Erectile dysfunction can strike adult males at any age, although the incidence of ED is greater among older men. And the reasons for ED vary significantly from one age group to another.
Erectile dysfunction (ED) is far from rare. The Massachusetts Male Aging Study estimated that in the United States alone, around 50 million men experience ED at some point in their lives. Definitions of what constitutes ED vary somewhat, but a generally accepted definition is that ED is difficulty achieving or maintaining an erection. Men of any age may experience ED, though it is more common in older age groups. Furthermore, what causes ED in one age group may be different from what causes ED in another age group. This article will explore ED decade by decade, exploring the most common causes for each age group and the various treatment options.
Erectile dysfunction is less common among men in their 20s, but young men who experience it are not alone. Because young men are considered to be in their sexual prime, and are generally healthier, physical causes of ED common to older age groups like coronary artery disease rarely cause ED in younger men. More common causes for men in this age group include:
- Alcohol use
- Recreational drug use
Young men experiencing ED should see their doctor so that problems that could contribute to ED (like diabetes or heart disease) may be ruled out. If a physical problem is found, successfully treating it will often “cure” the ED. If no physical problems can be found, many doctors may recommend counseling for coping with stress and may prescribe drugs like Viagra to help “kick start” a man’s sexual functioning while he learns new coping skills.
Though men in their 30s may have developed more confidence in the bedroom, the 30s are often a stressful decade for men. Many men get married, buy a house, or have children, all while trying to succeed professionally. Stress and plain tiredness can cause ED in men in their 30s, though the probability of physical problems like diabetes, obesity, and early heart disease slightly increases in this age group too. Scheduling an exam with a physician is the first step to addressing ED for men in their 30s. If underlying health problems like diabetes or high cholesterol are discovered, they can be treated, and better overall health may help with ED. Doctors may prescribe ED drugs for men in their 30s, but they may also recommend counseling for men who are coping with overly busy, stress-filled lives.
Approximately 40 percent of men aged 40 to 50 report experiencing erectile dysfunction at least occasionally. Research studies have found that men in their 40s who experience erectile dysfunction have a higher risk of coronary artery disease than men who do not. It is very important for men in their 40s who experience ED to see their doctor to determine if heart disease is present. The risk of diabetes also increases after age 40, and this too has been linked with ED in men in this age group. Fortunately, treatments for high cholesterol and diabetes are available, and treating these conditions may be sufficient to take care of the ED as well. However, ED drugs are often prescribed to men in their 40s, and if they are, following usage instructions closely for best results and fewest side effects is critical.
The Brief Male Sexual Function Inventory, a questionnaire administered by doctors at the Mayo Clinic, determined that 2.4 percent of men in their 50s have erectile dysfunction. As men get older, the likelihood of ED predicting coronary artery disease is lower, and this is good news. However, after age 50, having an inactive lifestyle, being obese, or having underlying medical conditions like heart disease and diabetes are associated with higher incidence of ED. The Health Professionals Follow-up Study published in the Annals of Internal Medicine found that after age 50, the percentage of men who experienced their first problems with ED increased by 26 percent. Though men in their 50s are often prescribed drugs for ED, many so-called “modifiable health behaviors” like regular exercise, healthy diet, and not smoking are also associated with improvement of sexual functioning.
A man’s testosterone production starts dropping after age 30 or so, but many men don’t notice problems with sexual functioning until much later — often after age 60. A man in his 60s who experiences ED should discuss with his doctors some of the possible health problems that could be related to sexual function. If heart disease, high cholesterol, or high blood pressure are found, those problems should be treated to improve overall health. If these problems are not present, a physician may want to determine the patient’s testosterone levels. Normally testosterone levels in men range from 300 to 1,200 nanograms per deciliters of blood. That is a wide range of “normal,” but once testosterone levels drop to 200 nanograms per deciliter or less, doctors may consider supplementing testosterone to bring them back up to normal levels. ED drugs like Viagra, when used as directed, are still good options for many men in this age group.
By age 70, some 75 percent of men have experienced erectile dysfunction at some point in life. Men report decreasing sexual desire with increased age, and this phenomenon is well-documented. However, in men aged 70 to 80, more than half report that they are still sexually active. By age 70, factors like arthritis, depression, kidney disease, and alcohol abuse are also reported as contributing to unsatisfactory sexual performance. Additionally, as men age, drugs are not cleared as swiftly from the body, and so undesired drug interactions affect quality of life and sexual functioning. Under medical supervision, and taking into account other medical conditions, men in their 70s may benefit from prescription drugs for ED or from testosterone replacement therapy.
The 80s and Beyond
Though 51 percent of men in their 80s report erections firm enough for intercourse, many other factors affect sexual functioning after age 80. Many men in this age group have lost partners to death, and men without regular sex partners report lower sex drive, poorer sexual function, and less sexual satisfaction, according to a study by Brigham and Womens Hospital in Boston. Though some men over 80 can take ED drugs like Viagra, they are at higher risk of complications, particularly if they take nitroglycerin for angina. Any man over 80 who wants treatment for ED should consult with a cardiologist to ensure they are healthy enough for sexual activity and that ED drugs are safe for them to take.
Erectile dysfunction can happen at any age, and men who experience it should not feel isolated. Men in their 40s and 50s may find ED more distressing than younger or older men. These men generally do not consider themselves “old” and may be dealing with personal issues like
- Children growing up and leaving home
- Death or disability of their parents
- Divorce and remarriage
- Job stress
- Increased financial demands
The good news is that there are many ways to effectively deal with ED, from lifestyle changes to treating underlying health conditions to use of drugs specifically designed for ED. There have never been as many options available for treating ED as there are today, and researchers are constantly pursuing treatments that are even more effective and safe.
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