Erections 101 – The Professor’s Prognosis

What is ED?

Erectile Dysfunction (ED), formerly called impotence, is the inability to achieve or to maintain an erection for sexual activity. An erection is a complex process involving psychological factors and disorders affecting the nerves, hormones and especially blood vessels that supply the muscles of the penis. Many men can experience more than one of these issues, such that trying to identify a single cause can be unrewarding and difficult.

Is it age-related?

Traditionally regarded as a condition of older men, we now realise that up to 40% of men under 40 suffer from ED problems at some time. Why? Well, younger men are under increased pressure to perform, often with unrealistic expectations promoted by TV, magazines, internet and social media. Younger men often expect peak performance all the time – even after a heavy night of partying, often associated with an excess of alcohol or recreational drugs.

Traditionally regarded as a condition of older men, we now realise that up to 40% of men under 40 suffer from ED problems at some time.  Why? Well, younger men are under increased pressure to perform, often with unrealistic expectations promoted by TV, magazines, internet and social media.

Professor Geoffrey Hackett

Is ED a sign of heart disease?

Decades of medical research has confirmed that ED is often the first presentation of heart disease and occurs 3-5 years before the heart condition would otherwise be diagnosed. This is the predominant case in men over 40 so if you’re experiencing ED, regardless of age, you should always see your GP to be on the safe side.

Is ED ever a psychological issue?

Yes. Psychological factors are suggested when erectile dysfunction happens intermittently or in certain situations. Maybe there’s improvement during holidays or times of reduced stress – or perhaps a worsening at times of stress or relationship difficulty. Being able to achieve a full erection that cannot be maintained until completion suggests psychological issues, especially if morning erections are preserved.

The morning erection

Morning erections are the body’s way of providing oxygen to preserve the muscle of the penis. Loss of night time or morning erections strongly suggests a significant medical issue or low levels of testosterone, especially if combined with a loss of sexual desire and erotic thoughts. These problems should be investigated by a healthcare professional, so don’t suffer in silence. See your GP.

What are the causes – and consequences – of ED, especially for younger men?

The causes of ED are varied. From cardiovascular, to psychological to medication-related problems. For example, taking body-building drugs or testosterone supplements – even a few months – can interfere with the body’s natural production of testosterone and be a cause of ED.

Smoking, obesity, excessive alcohol consumption, recreational drugs, pornography and vitamin deficiencies can also all be contributing factors to ED.

Unfortunately, for a lot of men, embarrassment often prevents them from seeking professional help.

Sometimes ED prevents men from even seeking relationships in the first place, and the longer the issue is ignored, the more difficult treatment becomes. The old adage of “use it or lose it” is certainly true. Certain internet dating sites and practices can increase the pressure in vulnerable men.

Sometimes ED prevents men from even seeking relationships in the first place, and the longer the issue is ignored, the more difficult treatment becomes. The old adage of “use it or lose it” is certainly true.

Professor Geoffrey Hackett

What about the effects of pornography?

Pornography can often become a substitute for sex in younger men. When it starts to consume several hours per day it, can get to the point of being labelled as “addiction”. Excessive masturbation to pornography results in a progressively stronger level of visual and physical stimulation being required to achieve a result. This can result in failed sexual relationships as a partner can rarely reach the higher visual and tactile expectations required.

How long do most men wait to see their GP?

Too long. Currently, men in the UK suffer ED for nearly 3 years before seeking medical help. After this period of time the physical, psychological and relationship issues are much more difficult to treat. So what are you waiting for? Go and see your GP ASAP.

Unfortunately, in my experience, men are very poor at seeking help from the medical profession in general. They often choose to seek help from non-professional websites, leading to misdiagnosis and medical treatments that are frequently counterfeit and potentially dangerous.

Persistent loss of morning and spontaneous erections should never just be dismissed as normal or put down to simple stress.

How do I know if it’s mild or severe ED?

Erections are usually considered a high priority for younger men, especially when developing new relationships or when looking to start a family. This means that for them “mild ED” can often be “catastrophic”. In contrast, older men in long standing relationships often tolerate “severe ED” for several years without seeking help, especially if their partner is less interested in sex.

It is the impact of the ED on the man and his relationship that is important, not whether it is seen as mild or severe. ED that becomes progressively more severe and persistent with time always suggests that the problem is associated with important medical conditions that require proper medical assessment. Again, your GP should be the one to check this out for you. And they can provide the solutions too, so there is good news on the horizon.

It is the impact of the ED on the man and his relationship that is important, not whether it is seen as mild or severe.

Check out Professor Hackett’s guide to treating ED.