Erectile Dysfunction: What Increases Your Risk

Most men have occasional erection problems (erectile dysfunction). But when erection problems become persistent, they can affect your self-image, sex life, and relationship. When you have persistent erection problems, "performance anxiety" can worsen the problem. If you cannot maintain an erection that is firm enough for intercourse, or you have an orgasm before or immediately after entering your partner (premature ejaculation), you may feel frustrated and believe you are not pleasing your partner.

Fortunately, many of the physical and psychological factors that cause erection problems respond to treatment.

erectile dysfunction and Age

Your risk of developing an erectile dysfunction increases with age.

• About half of men between the ages of 40 and 70 report erection problems.
• Among men in their 40s, about 15 percent report having moderate erection problems. That number roughly doubles to 30 percent in men in their 70s.
• Severe erectile dysfunction affects about 5 percent of men in their 40s and 15 percent of men in their 70s.

erectile dysfunction and Health Conditions

In addition to your age, the state of your overall health could increase your risk of ED. The presence of certain diseases, as well as physical or psychological problems could contribute to the problem.

Diseases that affect blood vessels and can cause erectile dysfunction include:

• Diabetes. About half of men with diabetes experience some form of erectile dysfunction.
• High blood pressure or other blood vessel diseases
• High cholesterol or low HDL (high-density lipoprotein) cholesterol

Diseases or procedures that affect nerves:

• Diabetes
• Multiple sclerosis
• Stroke
• Parkinson’s disease
• Surgery involving the prostate, bladder, rectum, or urethra. These procedures may cause injury to nerves involved in achieving and maintaining an erection.

Other conditions:

• Thyroid problems.
• Low levels of the hormones needed for the normal development and function of the sex organs (hypogonadism), leading to low testosterone levels.

Injuries or treatment:

• Injury to the penis or pelvic region
• Injury to the spinal cord or nerves of the penis
• Pelvic surgery
• Radiation in the pelvic area

Medicines and other substances that increase your risk:

• Some medicines to treat high blood pressure or depression
• Long-term (chronic) alcohol abuse
• Drug abuse
• Tobacco use

Psychological risk factors:

• Depression
• Anxiety or stress
• Relationship problems
• A recent major life change (birth of a child, retirement, job change, loss or death of a partner, divorce, or marriage)

Activities that constrict blood flow to the penis — such as frequent long-distance bicycle riding on a hard, narrow saddle — may increase a man’s risk of developing an erection problem (although experts continue to debate this issue).

A vasectomy usually does not cause erection problems. But pain after the operation may affect sexual performance for a time, and if a man was not comfortable with his decision to have a vasectomy, or is having second thoughts, it could affect him psychologically.

How to Reduce Your erectile dysfunction Risk

You may be able to avoid erection problems (erectile dysfunction) related to anxiety and stress by taking a more relaxed approach to lovemaking. Talk to your partner about your problems and concerns. Sexual intimacy is a form of communication. If you and your partner talk about your lovemaking, it will help reduce your stress and anxiety, and you may become more relaxed.

Erections may gradually become more difficult to get and maintain as you get older. But foreplay — erotic stimulation before intercourse — and the right environment can help increase your ability to have an erection, regardless of your age.

Other things you can do that may reduce your risk for developing an erection problem include:

• Quit smoking
• Avoid use of alcohol and illegal drugs
• Keep your cholesterol level in check to reduce the risk of hardening of the arteries (atherosclerosis)
• Treat high blood pressure.
• Keep your blood sugar in a safe range if you have diabetes
• Exercise regularly
• Lose weight, especially if you are obese
• Lower stress in your life

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