ED is a Dipstick for Everyday Health
Erectile dysfunction (ED) is the persistent inability to develop or maintain penile erection sufficient for satisfactory sexual performance, and is one of the most common sexual complaints by men of all ages. While many tend to think of erectile problems as an elderly man problem, the prevalence of ED in younger men is higher than most realize. Studies have shown ED occurs in 26% of men less than 40 years old, and the prevalence increasing each decade to 70% or higher in men over the age of 70. Many men find ED inconvenient, annoying, or a sheer embarrassment, but what most do not understand is that penis function is a critical barometer of underlying maladies that are far more serious.
Despite ED having been long regarded as a disease of older men, erectile function change is not a normal part of aging. Research has continued to illustrate the definitive connection between sexual function and long term, chronic diseases like diabetes, prostate and heart disease, as well as endocrine dysfunctions. Mood disorders and sexual side effects from medications are also common factors that change a man's sexual response. Yet it is the more frequent occurrence of chronic health issues in older men that accounts for the increase in ED with age, not the aging process itself.
All men lose their erection at some time during their sexual life and a periodic experience is normal. But a persistent loss of erectile function despite adequate sexual stimulus, either in partner activity or self stimulation, and a reduction of spontaneous non-sexual activity related erections (night or morning erections) are important signs that that a physician should take a look under the car hood.
Erectile Dysfunction and Cardiovascular Risks
Independent risk factors for both ED and heart disease are well recognized and include age, smoking, diabetes, hypertension, high cholesterol, depression, obesity, and a sedentary lifestyle. The penis is essentially a vascular bed, and because penile vessels have a smaller diameter than coronary arteries, the earliest manifestation of heart and vascular disease can often develop first in the penis. Men with ED have been shown to have a 62% increased risk of having a heart attack, and are at risk of developing diabetes 10 to 15 years earlier than a man without ED. A sign of an upcoming heart attack can in fact first start in the pants.
To comprehensively address erectile concerns, the underlying root cause must be explored and addressed. A car engine problem must be corrected far beyond focusing on a faulty stick shift. Up to 80% of erectile concerns have a medical cause; 20% of persistent ED is considered psychological in origin, and both mental and physical issues need to be considered in a man of any age with erectile difficulties. Men should have detailed investigations into cholesterol, blood sugar, testosterone, and other hormone levels. Prostate disease and neurological conditions are also common culprits that may first be discovered by erectile symptoms. Occasionally ED is the first indicator of a prolactin secreting brain tumor (read more on this at Why the Doctor prescribed Viagra for my Brain Tumor).
Understanding what is causing ED is the most important step to pairing an appropriate treatment, which include lifestyle changes, sex therapy, oral medications, medical penis constriction loops, pumps or vibratory devices, as well as penile injections, and surgical penile implants.
How to Take Control of ED
It is never too early to reframe thinking about the importance of sexual function for men. It is far more effective to begin lifestyle modifications to optimize preservation of sexual function than it is to reverse vascular or endocrine disease once it has progressed far enough impair an erection. For men who are concerned at the development of erectile changes, it is wise to see a doctor sooner than later. Men with erectile dysfunction who are 40 - 49 years of age have been found to have a near 50 - fold increased risk of coronary heart disease compared to men of the same age without ED. Early intervention is definitely worth it.
An initial approach to ED is to alter controllable risk factors shared with pathophysiology of cardiovascular disease, including smoking, obesity, alcohol intake, as well as addressing sedentary lifestyle, fatigue, depression and medication side effects. Especially if ED is occurring consistently 20 - 30% of the time, which is commonly how symptoms begin, many men are surprised how much lifestyle changes can significantly reverse erectile loss. Exploring psychological factors associated with ED is also imperative; even in men shown to have organic causes of erection rigidity changes, cognitive behavioral sex therapy has been found to improve sexual functioning when combined with medical therapies over medical treatment alone.
If loss of erectile function impairs the ability to engage in intercourse most of the time, a man has not had an erection in 5 years, or if he has undergone invasive surgery such as a prostatectomy (removal of the prostate) it is unlikely lifestyle changes will reverse symptoms, and a medication, device, or surgical intervention will be needed. However research has also shown that men taking an erectile medication alongside lifestyle changes such as weight loss and improved fitness work far better than simply taking an erectile medication alone for mild to moderate ED.
Healthy Sexual Function as a Life Philosophy
Healthy erectile function should be a lifestyle philosophy because after decades of medical research we now understand the penis to be a dipstick that indicates underlying disease. Sexual function is a window into a man's emotional as well as physical health, and when measures are taken to reverse the often multi-factorial causes of sexual concerns, sexual function not only improves, but health flourishes in many other areas as well, including mood, energy, and intimate relationship quality. Medical science has clearly proven that the resolution of erectile dysfunction also results in the prevention of serious chronic diseases such as diabetes and heart disease. Ultimately great sex leads to longer disease free living and a vital, full engagement in love and life.