Erectile dysfunction (ED) is something that most men dread – and one in four men say that they’d rather leave their partner than speak to their GP about the condition. If you’ve been experiencing ED, the first thing to remember is that you’re not alone. It’s a natural and normal part of ageing that affects 50% of men between the ages of 40 and 70.

Though ED can be difficult to cope with and may contribute to low self-esteem and depression, there are things that can be done to improve it.

Below, we’ll take a closer look at what erectile dysfunction is, what causes it, and how you can regain your confidence in the bedroom.

What is erectile dysfunction?

Erectile dysfunction (ED) refers to the inability to get or keep an erection that’s firm enough for sex – and you might also have a lower sex drive. ED not only affects a man physically by impacting his ability to have sex, but it also has many psychological effects too.

Many men will feel embarrassed about not being able to get an erection, which can affect their confidence and self-esteem. It can also affect romantic relationships as not only can sex become more difficult, but talking about the issue can be a challenge too. For these reasons, research has identified a strong link between ED and depression.

Why does erectile dysfunction affect more men later in life?

ED is very common in men aged 40-70, though it can affect men of all ages. 

Male sexual arousal is made up of a complex web of hormones, muscles, blood vessels, and brain activity. Emotions can play a key role too. So, there are a number of physical and psychological factors that can influence whether or not you’re able to get and keep an erection. Some physical or psychological factors alone can be the cause, while other times, it can be a combination of both.

The reason that ED is so common after the age of 40 is that many of the physical and physiological conditions that can cause it can often crop up later in life.

For example…

  • Diabetes. In the UK, Diabetes is most common in people between the ages of 40 and 64, and it’s a leading cause of ED. If uncontrolled, diabetes can affect a man’s sexual function. This is because it can damage blood vessels and the nervous system, which can limit blood flow to sexual organs and decrease penis sensitivity.

  • Heart disease or clogged blood vessels (atherosclerosis). If arteries become narrow and hardened or blood clots form, blood flow to the penis can become compromised. Without blood flow to the penis, an erection is impossible to achieve.

  • Certain medicines and treatments. For example, anti-depressants, beta-blockers, and antihistamines. It’s worth having a chat with your doctor about whether ED could be a side effect of any medication you’re taking. Certain medical treatments like radiation, or prostate cancer surgery can also cause ED.

  • Low testosterone. Testosterone (also known as the ‘male sex hormone’) is responsible for starting the erection process. It stimulates tissues in the penis to produce nitric oxide, which helps the penis relax so that it can fill with blood, and become erect. If testosterone levels are low, then achieving an erection can be difficult.

  • Multiple sclerosis, Parkinson’s disease, and stroke. These along with any other conditions that affect the nervous system can cause ED by damaging nerves needed to get an erection.

Other risk factors for ED include smoking, alcohol abuse, being overweight or obese, or injuries to the genital area that have damaged nerves or arteries.

ED can also be caused by mental health conditions such as stress, anxiety, and depression. Some men might also have trouble getting or keeping an erection if they are with a long-term partner and attraction has faded.

5 tips for regaining your confidence in the bedroom

ED can be incredibly debilitating both physically and mentally. While it’s considered to be a natural part of ageing, it’s important that you don’t struggle in silence if it’s affecting your quality of life.

With that said, here are a few tips that will hopefully help.

1. Have an open and honest conversation with your partner

If you’re feeling embarrassed about not being able to get or keep an erection, it’s only natural that you might not feel like speaking to your partner about it. However, often the idea of having that conversation will be worse than actually having it. If you’re with a partner that you love and trust, the more they can understand why your sex life has changed, the better – as they might be able to help.

This help could come in various forms. If you want to start making healthier lifestyle choices to improve your ED, perhaps you could focus on cooking healthy meals together or encouraging each other to exercise. Or if you’re feeling nervous about approaching a doctor, it might be helpful to talk it through with your partner first.

Sometimes relationship issues can also cause or contribute to ED, and having open and honest communication with your partner is often a helpful first step in resolving this. Bringing back date nights again, slowing things down in the bedroom, and spending longer having foreplay can also be helpful, to give you longer to get aroused.

2. Consider whether you could adjust your lifestyle

ED can often be improved by making some lifestyle changes, so it can be helpful to consider whether you’re really looking after yourself in the best way possible. We’ll cover some healthy lifestyle factors to consider below…

  • Maintaining a healthy weight. Studies show that ED is more common in overweight or obese men. But by making healthier food choices, getting regular exercise, and maintaining a healthy weight, getting a firm erection can become easier. Doing 40 minutes of aerobic exercise four times a week has been shown to improve ED.

