Erectile dysfunction: the canary in your trousers

Erectile dysfunction (ED) – sometimes called impotence – affects 2 in 3 men over the age of 45 and becomes more common as you get older. 

By Stephanie Anderson for Citro partner Pilot

Erectile dysfunction, or ED for short, occurs when you have trouble getting an erection, trouble maintaining one, or are experiencing a reduced desire for sex. But what causes it?

Mayo Clinic reports: "Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction."

The Better Health Channel reports ​​the majority of Australian men aged over 45 have some form of erectile dysfunction, but it’s much less common if you’re healthy than if you have a chronic disease, are overweight, smoke cigarettes or don’t exercise.

That means ED is like a ‘canary in your trousers’ or a warning sign of other health problems like high cholesterol, high blood pressure, diabetes or even damaged arteries.

Physical mechanics of erectile dysfunction

In order for an erection to happen, there's a lot going on inside the body. First, your brain becomes aroused. When that happens, your brain sends a bunch of messages to your penis, telling the muscles to relax so that blood can flow freely into your penis.

Then, a fibrous membrane — the tunica albuginea — traps the blood, keeping you hard throughout the sexual activity.

So, there are two main ways ED can happen, either through lack of blood flow, or lack of arousal. Let's break it down.

Erectile dysfunction physical causes at a glance include:

• Heart diseas
• Clogged blood vessels (atherosclerosis)
• High cholesterol
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
• Parkinson's disease
• Multiple sclerosis
• Certain prescription medications
• Tobacco use
• Peyronie's disease — development of scar tissue inside the penis
• Alcoholism and other forms of substance abuse
• Sleep disorders
• Treatments for prostate cancer or enlarged prostate
• Surgeries or injuries that affect the pelvic area or spinal cord
• Low testosterone

These are some of the underlying conditions that could be affecting your ability to get or maintain an erection.

Because a healthy erection relies on healthy blood flow, any kind of disease that affects your heart, blood pressure and arteries can impact your ability to make it happen.

Lifestyle factors, like physical inactivity, obesity, smoking, and too much alcohol or illicit drugs can also affect your ability to get hard. Whiskey dick, right? It's real, unfortunately.

Some medications, like certain antidepressants, antiandrogens, tranquilisers, appetite suppressants, ulcer medications, and some blood pressure meds, can also cause or contribute to erectile dysfunction.

Psychological factors of erectile dysfunction at a glance:

• Stress in your romantic relationships or difficulty with your sexual partner/s
• Stress and anxiety in your day-to-day life
• Depression and other mental health conditions
• Performance anxiety is real, as are issues related to anxiety, depression and stress.

Masturbation and erectile dysfunction

Masturbation does not cause erectile dysfunction, but let's explain why some people might believe that it does.

After masturbating, you may not be able to get another erection for a little while. This is what's known as the male refractory period, which is not ED. Rather, it's simply the recovery time a man's body needs before he'll be able to get hard again after orgasm. It's completely normal, and the time needed will vary from person to person.

For some men, the refractory period will be as little as half an hour, while for others, it can last up to 24 hours. Generally speaking, age plays a factor here, with older men needing longer to recover.

While masturbation won't cause erectile dysfunction, if you masturbate shortly before you plan on having sex, your sexual performance may be affected.

Still, masturbation can actually be good for you, as it has many health benefits.

In fact, masturbating can promote relaxation and better sleep quality, release endorphins that promote feelings of physical and mental wellbeing, reduce stress and boost self-esteem and body image.

Can porn use contribute to erectile dysfunction?

So what about watching porn? While there's no hard evidence (sorry, we had to) that masturbation causes ED, masturbating to porn is a slightly different story.

Psychology Today reports that some studies have found that when you frequently masturbate to porn, it can lead to desensitisation to sexual and physical imagery.

Calling it a "detrimental feedback loop", they report that “it’s easy to overstimulate your brain". When this happens, it can "produce neurological changes... which can desensitise a person to actual sexual encounters with a partner".

One 2016 study found that since internet porn tube streaming sites launched, there's actually been a pretty steep rise in young men reporting issues with erectile dysfunction.

The idea is that these porn tube sites, which boast massive varieties of content, including images, videos, stories, live cams but also in diversity across subgenres, has had an impact on how we think about sex.

Frequent exposure to this much porn can change both what we're into and what we expect from sex IRL (that’s ‘in real life’), and that can lead to diminished libido or erectile dysfunction, reports another study.

Erectile dysfunction risk factors to understand

While masturbation doesn't cause erectile dysfunction, there are quite a few conditions and risk factors that make ED more likely.

One of the most common predictors of erectile dysfunction is age, according to the Cleveland Clinic, but it can happen to men of any age. Other risk factors, according to Medical News Today include:

• Diabetes
• Being overweight
• Heart disease
• Lower urinary tract symptoms (bladder, prostate, or urethra issues)
• Alcohol and cigarette use

As ED is more commonly caused by psychological factors in young men, risk factors can include depression, anxiety and chronic stress, also.

How to treat erectile dysfunction

The good news when it comes to erectile dysfunction is that in most cases, it can be treated. Depending on what's causing your ED, there are a number of lifestyle changes you can make, and if they don't work, there are medical treatment options. Read more about the 10 lifestyle swaps you can make to increase your longevity.

But first things first. Before we get into how to treat ED, let's talk about how to prevent it.

Preventing erectile dysfunction means a healthy lifestyle

Generally speaking, a healthy lifestyle will help prevent the occurrence of erectile dysfunction. Some quick tips:

• Get regular exercise, 30 minutes a day
• Don't smoke or use illicit substances
• Cut back on your drinking, or quit altogether
• Maintain a healthy weight
• Keep stress levels at bay with meditation and mindfulness, or other stress relief techniques
• Get enough sleep

If you think you have an underlying health condition that's affecting your ability to get or maintain erections, it's always best to seek medical advice from a doctor.

Now come the treatment options for erectile dysfunction

Depending on what's causing your ED, there are a number of different treatment options that may work for you.

If your ED is being caused by emotional factors, such as sexual performance anxiety, stress or depression, it may be best treated with cognitive behavioural therapy (CBT).

One study found that when men who were in relationships did CBT with their partners to improve communication, they ended up with fewer ED problems.

When ED is being caused by an underlying health condition, treating that will often be enough to get you back up and going again. A doctor will be able to rule out any disease or health conditions that need to be addressed.

^{The information on this page is general information and should not be used to diagnose or treat a health problem or disease. Do not use the information found on this page as a substitute for professional health care advice.} 

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