Erectile dysfunction is very common and becomes even more common in older men. An Australian survey shows that at least one in five men over the age of 40 years, increasing to about two in three men over the age of 70 years, often experience erectile problems, and about one in ten men are completely unable to have erections. With each decade of age, the chance of having erectile problems increases. Below are some of the common psycho-social causes
• Performance anxiety • Employment & financial pressures • Sexual attitudes and upbringing • Depression
• Relationship problems • Psychiatric disorders
The mechanism for poor erectile function is universally the same. Stress, excitement, anxiety, anticipation, foreboding all release a hormone caused adrenaline, this is our fight or flight hormone that triggers a cascade of physical responses. One of these responses induces constriction of blood vessels in the periphery of the body, the idea is that blood and oxygen is then directed towards vital organs to maintain their survival. As a consequence many tissues have a reduction in their blood supply, in terms of the penis, this means that a diminished blood supply results in a softer erection or erectile dysfunction. In this instance the treatment is to manage the issue causing stress and put in place a program that identifies and promotes behaviors that reduce stress induced hormone release. Medication may offer temporary relief whilst these changes are put in place.