Jason Jameson, M.D.
Men’s Health Chair, Sexual Medicine Society of North America (SMSNA)
While it may cause significant concern to men, it is natural for male sexual function to change with age. Often caused by stress, fatigue, or anxiety, men may notice variability in the firmness of their erections, the ease of obtaining an erection, and an increase in the refractory period, which is the time required after ejaculation before sexual function can resume.
When these changes occur infrequently, usually there is no clinical significance. However, once a man notices persistent changes in their sexual function, it is known as Erectile Dysfunction, or ED.
ED is common, affecting up to 50 percent of men over the age of 40. It is the inability to achieve and/or maintain an erection adequate for sexual penetration. There are numerous conditions associated with ED, including hypertension (and the medications to treat hypertension), diabetes, obesity, heart disease, high cholesterol, smoking, sleep apnea, testosterone deficiency, chronic opioid use, and depression.
A sign of things to come
ED may be the first disease many men experience, but it may be a marker of future health issues, especially cardiovascular disease. The link between ED and heart disease involves the inner lining of blood vessels called the endothelium, and also the smooth muscle of the vessels in the heart and in the penis.
Dysfunction of these tissues leads to a series of events resulting in a decrease in blood supply to the penis, and, research shows, the younger a man is when he develops ED, the more likely he is to suffer from heart disease in the future. Thus, it is vital for men experiencing ED to talk to their doctor and be evaluated. If an underlying medical condition is found, such as diabetes or heart disease, treatment will lower the risk of future complications and may resolve the ED.
Lifestyle changes, such as smoking cessation, weight loss, and exercise, can be as effective as medications used to treat ED. FDA-approved medications for ED include sildenafil, tadalafil, and vardenafil, which are all generic, and branded avanafil.
Most insurers do not cover medications for ED and prices can vary dramatically. There are pharmacy coupon online search engines that provide a cost-effective option for generic medications that are FDA-approved and manufactured in the United States, so shop around. But, most importantly, do not ignore your sexual health — a discussion with your doctor can literally save your life!
Jason Jameson, M.D., Men’s Health Chair, Sexual Medicine Society of North America (SMSNA), [email protected]