Erectile Dysfunction Over 50
and Relationships



Erectile dysfunction (ED) is a major challenge.  Right!  That's like calling what you after surgery as "discomfort".  It is sort of accurate, but it just doesn't quite seem to fully describe the experience.  It attacks a set of habits, pleasures, and self-images that you have been working with for longer than most of us care to remember . . . and now it doesn't work? That's a tough row to hoe.

Well . . . what is is.  

It changes intimate relationships, at best, and has the power to destroy them at worst. For the sake of your own sake as well as your relationship with your partner, coming to terms with it in one way had better be your top priority. 


On top of that, it can be giving an early warning of developing underlying conditions that are affecting circulation. And that raises the chances that treatments will be effective. So, it definitely rates a trip to the doctor.

There are lots of things to do about ED.  Of course he topic itself may make taking action a bit difficult at times, but the stakes are high and once you get going, it gets easier.


Just what IS erectile dysfunction (ED), anyway?

  • In common usage it means that a guy can't get it up and/or keep it up hard enough and/or long enough to complete the intended sexual act.
  • It is not the same as impotence which refers to the ability to impregnate a female and also includes problems with sperm production, lack of sexual desire, etc.
  • Since erectile dysfunction, or ED, can be defined as a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections, estimating its incidence is difficult, but recent educated guesses range from 15 million to 30 million men in the US having the problem at any one time.

    According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for erectile dysfunction in 1985. By 1999, that rate had nearly tripled to 22.3. Most likely this wasn't because the problem was occurring more,but because more guys were telling their doctors about it. The increase happened gradually, presumably as treatments such as vacuum devices,injectable drugs, and oral medications became more widely available and discussing erectile function became accepted.

  • Still, no matter how you say it, no matter how many guys have it, no matter how many things you can do about it, it sucks. But, we can only play the cards in our hand, so let's get a better look at just what we're dealing with.



How does an erection happen when everything is working right?

The National Institutes of Health will tell you more than you want to know on this topic. I have put some of the high points from their description on this page. If knowing all the details is helpful to your process you can get their full description here.


The the penis is complex set of tubes, compartments, arteries, veins, and nerves.

The largest portion of it is made up of two chambers filled with spongy tissue, which run the length on each side. These are the spaces that fill up with blood causing the whole penis to get hard and stand up erect. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries.


The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the chambers of spongy tissue.

Erection begins with physical or mental stimulation, or both.

Impulses from the brain and local nerves cause the muscles of the two chambers of spongy tissue to relax, allowing blood to flow in and fill the spaces. The blood creates pressure, making the penis expand like a balloon. The chambers trap the blood within them, thereby holding the erection.

When the muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.


The system is a marvel (or accident waiting to happen, depending on how you look at it) of thoughts, feelings, muscles, nerves, and blood interacting in just the right way.

Bring another person into it and the complexity is mind boggling. That it works so well as often and as long as it does is probably more amazing than that it doesn't always work.


What causes Erectile Dysfunction?

While not within the relationship focus of this website, here are some things that have been mentioned in various places as potentially being involved in erectile dysfunction

  • age
    The older you are, the more likely you are to experience erectile dysfunction. The NIH reports that erectile dysfunction affects about 5% of 40 year old men and between 15% and 25% of 65 year old men, but it is not caused by aging per se.

    It can however be related to the same list of health/lifestyle choices that weigh on our health in general as we age: alcohol, cholesterol, blood pressure, weight, mood, healthy nutrition.

    Which results in a can't-lose situation since any improvement in any one of these areas affects your whole life positively as well your ability to get and keep an erection.

    Also,the older you are, the more likely ED is to be caused by something physical, so talk to your doctor. I've read estimates of up to 80% physical causes after 50.
  • diabetes
  • vascular problems ( blood, arteries, veins, etc.) In fact, recent studies seem to be showing that it can be an early signal of developing cardiovascular problems. Find more on erectile dysfunction as an early sign of other problems here.

