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Keeping it up; HEALTH The number of men with erectile dysfunction has increased. Michael Donlevy discovers simple lifestyle changes that can help make a difference.

Byline: Michael Donlevy

Sex is supposed to be the most natural thing in the world, but it doesn't feel that way when you're sitting on the end of the bed with your head in your hands because you can't get it up."

So says Chris Cooper, a "perfectly normal" (his words) 33-year-old from Essex who, like millions of men, has experienced erectile dysfunction.

In fact, the number of men suffering - often in silence - has doubled in the last 25 years, with 43 per cent of UK men between 18 and 60 having faced the problem. The issue is complicated by the fact it can be caused by both physical and psychological issues, with the former often triggering the latter.

"My girlfriend tried to be supportive and would say, 'Don't worry, we'll try again later'. Yet to me that was the problem," says Cooper. "You shouldn't have to try, and the word 'later' felt more of a threat than a promise.

"It put me under pressure to perform, which made things worse." Heart of the matter That pressure to perform is often the effect, rather than the cause.

Erectile dysfunction - defined as the inability to attain or maintain an erection for satisfactory sexual performance - can be triggered by a wide range of underlying health conditions. However, 90 per cent of cases are still the result of a physical issue rather than a mental block, according to the British Association of Urological Surgeons.

"The main causes are poor lifestyle habits: too many calories, not enough exercise, abdominal obesity, type 2 diabetes and cardiovascular disease," says Professor Mike Kirby, a urologist and trustee of the Sexual Advice Association. "Nearly three-quarters of men with type-2 diabetes will suffer from erectile dysfunction, but heart disease is the biggest issue."

It turns out that the penis is a barometer of cardiovascular health. "If you get narrowing of the penile artery you lose your night-time erections.

''

There effective including and "These are important for the wellbeing of your penis, which needs blood and oxygen for its own health," says Prof Kirby.

"The coronary artery needs a blockage of around 75 per cent to cause an occlusion, but the penile artery is much smaller so only needs a tiny percentage - and that's what stops blood flow to the penis," he adds.

"I worked on a study into men who had suffered heart attacks and 78 per cent of them had suffered from erectile problems, starting about five years before their heart attack."

Other lifestyle factors, including stress, alcohol, smoking and drugs, can have an impact, and in every case the course of treatment is simple. "A healthier lifestyle is key and sex is good for us," says Prof Kirby. "For older men, even two or three orgasms a week means they're likely to live longer."

are treatments, medication surgery

Other physical causes include hormone or anatomical irregularities such as a tight foreskin or curved penis.

"The good news is that there are lots of effective treatments, including various types of medication and surgery if necessary," says Prof Kirby.

One popular treatment is a PDE5 inhibitor, which helps to control blood flow by preventing the enzyme phosphodiesterase type 5 - found in the blood vessel walls - from working properly. Viagra is the best known of these inhibitors, and taken as required, but there are also daily treatments.

"These are good as you take one every morning and there's no need to plan, so there's no pressure on your partner to be in the mood," says Prof Kirby. All in the mind?

Not every lost erection is the result of a physical ailment. Psychological issues are more common in younger men, although even here lifestyle choices can be working against you.

"One failed experience, maybe due to drink or drugs, can snowball so you think, 'Will things work next time?' That's an important primitive reflex," says Prof Kirby - and one that goes all the way back to our prehistoric ancestors, who developed the fight-or-flight mechanism to cope with threats.

This mechanism causes your body to produce adrenaline and anything that produces this - whether it's threat of attack or performance anxiety - will kill your erection. Thankfully, this too can be treated with the help of PDE5 inhibitors.

The psychological element cannot be understated because erectile dysfunction can play on the mind, no matter how old you may be. "It can cause mental health problems: stress, anxiety or depression. Men lose confidence and withdraw, and that can cause problems for their partners, too," says Prof Kirby.

Erection problems can also be an issue for men already suffering with mental health problems.

"Antidepressants are a disaster for erections and ejaculation so it's important to get the right treatment," says Kirby. "Selective serotonin reuptake inhibitors (SSRIs) are particularly problematic."

" First stop for help should be your GP. "Men don't talk about it and many don't do anything about it," Prof Kirby adds. "They're missing the opportunity tolose confidence withdraw, that leads problems partners get checked and have simple things such as their blood glucose, blood lipids and blood pressure assessed. Doctors say a man suffering erectile dysfunction is a vascular patient until proven otherwise." Driven to action As for Cooper, he finally reached a point where his inability to maintain an erection drove him to action. "I made an excuse to go to the GP about a cough," he says. "Then I said, 'There is one other thing?' "The doctor asked about my lifestyle and I realised I wasn't as healthy as I had been. I felt under pressure at work so had been drinking a lot and eating a lot of takeaways on nights we weren't going out.

"I also discussed the fact that I had a tight foreskin. Although it wasn't enough to require surgery, a painful experience with a former girlfriend had been at the back of my mind. I started running again and my girlfriend bought some lubricant. The fact that she did it somehow made me feel better, like she was investing in me. The first time we used it was a massive breakthrough."

The key is that your GP can help, whether you're young or old, unhealthy or seemingly fit. "It's not something that I talked to my friends about at the time but I have opened up about it since and no one mocked me," says Cooper. "I'm glad I took action and don't want it to happen again. No one should suffer in silence - and you really do suffer with this."

? ?This feature is from the latest issue of Healthy for Men magazine, from hollandandbarrett.com and Holland & Barrett stores

'' There are effective treatments, including medication and surgery '' Men lose confidence and withdraw, and that leads to problems with partners
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Title Annotation:Features
Author:Michael Donlevy
Publication:The Mirror (London, England)
Date:Feb 23, 2021
Words:1123
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