In the long term, the best thing you can do for ED problems is “stay playful and keep the focus off getting your partner erect,” says Goldberg. Experiment with new erotic scenarios and situations, like having sex in a different room, wearing lingerie, or role-playing your fave fantasy. Oh, and don’t limit yourselves to just intercourse either (which applies to all couples, whether or not you’re dealing with ED). “The broader your definition of sex,” Goldberg says, “the more sex you can be having.”

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If the problem is physical, there are numerous treatments available, such as penile injections or penile revascularization surgery, which increases blood flow to the cavernosal artery of the penis. There are also medications like Viagra, Cialis and Levitra, but Lehmiller cautioned men with erectile difficulties not to self-medicate without seeing a doctor beforehand due to the potential negative side effects associated with such medications (such as chest pain or shortness of breath).

What causes erectile dysfunction in older males?


Cigarette smoking is a risk factor for ED, according to the 2014 Report of the U.S. Surgeon General. Excess weight can also contribute to erectile dysfunction. A 2004 Italian study found that one-third of their 110 obese study subjects were able to eliminate their erectile dysfunction problems by losing fifteen percent of their weight through diet and exercise.

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Assuming an absence of any significant spinal damage or hormonal disorders, the potential barriers are in fact different at stage one and two. At stage one, anything that causes impairment in your psychological ability to become stimulated will hamper an activation of your nervous system. At stage two, anything that contributes to a narrowing of blood vessels will hamper the engorgement of your erection.

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Another way to keep your libido up is to act when you do get aroused. This might mean going home at lunchtime to have sex with your spouse, or leaving a party early with your date if you’re both aroused. Staving off an arousal trains your body to disassociate arousal with erections. You want the opposite. You want to get and keep a strong erection when you feel aroused so that you can have better sex. So this is a great excuse to tend to your sexual needs as they come, if you can.
Stiffy Solution: Obviously, no one should ever go off a prescribed med without consulting with a doctor. But there are erection-friendly alternatives to nearly every daisy-wilting medicine listed above. And your dude shouldn't let embarrassment keep him from talking to his GP about this — doctors are well aware that erectile difficulties are a possible side effect for all of these medicines; they just don't know which patients will experience what side effects, so they're waiting for you, the patient, to bring it up.
Low libido can be caused by many different things including medications, fatigue, recreational drugs, alcohol, depression, relationship problems, fear, systemic illness, and testosterone deficiency. Problems with maintaining an erection is a common symptom of erectile dysfunction (ED), and can be frustrating to deal with when trying to engage in any type of sexual activity. In most cases, ED is triggered by one or more health problems or unhealthy lifestyle habits, but can be improved or resolved by treating the underlying cause, which may be vascular, neurologic, penile, hormonal, drug induced, or psychogenic.
Francis,*, 42, had ED for 11 years before he decided to seek treatment a few years ago. At first, he didn't even realize that he might have ED. "I thought I was either depressed or that I had lost interest in my girlfriend at the time," he said. But when the problem persisted, he realized it was preventing him from having sex with his partner, who often taunted him for struggling to maintain an erection.
"It definitely was a blow to my masculinity," Francis told Mic. "It didn't help that my wife at the time would say that I must be gay if I couldn't keep it up for her." Compounding the issue, if an erection doesn't happen during a given sexual encounter, the man can obsess over it, inevitably creating pressure and making it difficult for him to become fully aroused during future encounters. 
Erectile dysfunction can be embarrassing and difficult to talk about for some men. Many men may feel like they need to hide their diagnosis from their partner. "Failure to communicate openly about erectile dysfunction can result in both partners drawing away from the relationship," warns Feloney. Remember that your partner is also affected by your problem; being open and honest is the best way to decrease fear and anxiety. Discuss options for achieving sexual satisfaction together, and be positive — most erectile dysfunction problems can be treated.

Some of the most reliable ED stats have emerged from a large data collection effort called the Massachusetts Male Aging Study. According to that data, rates of ED among men tend to correlate with their age bracket, says Tobias Köhler, M.D., chief of the Division of Male Infertility at Southern Illinois University. “Roughly 40 percent of men in their 40s suffer from ED, 50 percent in their 50s, etc.,” he says.
"Start by cutting out junk, processed and packaged foods. Instead, focus on eating high fiber foods, like fruit, vegetables, nuts and seeds, and foods that will help to improve blood flow, such as leafy green vegetables. It's also helpful to avoid drinking too much caffeine and alcohol. Next, make sure you are getting regular exercise. This will help you to balance your hormone levels, improve circulation and manage stress."
Performance jitters. For some young men, the desire to perform well in bed can be so overwhelming that, in turn, it causes them to not perform at all. “When a younger man experiences ED, it often is associated with significant performance anxiety, which in turn increases the problem, sometimes turning a temporary situation (i.e., too much to drink that night) into a permanent problem,” says Jerome Hoeksema, MD, assistant professor of urology at the Rush University Medical Center in Chicago. “The more they worry about it, the worse it gets. Young men need to recognize this cycle and try to reduce the ‘stress’ surrounding sex.”
A “cycle”, as you put it, can certainly become established after a man experiences a number of erectile failures and begins to lose confidence. Once the idea of attempting intercourse produces anxiety rather than excitement, it becomes less and less likely he will successfully produce a reliable erection. Pharmaceutical agents can bypass this cycle, but it can also be extremely important to learn to be less fixated on erectile ability and instead focus on pleasure. Learning it is possible to give and receive enormous pleasure without an erection can be a vital aspect of a return to sexual health. This knowledge can lead to a reduction of the pressure you mentioned, as well as to a lifetime of sexual confidence and enjoyment.