  • physical damage to nerves -- surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED.
  • Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.
  • narrow, hard bicycle seats
  • prolonged alcohol use
  • some people say that large amount of marijuana or steroids can cause it
  • side effects of some prescription medicines including but not limited to those for blood pressure and depression.



Talk to your doctor.

  • Often there is another medicine that will do the job that does not cause this side effect in a particular patient. My understanding is that while they know it can happen, they can't tell in advance which medicine will do what to whom.
  • Make sure that they know that it is important to you. The older we are, the greater the chance that someone will assume that we don't care about sex anymore, especially if we are single.


So, give them a chance to do their job well. Tell them what is going on with you. This is a case where being a "good soldier" who doesn't complain is dumb.



What Can Be done About It?

Lots lots can be done about it, actually, and more all the time. Don't let yourself get into a hopeless mode. Talk to your doctor about it. If you feel like you can't talk to you doctor, it is important that you do something about that.

Anyway, right now the list includes

  • medicines, the brand names that most often come to mind are "Viagra" and "Cialis", though others are certain to come along.
  • herbal remedies: The news here is mixed, but generally not too encouraging.
  • psychotherapy
  • treating underlying medical conditions of which ED can be an early warning signal
  • changing ongoing prescriptions to minimize or eliminate ED as a side effect
  • lifestyle changes
  • adjustments in sexual interactions

    HINT: Did you know that the nerves that control erection are different from the nerves that that are involved in feeling and orgasm? Think creatively here.

    Earlier I suggested that you consider ED to be the inability to get and/or keep an erection that will do what you want it to do. That depends on what you want it to. Oh, the medical sorts will still define the system as dysfunctional, but after we leave their office we still have a life to live and get something out of.

    Mick Jagger had this one bang on when he said that you can't always get what you want, but if you try sometimes you can get what you need. Who knows? Maybe he was having a bout of erectile dysfunction at the time.


Is calling erectile dysfunction "relationship challenge" cruel, the understatement of the century, blind optimism, or just plain pragmatism?

Maybe it is a bit of all four, but what choice do you have?

While following up on all the medical and physical options is the place to start, it isn't the whole smart response, no matter what the result of the medical intervention.

The psychological and relational side of this situation can actually result in some very positive things happening. Coping with impotence calls for involvement of mind, body, and spirit in ways that can indeed make aspects of life and aging and relating better and more rewarding in ways that cannot be predicted before you start doing it. For a bit more on this topic CLICK HERE.

When you can't get it up, the list of assumptions and beliefs that come pouring into your head about being a man, being with a woman, sexual attractiveness, human frailty, and others that we didn't know we had can be pretty frightening.

This calls for a lot of informed, respectful, and direct talk between you and your partner if things aren't to take off in a bad direction.


Find a discussion of specific things that you can do to give yourself the best chance of positive results from talking about your ED here.


If you are the partner of a man with ED, find more on talking with him about ithere.


Professional Help for Erectile Dysfunction

For More InformationAmerican Urological Association (AUA)1000 Corporate BoulevardLinthicum, MD 21090Phone: 1–866–RING–AUA (746–4282) or 410–689–3700Fax: 410–689–3800Email: aua@auanet.orgInternet www.auanet.org
www.urologyhealth.org

AUA can refer you to a urologist in your area.


American Diabetes Association (ADA)Attn: National Call Center1701 North Beauregard StreetAlexandria, VA 22311Phone: 1–800–DIABETES (342–2383)Internet:www.diabetes.org

ADA can help you find a doctor who specializes in diabetes care in your area.


American Association of Sex Educators, Counselors, and Therapists (AASECT)P.O. Box 1960Ashland, VA 23005–1960Phone: 804–752–0026Fax: 804–752–0056Internet:www.aasect.org

Check the AASECT website to find a certified sexuality educator, counselor, or therapist in your area.


National Kidney and Urologic Diseases Information Clearinghouse3 Information WayBethesda, MD 20892–3580Phone: 1–800–891–5390Fax: 703–738–4929Email: nkudic@info.niddk.nih.govInternet:

www.kidney.niddk.nih.gov