Erectile dysfunction (ED) is extremely common in modern day men. Today’s diet, hectic lifestyle and lack of exercise all contribute to this common problem. Some degree of ED occurs in about 40% of men at age 40, rising to 70% at age 70. Body weight, inactivity, oxidative stress and diabetes, along with medication use that may have a negative effect on erections, can lead to ED. Both prostate enlargement and cancer increase the likelihood of ED . There is also evidence that the enzyme responsible for producing NO (Nitric Oxide) decreases with age. Decreasing sexual frequency plays a role in aggravating ED. Like almost every other organ in the body including the brain, the rule is “use it or lose it. Mind over matter?

It used to be said that 95% of ED is “psychological”. A significant percentage of ED may be related to “psychological” factors in the sense that stress is very often a contributing cause of poor erectile function (see Stress and Erectile Dysfunction), but most experts now believe that only a small minority of erectile problems start out as purely psychological. One example of this is depression that frequently results in loss of interest in sexual activity and ED. In fact, it is now widely believed that 95% of ED has a medical basis when common factors such as lack of exercise, excess body weight, poor diet, diabetes, prostate surgery, and the side effects of medications are considered!

What tests do I need?

It is very important for men with significant ED to be screened for potential medical problems. Some appropriate screening tests include: Calculation of BMI, measurement of the waste to hip ratio, measurement of blood pressure, blood sugar, blood lipids, and total and free testosterone levels. These measurements and tests, after they have been professionally evaluated, should exclude most of the significant medical problems associated with ED. Examination of the prostate and measurement of prostate specific antigen (PSA) is advisable in men age 50 or older. Questionnaires may be used to assess whether there might be a significant component of depression or anxiety. Significant anxiety or depression should always be professionally evaluated and treated. Review of any medications that are being taken, particularly for high blood pressure or depression, may uncover the reason for ED.

The Good News!

Many of the chronic medical conditions that can lead to ED can usually be controlled and treated in a way that erectile function will improve. At the least, men who improve their overall health and weight will generally require a lower dose of prescription medication to treat ED. And by improving diet and lifestyle many men can avoid ED and improve their overall health at the same time!