What works as good as Viagra?


A “cycle”, as you put it, can certainly become established after a man experiences a number of erectile failures and begins to lose confidence. Once the idea of attempting intercourse produces anxiety rather than excitement, it becomes less and less likely he will successfully produce a reliable erection. Pharmaceutical agents can bypass this cycle, but it can also be extremely important to learn to be less fixated on erectile ability and instead focus on pleasure. Learning it is possible to give and receive enormous pleasure without an erection can be a vital aspect of a return to sexual health. This knowledge can lead to a reduction of the pressure you mentioned, as well as to a lifetime of sexual confidence and enjoyment.

What works as good as Viagra?


Obesity. Obesity itself is not a risk factor for ED — but there is a connection. “The bigger concern is that obesity can lead to type 2 diabetes or vascular diseases, which are risk factors for ED,” says Montague. Morbid obesity, a term used to classify individuals who are significantly overweight, can cause hormonal changes that are triggered by excess body fat. In addition, obesity can put physical limitations on sexual intercourse.

Is there a topical cream for erectile dysfunction?


Instead, bench any P-in-V action for a beat and lower the stakes by telling him you want to fool around—not as a precursor to penetrative sex but just for the fun of it, suggests Natalie Finegood Goldberg, a sex therapist in Los Angeles who specializes in erectile dysfunction therapy. If this is a hookup situation, make it clear to him that you don’t expect or need him to have an erect penis for the two of you to have a good time, Goldberg says. You can always have oral sex, make out, or do some manual stimulation—because the worst thing you can do is freeze him out.
Now, it may be that all you need to do is tackle some of the issues outlined in these key tools. However, yes, that advice may also come in the form of a small magic blue pill. Sildenafil (Viagra) is a phosphodiesterase type 5 inhibitor, designed to promote blood flow to your penis and achieve a sustainable erection. It can sometimes be a short-term option to help you "get back on the horse" or a longer-term method (if there is an irreversible dysfunction) to help you enjoy a healthy intimate relationship.
Natural treatments: Although natural remedies are increasingly available for sale over the counter, there is little scientific evidence to support their claims of improving ED. These remedies may produce adverse side effects or react negatively with other medications a man is taking. Before trying any over-the-counter treatments, it is essential to consult a doctor.

"Erectile dysfunction medication interferes with the process that allows blood to leave the penis," adds Reitano. "Men with erectile dysfunction would benefit from having the chemicals leading to the erection outweigh the actions of the chemicals that cause the penis to lose its firmness, to have the systems that cause the inflow outweigh the chemicals that cause the outflow."

How do you please a man with ED?


The penis is the male sex organ, and the shaft of it is the longest part. The glans and head are located at the end of the shaft. The opening at the tip of the head when semen and urine come out is termed the meatus. Inside the shaft are two cylinder-shaped chambers called the corpora cavernosa and they run the length of the penis. They have blood vessels, maze, open pockets, tissue, and others.
Mention older men’s wilting erections, and people immediately think Viagra. Yes, Viagra, Cialis, and Levitra, can raise flags that have fallen to half staff. But fewer than half of men over 50 have tried them, and of those, fewer than half have renewed their prescriptions. Why? Because the drugs don’t work as well as advertised, and the side effects can be annoying.

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Pycnogenol is a compound found in the French maritime pine (Pinus pinaster), which grows in southern Canada. Several studies show that in combination with the amino acid L-arginine, it boost synthesis of nitric oxide, which plays a significant role in erection. Other studies show that pycnogenol helps restore wilting erections. In one study, 124 ED sufferers took either a placebo or pycnogenol and L-arginine (four tablets a day, 20 mg pycnogenol, 700 mg L-arginine). After six months, the supplement group showed a modest but significant improvement in erection, without side effects.
“With the success of Viagra-type drugs, there has been a tendency to start all patients with ED on one of these drugs and not look much further for a medical cause. But we now know that ED may be an early warning for heart and blood vessel disease, so it is important to look for common risk factors. These include high blood pressure, diabetes, medications, smoking, drinking, and drugs,” said Dr. Wang.
Depending on the age of the man, the reason why he is experiencing deficiencies in maintaining an erection will be due to a cause or another. Among young men, it is often due to psychological factors, either due to the size of the penis, past experiences, depression, undervaluation or other reasons, but can be summarized as: fear of sexually disappointing the couple.
There are many factors that can lead to ED. “Psychological causes of erectile dysfunction in young men can include performance anxiety, guilt about sex in general, guilt about having sex with a particular partner, feelings of anger or resentment towards a partner, or simply finding a partner undesirable,” said Carole Lieberman, MD, a psychiatrist on the clinical faculty of the UCLA Neuropsychiatric Institute in Los Angeles.