  • Cutting down on alcohol, and drinking no more than 14 units per week. This is because alcohol interferes with the response in the brain that triggers the penis to fill with blood. It can also lower testosterone levels, and dampen sexual desire.

  • Stopping smoking. Smoking can damage blood vessels and cause poor blood supply to the penis. You can find help and advice on how to quit smoking on the NHS website.

  • Keeping an eye on your blood pressure, blood sugar, and cholesterol levels. The health of your blood vessels can have a significant impact on your sexual health, and will often influence whether you are able to get an erection or not. If you’re concerned about any of the levels mentioned, it’s worth making an appointment with your GP who will be able to check these out for you. Most pharmacies will also be able to check your blood pressure for you.

  • Taking steps to reduce stress levels. Stress in your personal and professional life can affect your ability to get an erection, so it’s important to consider the areas of your life where you could either remove stress altogether, or at least work on managing it. Our article, 7 tips for coping with stress and anxiety, has some ideas for how you could do this.

Making healthier lifestyle choices not only improves your health, but it can improve your overall sense of wellbeing too. We tend to feel happier in our own skin when we’re taking care of ourselves, and this can feed into how aroused and confident we feel in the bedroom.

It’s also worth considering whether there are additional things you could do to boost your confidence, such as treating yourself to some new clothes or upping your grooming routine. You might also find experimentation with male sex toys helpful.

3. Strengthen your pelvic floor

Many people assume that pelvic floor exercises are just helpful for women, but they can also help men to keep a firm erection. This is because the stronger your pelvic floor is, the better it will be at pressing on a key vein that keeps blood in the penis for longer.

Research suggests that pelvic floor exercises can be an effective way to resolve ED long-term. In this particular study, 40% of men who did regular pelvic floor exercises had regained normal erectile function, and 35.5% had improved function.

To get started with some daily pelvic floor (or kegel) exercises have a watch of the video below.

4. Make an appointment with your GP

Speaking to your GP about erection problems might be the last thing you want to do, but it can help to try and think about the outcome, rather than that (potentially awkward) chat itself.

While you might feel uncomfortable speaking to your GP, it’s important to remember that ED is very common, and that doctors are rarely phased by the issues that anyone – man or woman – presents them with. You can also request to speak to a male doctor if you’d prefer.

Your GP will be able to advise you on the best treatment option for your individual circumstances. For example, they might recommend that you take some tablets to improve blood flow to your penis.

The most common tablet that many of us will have heard about is Viagra – but there are also others too like Cialis or Sildenafil. These kinds of medications will usually be for short-term use, while you work on making any relevant lifestyle changes alongside.

However, it’s worth noting that ED tablets aren’t suitable for everyone. Some people can react with certain medications (those that contain nitrates); and they’re also not recommended for people who have a history of stroke or heart attack (or who are taking alpha-blockers). Your GP will be best placed to advise you on this.

You can also get ED tablets over the counter, but they should always come from a trusted source, such as Lloyds Pharmacy, who can ask you some questions about your medical history and verify your purchase.

Some GPs might also recommend that you use a vacuum pump, as these can be used as an alternative to medication. They encourage blood flow to the penis and tend to work for most men. Your GP will be able to advise you on where to get one, as they aren’t always available on the NHS.

5. Find out whether your testosterone levels are low, and explore ways to boost them

Testosterone alone won’t determine whether or not you can get a firm erection. But it does play a key part in the process because it stimulates tissues in the penis to produce nitric oxide. This helps the penis relax so that it can fill with blood and become erect.

If your testosterone levels are low, you might find it more difficult to get an erection. You might also find that your sex drive is lower. Other common symptoms of low testosterone include excessive sweating, fatigue, and difficulty with memory and concentration.

Your GP will be able to do a blood test to confirm whether your testosterone levels are low or not. Alternatively, you could pay to do a home test with Thriva if you prefer. They work with NHS doctors, data scientists, and clinicians to provide you with the most accurate and reliable information (usually within 48 hours). Or, you might find it useful to take this free and confidential low testosterone symptom test from the Centre for Men’s Health first.

Testosterone replacement therapy (TRT) is sometimes used to improve testosterone levels. Natural remedies, such as getting more vitamin D, improving the quality of your sleep, and eating magnesium-rich foods can help too. To find out more about low testosterone levels and how to improve them, you might like to have a read of our article, 9 ways to boost testosterone levels in men.

Final thoughts…

With erectile dysfunction affecting 50% of men between the ages of 40 and 70, it’s something that should be spoken about more. Though it can be embarrassing to deal with, very often ED can be resolved by speaking to your doctor and/or your partner, and making some positive changes to your lifestyle.

For further reading, head over to the men’s health section of our website.