Erectile dysfunction (impotence) is an inability to sustain an erection for sufficient time for satisfactory sexual intercourse to occur. Causes may include both physical and psychological issues.
Occasional episodes of erectile dysfunction are normal, and affect most men from time to time, especially if they are tired, stressed, or have been drinking too much alcohol.
Changes in erectile function are a normal part of aging. For example, as men get older, it may take longer for them to become aroused, and the erection may not be as firm as it was previously.
However, even though erectile dysfunction becomes more common with age, it can affect men of any age. Regardless of how old you are, if you regularly experience issues getting or keeping an erection, it is important to consult your healthcare professional so that any underlying causes can be investigated and addressed.
In the past, impotence was a taboo subject, and an issue that many men and their partners dealt with in secret. However, we now know that a wide variety of factors can impact on a man’s sexual performance, and that erectile dysfunction is nothing to be ashamed of.
Causes may include:
- Impaired blood circulation to the penis: For example, erectile dysfunction may be a symptom of atherosclerosis (plaque in the arteries), or diabetes.
- Lifestyle choices: Smoking may exacerbate the issue due to the additional damage it causes to the blood vessels. Being overweight or eating a fatty diet may also contribute to the problem.
- Impaired nerve supply to the penis: For example, multiple sclerosis and other nervous system diseases may be involved, or nerve damage may occur as a consequence of surgery for bowel or prostate disease . Diabetes may also interfere with sexual performance via impaired nerve function.
- Hormonal imbalance: For example, low levels of testosterone.
- Adverse effects of prescribed or recreational drugs: Erectile dysfunction is a common side effect of many groups of drugs including blood pressure drugs, sedatives, antihistamines, anti-ulcer medicines, and drugs for prostate cancer. It may also occur as a side effect of many recreational drugs.
- Adverse effects of excessive alcohol intake.
- Stress: Including relationship problems, financial difficulties and work stress.
- Psychiatric conditions: Depression, anxiety and other mental health problems contribute to around 10% of cases of erectile dysfunction.
In some cases, a number of the conditions listed above may combine to cause performance problems. Infrequently, no cause may be discernible at all.
- Take a multivitamin and mineral supplement that’s specially formulated to support men’s performance. Key herbs and nutrients to look for include:
- Zinc, for reproductive health and the production of healthy sperm.
- Magnesium, which supports energy production.
- B-group vitamins, for additional support during times of stress.
- Tribulus terrestris, used traditionally to assist male sexual performance.
- Ginkgo biloba, which has traditionally been used to improve circulation to the extremities, and may be of assistance where vascular causes are involved.
- Korean ginseng may help to improve signs and symptoms of erectile dysfunction. This restorative remedy has also traditionally been used to enhance mental and physical performance and endurance (especially during times of stress), support energy levels and help with fatigue.
- A diet and lifestyle that supports the health of your heart and blood vessels will also support your sexual performance by aiding blood flow to your genitals.
- Eat a well balanced diet that’s low in saturated fats and cholesterol, and rich in fresh fruit and vegetables, legumes and whole grains. Oily fish are a better source of protein than red meat or other animal products, as the essential fatty acids they contain help to support blood vessel health.
- Exercising regularly will help to manage your stress levels at the same time that it supports your circulation, but talk to your doctor before starting any new exercise programme.
- Stop smoking, as it significantly increases the risk of erectile dysfunction by restricting blood flow to the penis and groin area.
- Don’t drink to excess or use recreational drugs.
- If you are diabetic, work with your healthcare professional to ensure your blood sugar levels are well controlled. Blood sugar fluctuations make erectile dysfunction more likely.
- If emotional or psychological problems are contributing to your sexual difficulties, seek counselling or another form of professional support, and take steps to manage your stress levels more effectively.
- Your doctor should investigate any persistent or recurrent sexual difficulties so that any underlying cause can be identified and treated appropriately. In some cases, erectile dysfunction is symptomatic of underlying diabetes or cardiovascular disease, so prompt diagnosis is essential.
- Talk to your doctor if you suspect that your prescribed medicines may be interfering with your sexual function. You may need to change to a different medication or dosage.