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As recently as two decades ago, doctors tended to blame erectile dysfunction on psychological problems or, with older men, on the normal aging process. Today, the pendulum of medical opinion has swung away from both notions. While arousal takes longer as a man ages, chronic erectile dysfunction warrants medical attention. Moreover, the difficulty is often not psychological in origin. Today, urologists believe that physical factors underlie the majority of cases of persistent erectile dysfunction in men over age 50.
Don’t panic. That will only make it worse. Erectile dysfunction is common. In younger age groups it is more likely to be a psychogenic issue around performance anxiety (don’t seek to be like a porn star is a top tip). In men between the ages of 40 and 70, it is estimated that 50 per cent will have some degree of erectile dysfunction. In this age group, there may be a more of a physical issue around blood flow. In either case, consult your doctor and they will be able to give you some more advice. An erectile litmus test is, if you are getting nighttime or early morning erections, it is likely a psychological not a physical vascular issue.
"This can take some time, but it can help to stop a cycle of too much anxiety, followed by an erectile issue. It also can help you realize where you draw the most physical pleasure. People tend to focus only on the genitals when it comes to sex. However, they can experience pleasure all over their bodies. If they learn how to utilize this, it can be a resource for future arousal, fun and pleasure."
“Although having sex at 70 is not the same as having sex at 20, erectile dysfunction is not a normal part of aging,” according to Michael Feloney, MD, urologic surgeon and expert on sexual dysfunction issues at the Nebraska Medical Center in Omaha. “You should still be able to have a satisfying sex life as you age." If you are experiencing erectile dysfunction, these 10 dos and don'ts may help.
Failure to achieve an erection is not uncommon for most men and may be considered normal even if it happens as often as 20 percent of the time. There is a wide range of normal when it comes to sexual functioning and sexual relationships. "Generally if a couple feels comfortable with their sex life and they enjoy intimacy together, erectile dysfunction may not be much of an issue. But if erectile dysfunction is causing stress in a relationship, then help is available," says Feloney.
Andrew McCullough, MD, associate professor of clinical urology and director, male sexual health program, New York University Langone Medical Center. Lecturer: Auxillium. Research grant: Pfizer. Data safety monitoring board: Pfizer. Consultant: Slate Pharmaceuticals. Clinical trials: Warner Chilcott, Vivus, Lilly, Bayer-GSK, ICOS, Timm, Schering Plough, Aeterna.
Alcohol is a depressant, not an aphrodisiac or a libido enhancer. Excessive consumption can interfere with the ability to achieve an erection at any age, and even occasional drinking can make erectile dysfunction worse in older men. Feloney advises using alcohol in moderation: "In small amounts, alcohol can relieve anxiety and may help with erectile dysfunction, but if you drink too much, it can cause erectile dysfunction or make the problem worse." 

The third tip for how to keep an erection longer is to frequently switch positions during sex. You’ll like some positions, but hate others. Keep mixing it up. Return to the ones you like every so often, but spend just as much or even more time in the positions you don’t like. As long as the positions aren’t painful for either you or your partner, doing this will lengthen your erection.

It may be that after trialling all the above, including the little blue pills, you are still having challenges. There are always other options. The only issue is that they tend to move further away from science, proven efficacy and fact and more towards anecdotal evidence and illegitimate science, all while preying on a natural desperation to find a solution. I would say, if you are at this stage, go and see your doctor to discuss a referral to see a urology specialist. It may spare you dabbling, unsuccessfully, with the various less-proven methods, including:


About 5 percent of men that are 40 years old have complete erectile dysfunction, and that number increases to about 15 percent of men at age 70. Mild and moderate erectile dysfunction affects approximately 10 percent of men per decade of life (i.e., 50 percent of men in their 50s, 60 percent of men in their 60s). Erectile dysfunction can occur at any age, but it is more common in men that are older. Older men are more likely to have health conditions that require medication, which can interfere with erectile function. Additionally, as men age, they may need more stimulation to get an erection and more time between erections.

How long will it take to cure erectile dysfunction?


Most of us are raised to believe that men are ravenous sex-beasts, eternally horny and only pretending to be a part of polite society so that they can find some new crevice to jam their Jeremy Irons into. So the first time we cross paths (and genitals) with a guy who can't get an erection, many of us immediately panic and assume that the problem must be us. We must be profoundly unsexy. After all, what could else possibly stop these hormone-addled maniacs from getting an erection?

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