty rare.

If you are tempted to go to one of the many private clinics that make a habit of diagnosing 'male hormone deficiency', and then charging huge sums of money for testosterone treatment, I suggest you think twice!

What is an erection?

An erection occurs when blood is pumped into the penis and stays there, making it hard. It generally happens because a guy is thinking about sex, or because his penis is being stimulated - or both.

The result is that signals go down the nerves that lead from his spinal cord to his genitals. They tell the blood vessels which supply the penis to open up. Blood flows in and the organ 'blows up' like a balloon.

A valve mechanism near the base of the penis keeps the blood from flowing out again – a least, until sex is over.

As you can see, getting an erection is a complex process. It's awfully easy for various factors to interfere with it - for instance, worry, tiredness, too much alcohol or in later life, narrowing of the blood vessels.

Nicotine is now known to narrow those vital blood vessels – which is why ED is much commoner in smokers. But often, there is nothing physically wrong with men who develop ED.

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