Fighting to keep it? This is what it could say about your health

• 78 percent of men don’t know that erectile dysfunction is related to heart disease.
• Doctors blame stigma on men not seeing GP with erectile dysfunction

You may assume it’s simply because you (or your man) are getting older. Or you can blame the drink instead.

But struggling to maintain an erection can be a sign of something much more sinister, experts say.

Impotence, which is estimated to affect half of all men over the age of 40, can be caused by high blood pressure and diabetesaccording to the National Health Service.

Here, so-called erection experts explain the lesser-known medical causes…

cardiovascular disease

Although it’s usually due to stress, not being able to perform in the bedroom can be a warning sign of heart disease.

For a man to have an erection, the vessels that supply blood to his penis must dilate. As a result, more blood flows into the penis and it swells.

But heart and circulatory diseases can narrow the arteries that supply blood, meaning less can flow.

This then causes problems getting or keeping an erection.

Narrowing of the arteries, or atherosclerosis, can increase the risk of having a heart attack.

Because the arteries in the penis are so narrow, erectile dysfunction can be one of the first warning signs, says the British Heart Foundation.

Professor Albert Ferro, a specialist in cardiovascular clinical pharmacology at King’s College London, told MailOnline: ‘Erectile dysfunction can be caused by a multitude of factors.

What is impotence?

Erectile dysfunction, also known as impotence, is when a man is unable to get or maintain an erection.

It is most common in people over the age of 40, but it affects men of all ages.

The inability to stay upright is usually due to tiredness, stress, anxiety, or alcohol, and is not a cause for concern.

However, it may be a sign of an underlying medical condition, such as high blood pressure or cholesterol, medication side effects, or hormonal problems.

Lifestyle factors that can affect the condition include obesity, smoking, cycling too much, drinking too much, and stress.

Source: NHS Options

‘In recent years, it has been increasingly recognized that erectile dysfunction may be an early manifestation of cardiovascular disease.

“Rapid diagnosis of silent heart disease is important because it will allow preventative treatments to be started at an earlier stage, helping these people live longer, healthier lives.”

Three-quarters of men are unaware that straining to keep it up is a recognized sign of heart disease, according to a 2000 survey by The Urology Foundation.

Diabetes

Diabetes is usually only related to having high blood sugar levels and not making enough insulin.

But men with diabetes are three times more likely to have problems getting or keeping an erection, charities say.

And men with diabetes are thought to develop erectile dysfunction up to 10 to 15 years sooner than men without it, according to Diabetes UK.

Diabetics can have damaged blood vessels and nerves, making it difficult for them to stay that way.

Other diabetes-related factors that can make maintenance difficult include being overweight, smoking, and lack of exercise.

“Poor lifestyles, such as an unhealthy diet, lack of exercise, smoking, chronic stress and lack of sleep, can also cause erectile dysfunction,” said Amr Raheem, consultant andrologist at Andrology International London.

But experts say you shouldn’t just reach for a blue pill in the hope that it will solve your problems.

He added: ‘All of the above factors work by damaging the erectile tissue, nerves and blood vessels responsible for erection.

“That’s why it’s important to see your doctor if you develop erectile dysfunction rather than just taking Viagra. Your doctor will perform blood tests to rule out any underlying health problems.

hormonal imbalances

Low testosterone levels may also be to blame for performance problems, experts say.

Testosterone regulates sexual desire and blood flow in men.

If you don’t have enough, your libido can suffer, says EDclinics. He claims that it can also decrease blood flow, which is vital for maintaining an erection.

Low levels can also cause stress and weight gain, both of which can contribute to erectile dysfunction, according to the Cleveland Clinic.

Low levels can be caused by a multitude of factors, including excessive alcohol consumption, diabetes, aging, and obesity.

Testosterone replacement therapy (TRT) can help with erectile dysfunction in this case, but with side effects including oily skin, decreased sperm count, and sleep apnea, TRT isn’t for everyone.

“As a society, we need to end the stigma associated with erectile dysfunction and open up conversations,” says Rebecca Porta of The Urology Foundation.

He added: “Erectile dysfunction can have a huge impact on someone’s mental health, especially where it affects fertility and intimacy.”