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.

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If you’re a guy over 40, there’s a fifty-fifty chance that you have a problem getting or keeping an erection. Now, I don’t mean the sort of erection you saw in American Pie! I mean an erection that’s firm enough and long-lasting enough for sexual satisfaction. Every guy has times when he just can’t manage an erection. Still, if you’re having trouble achieving a satisfying erection more than 50% of the time, you’ve got erectile dysfunction (ED).

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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.
Ask about transurethral pharmacotherapy. Your doctor may suggest you try this treatment, which involves placing a suppository into the urethra. The suppository contains alprostadil, which is then absorbed into the blood stream, relaxing blood vessels and improving blood flow into the penis. This treatment is thought to be less effective than the vacuum devices, or injection therapy.[16]

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There is no evidence that mild or even moderate alcohol consumption is bad for erectile function, says Ira Sharlip, MD, a urology professor at the University of California San Francisco School of Medicine. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions -- such as interfering with the normal balance of male sex hormone levels -- that can lead to ED.
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.
Like going bald, ED becomes more common as men age. According to the National Institutes of Health, about 5% of all 40-year-old men have ED and that number rises with age. Between 15% and 25% of 65-year-old men have ED. This is one of the reasons you see so many ED drug commercials during televised sporting events, Fox News programs, and other shows that typically attract men over 50 (just kidding, Fox).
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.

While physical anatomy and chemical reaction are both important for getting and keeping an erection, the brain is one of the most vital parts of this puzzle. "An erection is controlled by multiple areas of your brain, including the hypothalamus, limbic system and cerebral cortex," notes Axe. "Stimulatory messages are sent to your spinal erection centers and this facilitates an erection. When there's an issue with your brain's ability to send these important messages, it can increase the smooth muscle tone in your penis and prevent the relaxation that is necessary to get an erection."
"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. 
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’s important not to take a bout of psychological ED personally. Still, when confronting a suddenly soft penis in the moment, “It’s not you” can be hard to believe. For instance, Erin, 22, tried—really tried—to make sex with Drew* happen. The first time his erection died right before they were about to have sex, she improvised and gave him “really long” oral instead. But the lack of a boner was confusing. “That had never happened to me with a sexual partner, so I was like, ‘Okay, he’s just not into me,’” Erin recalls.

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