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Erectile dysfunction (ED) is a common complaint that affects most men from time to time. The prevalence increases with age, and it’s estimated that around half of all men over the age of 50 have some form of ED. It’s defined as the inability to sustain an erection long enough for a satisfactory sexual experience. 

Although it’s not a natural consequence of ageing, it tends to be more common in older men because they are more likely to have health problems that cause or contribute to ED, such as cardiovascular disease or diabetes. There’s naturally a lot of discussion and awareness of the physical causes of ED because it’s vital to address underlying health problems.

However, this can lead to the psychological factors that cause ED to be overlooked. Many men are not aware that their mental state has a strong influence on their sexual performance. Mental health can be a significant factor for younger men who are experiencing ED, especially if they do not have any significant physical health problems.

Stress and anxiety are common underlying causes of ED, for example. This is because chronic stress elevates the levels of cortisol in the body, which can interfere with the messages between the brain and erectile tissues in the penis. This makes it more difficult to get aroused and to achieve an erection. 

Unfortunately, stress is becoming increasingly common in people under the age of 40, and it can become a vicious cycle that is difficult to break free from because it triggers further anxiety. Younger men may also be prone to performance anxiety, particularly if they are inexperienced or have had previous negative sexual experiences.

Performance anxiety can also be related to low self-esteem. Men may worry if their partner finds them attractive, or feel inadequate about their body shape or sexual abilities. This can lead to difficulties with relationships or finding partners, which can also cause depression and perpetuate the negative cycle of ED. 

Men who are high users of pornography may find it more difficult to perform with a real partner because they have unrealistic expectations of sex or sexual partners and struggle to become aroused in that situation. This may cause a man to feel guilty and ashamed, and withdraw further away from real relationships and towards unhealthy use of porn.  

Last year, Medical Life Sciences News reported that both the psychological causes and treatments for ED can be overlooked. Instead, doctors persist in looking for a physical cause and thus do not receive the most effective and appropriate treatment. 

Researchers from Leeds Trinity University and the University of Derby reviewed existing studies investigating the causes and treatment of ED. They concluded that there should be a more integrated approach between the biological and psychological components of ED when considering potential causes and treatments. 

Mark S. Allen, a health and psychology researcher at Leeds Trinity University, commented: “We wanted to bring together the major findings on the psychology of erectile dysfunction into a single framework and raise awareness about the psychological impact on individuals and their partners.”

He added: “It is important to remember that erectile dysfunction is a common problem affecting individuals of all ages. Bringing psychological treatments such as couples therapy into the treatment regime could really be beneficial in treating erectile dysfunction and improving the psychological states of affected individuals and their partners.”

The researchers also suggested that certain personality traits may increase the risk of ED. They identified men who scored higher for traits such as neuroticism and introversion as being more likely to develop ED than those who were more extroverted. 

However, they also found that men with neurotic traits also had a more unhealthy lifestyle, with a higher prevalence of smoking and a reduced level of physical activity compared to men who were more extroverted. 

Smoking and lack of exercise are both considered to be high-risk factors for ED because the blood vessels and cardiovascular system have to work harder to pump blood around the body. Therefore in some cases a change of lifestyle may help to improve sexual function.

Regular exercise, maintaining a healthy weight, drinking alcohol in moderation and quitting smoking can all contribute to a healthier mind as well as body, and so these factors should be addressed for all men with persistent ED.

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