Erectile dysfunction

52% of all men over the age of 40 experience erectile dysfunction.

Erectile dysfunction is the inability to obtain or maintain an erection during sex. This problem does not only include the complete lack or loss of erection but also a reduced ability. This may manifest itself as a weak erection, often combined with a short duration, which leads to the inability to complete intercourse. Problems of this kind often increase with age.

The problem is more common than you may think, perhaps due to the fact that it is generally perceived as shameful to talk about the condition. Today, studies show that approximately half of the world's male population over the age of 40 suffers from erectile dysfunction (Arizton, 2018; European Association of Urology).

Common causes

Psychological factors

Low sex drive, nervousness in a sexual situation, problems in a relationship, stress or depression affect our sexual desire which is a prerequisite for the ability to withhold a well-functioning erection.

It is common to become increasingly stressed during sex once a problem has been established. A common phenomenon is that the man takes on the role as spectator when having sex. This means that when he expects the erection to give way, begins to think about the problem and distances himself from the sexual situation whereupon the desire decreases and loses its power as an enhancer of the erection. And thus, a vicious circle begins.

Men with depression have approximately 40% higher risk of developing erectile dysfunction (The Journal of Sexual Medicine, 2018, Vol. 15, Edition 8).

Underlying diseases

A fully functioning nervous system and healthy blood circulation are required to get an erection. This means that ailments such as diabetes and cardiovascular diseases can affect the outcome. High blood sugar impairs both the functions of nerves and blood vessels throughout the body and high blood pressure and atherosclerosis impair the circulation of blood.

Approximately 60% of those who have had a heart attack or bypass surgery suffer from erection problems. 35 to 75% of all diabetic patients will experience erectile dysfunction and up to 40% of those with renal failure (Boston University School of Medicine, 2002).

Side effects of medication

Medication causes 25% of all cases of erection failure and blood pressure medication is the most common cause affecting this. Impaired sexual ability is also common in patients taking antidepressants and so-called beta-blockers.

Hormonal disorders

Hormonal disorders may lead to testosterone deficiency or disturbed thyroid function which affects sexual ability.

Prostate or bladder surgery

Genital procedures such as prostate or bladder surgery can damage nerves and thereby affect sexual ability.

Consequences of erection failure

Psychological effects

Erectile dysfunction affects our general well-being and quality of life. Stress or lowered self-esteem are common consequences. 63% of men with erectile dysfunction between the age of 51 and 60 were unsatisfied with the sex in their lives (European Association of Urology. European survey September 2020).

Depression not only leads to erectile dysfunction but can also become a consequence in an otherwise mentally stable person. With erectile dysfunction, the risk of depression increases by 192%. Men with erectile dysfunction are almost three times more likely to experience depression compared to sexually healthy men (The Journal of Sexual Medicine, 2018, Vol. 15, Edition 8).

Relationship problems

Erectile dysfunction has a direct impact on a man's life and relationship and is partial cause as to why one in five marriages end in divorce (Wespes et al., 2002).

For 20 to 25% of couples who cannot have children, the cause is sexual dysfunction where erectile dysfunction is one of the more common dysfunctions (Reproductive Partners Medical Group, 2020).

Medical illness

Men with erectile dysfunction are twice as likely to have heart attacks and strokes compared to sexually healthy men (American Heart Association, 2018).