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.

Regardless of the reason, men spend a lot more time on their butts than they ever have before, shows data from the CDC. And all that sitting hurts your heart and your waistline, which saps your vigor below your belt, Dr. Köhler explains. You need a good 30 to 45 minutes of vigorous exercise at least 5 days a week to counteract all your chair time, experts say.
Avoid cholesterol and high blood pressure: high blood pressure and high cholesterol damage the blood vessels and that doesn’t exclude those blood vessels to the penis. This can lead to the issues of ED. Make sure your doctor keeps an eye on your blood pressure and cholesterol levels. One can also get a check of their blood pressure during the visits to their physician as part of a regular checkup.

Remember that he is in his 40's, and that's a huge factor too. Around the age of 30, testosterone, androgen, and other hormone levels gradually begin to drop at about a rate of 1 percent. and as a direct result, by the time a man reaches 40, hormone drops cause loss of muscle mass and increased body fat. As a man reaches 45 these gradual hormone drops cause brain capacity and function to slowly regress. This, mixed with risks of genetic diseases like diabetes and high blood pressure, all take a toll on the body, especially the sex organs. Those who are physically active are at a huge advantage, as working out inhibits hormone levels, the neuromuscular system, and protein synthesis to maintain.
If the problem is physiological, that is, if a man cannot maintain an erection due to illness, it is best to go to the doctor or specialist and treat the problem accordingly. Sometimes treating this problem with medication is enough to solve the problem; other times, however, a doctor might recommend the use of Viagra in order to achieve full erection.

At what age does a man stop being sexually active?


Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

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Don't forget mental health, either! "If you are experiencing stress at work, in your relationships or at home, open up communication about these issues," notes Axe. "Try natural stress busters like spending time outdoors, taking some vacation time for yourself or seeing a therapist. You also need to make sure that you are getting enough rest every night — seven to nine hours of sleep per night."
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.
Regular exercise and a diet rich in antioxidants is also the foundation of permanent weight control and diabetes prevention. Studies at the Duke University Diet and Fitness Center show that weight loss is strongly associated with better sexual function. Other studies show that diabetes is a major risk factor for ED, and that a healthy lifestyle prevents the disease and can restore erection function.

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.
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.

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"When it's persistent and consistent, it's extremely likely to have biological factors" regardless of age, Dr. Irwin Goldstein, director of sexual medicine at Alvarado Hospital in San Diego and the director of San Diego Sexual Medicine, told Mic. But the cause of ED can also be psychological: For instance, if a man can get an erection on his own but not with a partner, then his ED is more likely to be rooted in performance anxiety or a deeper psychological issue. 
If he's over 40 and not the most healthy, then years of "bad habits" could have provoked the incident; lack of exercise, shitty eating, alcohol abuse, drugs, tobacco, all damage our blood vessels. The same exact blood vessels that take the long juan from 6 to 12. Plus, you guys were taking a hot bath together, which also thins blood. So, right off the bat, there are six different variables you have no control over. If his exterior his A-ok, then lets dig deeper...
ED used to be something most men could barely admit to themselves, much less discuss with their partner or doctor. But the arrival of drugs such as Viagra (sildenafil), which help at least 80% of men with ED achieve solid erections, changed that attitude in a hurry. The important thing is that many men now openly talk about their erection troubles with their doctor. ED can be a dipstick for your health -- an early warning sign of serious health problems such as high blood pressure, heart disease, and diabetes. By making healthy choices, you can avoid ED and heart disease. More than 25% of 80-year-old men still enjoy great sex regularly, so you are never too old for great sex.
Depression, anxiety, stress, insecurity, conflicted emotions, missing the last quarter of the basketball game, all can have an effect. If your man is a healthy dude, then his brain could be cockblocking your giving of "brains." As a man, it is a very defeating feeling and not something you just talk out with your penis. He has got to remain cool. If it happens, the faster he pushes it out of his brain the faster his subconscious will kick in his arousal. Try something like this: grab a glass of water, take a pee break and then just hang in bed together. Share laughs, talk about other things and let your companionship do the work. The less he is engaging his inner dialogue and the more he is engaging you, the faster his inner workings will settle and his libido will be back in action. That is, of course, if he really does want it to happen.

So not only are erectile problems common, they're nothing for you or your special friend to be freaked out about. Check out the nine most common reasons that dudes sometimes can't get it up, and get ready to become the soothing voice of reason the next time the guy you're with has a hard time pitching his tent in your happy valley. Everything (and every penis) is gonna be fine!
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.
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The American Medical Association (AMA) estimates that more than 30 million men in the US experience ED. And they expect that number to double by 2025, largely due to the fact that erectile dysfunction is affecting more and more guys in their 20’s and 30’s. ED in your 20’s is becoming more common, and that can signal some serious health risks to a growing number of young men.

Having these factors work in tandem all at once is key. "So many things have to go right for you to achieve a strong erection, which is why the strength of a man's erection is a great indicator for their overall health," explains Reitano. "For starters, your hormones must be released on demand, your arteries need to carry blood to the penis with perfect efficiency, your nervous system must transmit its signals without a hitch, and your mind must be working in perfect harmony with your body. That is a lot to ask of your body on demand."
Men with a healthy lifestyle and no chronic disease had the lowest risk for erectile dysfunction; the greatest difference was seen for men aged 65-79. For instance, men who exercised at least three hours per week had a 30% lower risk for ED than those who exercised little. Obesity, smoking, and excessive TV watching were also associated with having a greater risk of erectile dysfunction.

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?


Remember that he is in his 40's, and that's a huge factor too. Around the age of 30, testosterone, androgen, and other hormone levels gradually begin to drop at about a rate of 1 percent. and as a direct result, by the time a man reaches 40, hormone drops cause loss of muscle mass and increased body fat. As a man reaches 45 these gradual hormone drops cause brain capacity and function to slowly regress. This, mixed with risks of genetic diseases like diabetes and high blood pressure, all take a toll on the body, especially the sex organs. Those who are physically active are at a huge advantage, as working out inhibits hormone levels, the neuromuscular system, and protein synthesis to maintain.
Erectile dysfunction is the inability to attain or maintain an erection adequate for the sexual satisfaction of both partners. At one time, doctors tended to blame ED on psychological problems or, with older men, on the normal aging process. Today, urologists say physical factors underlie perhaps 90% of cases of persistent erectile dysfunction in men older than 50. 

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