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Keeping it up; 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 perform.

The number of men with erectile dysfunction has doubled in the past 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.

"My girlfriend would say, 'Don't worry, we'll try again later'. Yet to me that was the problem," says Chris Cooper, 33, of Essex. "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 Erectile dysfunction - defined as the inability to attain or maintain an erection for satisfactory sexual performance - can be triggered by a range of health conditions. However, 90 per cent of cases are still the result of a physical issue rather than a mental block,

No should suffer in - and you do with this 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. These are important for the wellbeing of your penis, which needs blood and oxygen for its own health," says Prof Kirby.

"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."

Stress, alcohol, smoking and drugs can also have an impact, as can anatomical irregularities such as a tight foreskin.

"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. 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 again lifestyle choices can have an impact.

"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, it can be treated with PDE5 inhibitors.

The psychological element is important because erectile dysfunction can play on the mind, no matter your age. "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 Prof Kirby. "Selective serotonin reuptake inhibitors 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 to get checked and have simple things such as their blood glucose, blood lipids and blood pressure assessed."

Driven to action As for Chris, he reached a point where his inability to maintain an erection drove him to action. "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 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.

"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 shops

No one should suffer in silence - and you really do suffer with this

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MENTAL BLOCK Many factors are at play
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Author:Michael Donlevy
Publication:Daily Record (Glasgow, Scotland)
Date:Feb 23, 2021
Words:842
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