Turning 40 can be fraught with anxiety for all kinds of reasons. Those first gray hairs might be sprouting (if your locks aren't already hanging on for dear life) and suddenly your old belts just don't seem to fit any more. Add to this to your list of middle-age concerns: the rising risk of erectile dysfunction (ED), or difficulty having or keeping an erection.
Regardless of age, if a man is obese and sedentary, with poor dietary habits, he is at greater risk of developing diseases that can lead to erectile dysfunction. These include heart disease, hypertension and type 2 diabetes. Some forms of congenital heart disease may remain hidden and only cause problems in adulthood. Men of any age noticing a marked change in sexual function should contact their physicians to rule out the possibility of a more serious condition.
"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."
“Studies looking at men under 40 with ED have found certain psychiatric conditions, like depression and anxiety, at a higher rate than other groups,” Trost says. And as he explains it, anxiety and depression—two things millennials experience at uniquely high rates—can make it more difficult for a man’s brain to respond to arousing stimuli, which can cause a low sex drive or issues getting an erection.

Remember those cultural messages we discussed earlier, about how men are wild sex aliens from the planet Weenus? Well, men are raised hearing those messages, too, and they can end up screwing with their sexual self-image —for instance, they can lead men to obsess over their own virility, and panic about impressing a new partner, until they've thought their boner into a corner and can't get an erection. Performance anxiety is one of the most common culprits behind lost erections, especially among younger, less experienced men.
For many young men, performance anxiety plays a large role in erectile dysfunction. Other factors include money and work problems, as well as relationship issues and even issues about sexual orientation. Undiagnosed depression and post-traumatic stress disorder can cause erectile dysfunction--especially if the PTSD is related to a past sexual experience.
Though few things are worse for your erection than a cigarette habit, coffee can actually help you out below the belt. A study by the University of Texas Health Science Center at Houston found that men who consumed the caffeine equivalent of 2-3 cups of coffee per day were less likely to suffer from erectile dysfunction than those who preferred to wake up with caffeine-free beverages.
Performance anxiety: Perhaps the most common cause of erectile problems among younger guys is performance anxiety. Many cultures place pressure on men to be the "experts" when it comes to sex, which can make men feel like they have to be responsible for sex or know how to please their partner every time. This pressure can be stressful and make it more difficult to get or maintain an erection.
When these mental hang-ups happen in the moment (aka in bed), they can trigger his brain’s fight-or-flight response, which sends a message to his penis to shut things down. In this way, performance anxiety–induced ED is actually pretty similar to what women experience when our thoughts during sex make it hard to stay turned on and/or orgasm—we just don’t have an appendage that shows the evidence.

These specific chemicals are found in erectile dysfunction medications such as Viagra and Cialis."The chemicals that cause the outflow are called phosphodiesterases," says Reitano. "To give you a stronger erection, erectile dysfunction medications (PDE-5 inhibitors) block or inhibit the phosphodiesterases, which enables the blood vessels in the penis to stay open and receive more blood, creating a firmer and longer lasting erection. This is why the drugs are called phosphodiesterase inhibitors (PDE-5 inhibitors for short)."
The strength and frequency of your erection are an important indicator of your overall health. The blood vessels in the penis are smaller than arteries and veins in other parts of your body, so any problems like blockages, blood vessel dilation issues, or hormone imbalances will often show up as erectile dysfunction (or less firm erections) before something more serious like a heart attack or stroke. 

“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.

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