Erectile dysfunction is the inability to maintain an erection to completion of intercourse.  Erectile dysfunction is not a normal part of aging.  It may, in fact, mean there is something else going on with your health.

Sexual dysfunction has often been seen as a byproduct of aging, but that outlook is changing as we define what aging really means.  There are people in their 80s who are sexually active and, conversely, there are people of all ages who have erectile dysfunction. Renowned researchers of human sexual response, Masters and Johnson, have stated that the ability to have sex well into old age essentially depends on not stopping. 

What's "average" for older men? 
Keeping in mind that everyone ages differently:

• Arousal may take longer
• Erection may be less full
• The time it takes to reach orgasm may increase
• Orgasms may be less intense
• Recovery (the time needed before another erection can be achieved) after orgasm may take longer

Bottom line, ED is not an inevitable consequence of aging.  In fact, medical professionals who study aging have found that many of the common changes we used to believe were unavoidable, including ED, have turned out to be the result of disease.        

What causes ED?
The process of erection is complex and involves the vascular system, the nervous system, the endocrine system and the individual's emotions.  (See Key Point #2 for more information.)  Medical experts estimate that 70 percent of ED cases can be traced to a physical cause and another 20 percent to stress, anxiety and depression.

Physical causes and risk factors
ED is related to basic health, meaning that if you have other health problems, your likelihood of having ED is greater.  Conditions that lead to reduced blood flow to the penis, inability of the penis to retain blood during erection and reduced ability of the nerves to send or receive the proper signals are the most common physical causes. 

Common conditions include:

• Cardiovascular disorders, such as high blood pressure, blocked arteries, and high cholesterol levels
• Diabetes
• Insulin resistance
• Use of some prescription drugs, such as certain blood pressure and cardiovascular medications, tranquilizers and antidepressants
• Hormone disorders, such as thyroid disease and hypogonadism
• Pelvic trauma, surgery, radiation therapy
• Neurological disease, including Parkinson's, Alzheimer's, and multiple sclerosis
• Spinal cord injuries
• Renal
• Enlarged prostate
• Disorders of the penis itself, such as Peyronie's disease

Lifestyle choices that lead to those physical disorders may affect erectile function as well, including.

• Excessive caffeine
• Cigarette smoking
• Alcohol and drug abuse
• Lack of exercise
• Obesity

Psychological causes and risk factors
Emotional and psychological issues – including almost any form of stress, worry and anxiety – can be causes of erectile dysfunction.  Though psychological causes of ED are a much smaller percentage of the total, they are equally important and very treatable. 

The consequence of ED

• Physical causes of ED can be early warning signs of more general and potentially dangerous conditions. 
• ED may diminish a man's willingness to be intimate and affectionate with his partner, damaging their relationship and hurting the person he most cares about.
• ED can affect more than your sex life.  It can create mental stress that affects your self-confidence and the way you approach the world.

No one needs to passively accept the loss of sexual function because they think it's normal.  With the help of your primary care physician or urologist, you can deal with the causes of ED with lifestyle changes, medical treatment for underlying disorders, ED-specific treatment and/or counseling.