Erectile Dysfunction: When Is It a Cause for Concern?

One in three men experiences erection problems after the age of 40. Why is this and what types of treatments are available?
Erectile Dysfunction: When Is It a Cause for Concern?

Last update: 07 November, 2021

Erectile dysfunction in men is often a source of embarrassment and awkwardness for both them and their partners. It means that sexual intercourse tends to come to an end because the penis is no longer erect. Therefore, it becomes almost impossible to continue.

It’s difficult to know when erectile dysfunction is the result of a specific disorder without analyzing the sufferer’s sexual life in context and over time. As a matter of fact, almost one in three men experience erection problems after the age of 40. This rises to one in two after the age of 60. However, what are the most common causes? Furthermore, what can men do to achieve a satisfactory erection?

Man worried about trigger

An embarrassing problem

Due to its embarrassing nature, erectile dysfunction is a problem that’s often not talked about. Furthermore, it tends to be viewed as a lack of virility which often makes a man feel like a failure.

On the other hand, it’s sometimes thought that erectile dysfunction occurs due to problems in a couple. For example, the woman isn’t arousing the man enough or he simply isn’t that interested.

Why does it happen?

Erectile dysfunction can occur due to multiple causes. For example, fatigue, substance use, or low motivation to have sex at a specific time, among others.

However, if it occurs on multiple occasions and for a long time, we may be talking about an erectile dysfunction disorder.

Causes of erectile dysfunction

15 percent of men with high blood pressure have erectile dysfunction problems. However, only 25 percent of men worried about this problem see a doctor. Furthermore, 20 percent of erectile dysfunctions are psychological in origin and 80 percent are caused by a medical abnormality.

A small percentage of men who suffer from erectile dysfunction are treated correctly. Nevertheless, the vast majority of them don’t go to a doctor. This is usually either because they’re too embarrassed or they don’t know that there are any effective treatments available. Furthermore, older men tend to think that the appearance of this discomfort is just a normal part of aging.

Main causes

  • The first cause of erectile dysfunction is simply an unavoidable event like aging. With age, tissues lose their ability to contract. Consequently, they relax less easily and blood vessels have a harder time swelling and allowing blood to flow into the penis. The age of fifty is usually an important turning point.
  • Circulatory problems are one of the most common causes of erectile dysfunction. For example, diabetes causes poor blood circulation, particularly in the sexual organ. In addition, high blood pressure and kidney failure can cause poor blood circulation.
  • An excess of cholesterol will end up accumulating and forming deposits such as atheroma plaques on the walls of the vessels. Hence, their diameter is reduced and the blood is unable to circulate properly.
  • Hormonal problems can be the cause of erectile dysfunction. For example, if there are insufficient levels of testosterone, this can lead to erection problems, especially at the time of andropause, or the male menopause.
  • A psychological block. The more men seek adequate sexual performances, the more they forget to think of themselves as individuals. This can make erection difficult or impossible. As a matter of fact, stress plays a powerful inhibitory role here. It’s the archetype of the vicious cycle: it didn’t work last time, so they approach the next time with apprehension and, inevitably, it doesn’t work either, reinforcing their sense of failure. The only solution is to work on themselves in order to break this cycle.
  • Prostate operations usually involve the removal of a tumor or even the entire gland. Often, it’s difficult for surgeons to remove these entities without touching nerves. If the nerves are destroyed, a natural erection is no longer possible. Until a few years ago, when there was no surgery to treat prostate cancer, impotence was almost always an inescapable consequence. Now, fortunately, things have changed. In fact, doctors usually attempt to maintain at least one erector nerve as far as possible.


Erectile dysfunction can be minimal, episodic, or persist for months or even years if left untreated. It can be manifested by an inability to obtain an erection, an inability to penetrate the partner, difficulty in maintaining a rigid and stable erection during sexual intercourse, or even rapid interruption of the erection after having penetrated the partner, without being able to ejaculate.


For an isolated incident of erectile dysfunction in a man with no other sexual problems, the first thing they should do is try and stay calm. After all, men are human beings, not machines. They’re subject to certain psychological and physical processes that can, for example, make them feel unwell, unable to play sports, or have an erection.

Furthermore, the fact that erectile dysfunction has happened once doesn’t necessarily mean it has to again. In fact, men should only worry if it happens many times. Then, it could be due to something more widespread like an erectile dysfunction disorder.

Erectile dysfunction treatment

It’s essential to treat the medical cause first:

  • High blood pressure or diabetes can cause erectile dysfunction. There are drugs that induce erection such as Viagra, Cialis, or Levitra. These drugs will act as a crutch that allows the patient to function properly.
  • Injections into the penis: Intracavernous injections can be given. The penis is like a sponge and if this sponge is dry, the blood doesn’t circulate. The advantage of this method is the reduction of side effects. In fact, the only risk with injections is possibly priapism (prolonged erection). Initially, the doctor will perform the injections. Then, they teach the patient how to do them, using auto-injectors.

Psychological treatment

Although erectile dysfunction is predominantly associated with physical causes, such as circulatory problems, insufficient attention is paid to the psychological contributions of the problem. For example, when an erection occurs but is inhibited by psychological factors.

Sex is an extremely subjective experience, requiring both body and mind to work together. When this sweet spot is reached, it’s often possible to find the cure for erectile dysfunction.

In addition, it’s often forgotten that achieving and maintaining an erection requires a man to be psychologically committed. Indeed, he’s not simply a puppet of a mindless physical response.

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) is perhaps one of the most useful forms of therapy for treating erectile dysfunction. It’s especially useful in relation to performance anxiety, low self-esteem, and loss of sexual arousal.

CBT is a proactive and actionable therapy that aims to help change the way the patient thinks and behaves. It favors the idea that thoughts, feelings, and physical sensations are interrelated.

By following this method, the patient works to understand how specific triggers can evoke thoughts, feelings, sensations, and behaviors. As a result, they can take a more positive and realistic approach to sex in general and stop simply concentrating on getting an erection.

Sex and pleasure involve so much more than just intercourse. In fact, often, when men stop focusing solely on penetration, which is rarely what gives women pleasure anyway, sex becomes more open, they relax, and their erection returns naturally.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.