As recently as two decades ago, doctors tended to blame erectile dysfunction on psychological problems or, with older men, on the normal aging process. Today, the pendulum of medical opinion has swung away from both notions. While arousal takes longer as a man ages, chronic erectile dysfunction warrants medical attention. Moreover, the difficulty is often not psychological in origin. Today, urologists believe that physical factors underlie perhaps 90% of cases of persistent erectile dysfunction in men over age 50.
Erectile dysfunction in older men. Because erections primarily involve the blood vessels, it is not surprising that the most common causes in older men are conditions that block blood flow to the penis, such as atherosclerosis or diabetes. Another vascular cause may be a faulty vein, which lets blood drain too quickly from the penis. Other physical disorders, as well as hormonal imbalances and certain operations, may also result in erectile dysfunction.
The vascular processes that produce an erection are controlled by the nervous system, and certain prescription medications may have the side effect of interfering with necessary nerve signals. Among the possible culprits are a variety of stimulants, sedatives, diuretics, antihistamines, and agents to treat high blood pressure, cancer, or depression. In addition, alcohol, tobacco, and illegal drugs, such as marijuana, may contribute to the dysfunction.
Erectile dysfunction in younger men. With younger men, psychological problems are the likeliest reason for erectile dysfunction. Tension and anxiety may arise from poor communication with the sexual partner or a difference in sexual preferences. The sexual difficulties may also be linked to these factors:
- Feelings of inadequacy
- Personal sexual fears
- Rejection by parents or peers
- Sexual abuse in childhood
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