Senior Sex: How to Maintain or Improve Intimacy

Sex in the Senior Years

By Mark Stibich, PhD | Updated on August 13, 2023
Medically reviewed by Isaac O. Opole, MD, PhD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key takeaways:

‧ People in their 70s and 80s and beyond can continue to enjoy sex.

‧ Striving for optimal physical and mental health can allow one to continue to enjoy sex in older age.

‧ Issues you cannot resolve on your own should be brought to the attention of a qualified medical professional.

Many people in their 70s and 80s are not only sexually active, but satisfied with their senior sex lives.1 Though the frequency or ability to perform sexually may decline with age due to physiological changes, these don’t necessarily affect how a person experiences or enjoys sex.

Aging-related problems like erectile dysfunction (ED), vaginal dryness, or urinary incontinence can affect sex. But their impact can also be minimized by using medication, managing chronic conditions, seeking individual or couples counseling, and changing sexual practices.2

This article explores the sex lives of adults 65 and over and the problems that can interfere with sex as the body ages. It also discusses the various treatment options and ways to maintain—or even jumpstart—your senior sex life.

Sexual Activity in Older Adults

Studies suggest that men are almost twice as likely as women to still have sex or masturbate in their later years. A British study found close to 60% of men ages 70 to 80 and 31% of men ages 80 to 90 are still sexually active. In women, those figures drop to 34% and 14%, respectively.3

This lower rate of sexual activity in older women may be due to a lack of opportunity rather than a lack of desire. Research shows that older women are less likely to have partners (due in large part to the fact that they often outlive their partners). This is sometimes referred to as “the partner gap.”1

Sexual Health Problems in Older Men

It is common for men to experience sexual problems after age 40. Reasons include a natural decline in testosterone levels, heart disease, and prostate problems. The inability to achieve or sustain an erection or reach orgasm or ejaculation are common concerns.4

Erectile Dysfunction

Erectile dysfunction (ED), formerly known as impotence, is the inability to achieve or maintain an erection firm enough for sexual penetration and long enough to achieve orgasm.

While ED is more common in older men, aging itself does not cause the problem. ED is related to conditions, sometimes several at once, that directly or indirectly interfere with erections.

Risk factors include high blood pressure, diabetic nerve damage, smoking, obesity, Peyronie’s disease, depression, and even certain medications. An accurate diagnosis is needed to ensure the right treatment.5

ED drugs like Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are often the first-line treatments for ED. Lifestyle changes and counseling can also help. For some men, hormonal therapy, penis pumps, and penile implants may be recommended.
Is There a Female Viagra?

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a non-cancerous enlarged prostate and one of the most common health problems in older males.6 BPH can cause symptoms like difficulty urinating, frequent urination, or waking up in the middle of the night to urinate (nocturia).

On top of this, BPH can cause sexual problems like low libido (low sex drive) and delayed ejaculation (difficulty reaching orgasm).

Among the treatment options, testosterone therapy may help restore libido. There are also certain drugs used off-label that may help with delayed ejaculation, including cabergoline (originally marketed as Dostinex) and Wellbutrin (bupropion).7

Because some BPH medications can also cause sexual dysfunction, a change in the dose may help resolve these concerns.8

Sexual Health Problems in Older Women

More than a third of older women experience sexual problems. These are typically due to menopause, when estrogen levels steeply decline. Hormonal changes can lessen sexual desire and make it harder to become aroused.9

Sexual organs also change as a person gets older. A woman’s vagina will shorten and narrow. The vaginal walls become thinner and less flexible, tearing more easily. Vaginal lubrication decreases, making vaginal intercourse more painful.10

Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is diagnosed when an absence of sexual fantasies, thoughts, and desires causes personal distress. It is a problem that is common among many older women.

A medication known as Addyi (flibanserin) is used to treat HSDD in women. It is currently only approved for premenopausal women, but research shows that it can also improve libido in older women as well.11

Vaginal Dryness

Vaginal dryness is uncomfortable and can make sex painful. Over-the-counter (OTC) remedies that can help relieve irritation and itching from vaginal dryness include lubricants such as K-Y Jelly or vaginal suppositories like Replens.

If OTC remedies don’t help, your doctor may prescribe estrogen cream as well as estrogen-containing vaginal rings and vaginal suppositories.

There are also plant-based products, like black cohosh, that have estrogen-like effects. These should be used with caution in women who have had or are at risk of breast cancer.12

Pain With Sex

Painful intercourse is more likely in older women as vaginal tissue tends to thin and tear easily after menopause. Standard treatments for vaginal dryness can often help ease pain during sex.

If that is not effective, prescription drugs like Osphena (ospemifene) and Intrarosa (prasterone) can treat thinning vaginal tissues and help relieve moderate to severe vaginal dryness.12

Pelvic Organ Prolapse

The pelvic floor muscles and tissues hold the bladder, uterus, cervix, vagina, and rectum in place. Pelvic organ prolapse (POP) occurs when the pelvic floor weakens, causing the pelvic organs to drop and bulge (prolapse) in the vagina. This can cause pelvic pain and pressure, pain with sex, and urinary incontinence.13

POP is often treated with pelvic floor physical therapy to strengthen the supporting muscles. In some cases, surgery may be needed.14

Other Health Concerns

Chronic medical conditions become more common as a person ages. Many of these can interfere with an older person’s sex life.
Arthritis and Chronic Pain

Arthritis and other chronic pain conditions are common among older adults and can make sex very difficult. Depending on the cause, doctors may recommend physical therapy to strengthen muscles and improve flexibility.

Nonsteroidal anti-inflammatory drugs (NSAIDs), both over-the-counter and prescription, can be taken before sex to help ease the pain. Opioid drugs, while effective as a pain reliever, can cause a drop in testosterone and contribute to ED.15

If the pain only occurs in certain sexual positions, let your partner know and try different positions. Bolstering your bodies with pillows and cushions can also help.

Diabetes

In the United States, almost one-third of adults over 65 have diabetes. Approximately half of these are undiagnosed.16

Diabetes can cause sexual dysfunction in both men and women. This can be due to circulation problems, medication side effects, or nerve damage. Problems include:17

‧  Low libido
‧ Difficulty with arousal
‧ Erectile dysfunction
‧ Painful intercourse
‧ Reduced genital sensation
‧ Urinary tract infections
‧ Yeast infections

The best way to reduce the impact of diabetes is to gain control of your blood sugar. Speak with your doctor if you have difficulty managing your blood sugar, and be sure to mention any sexual health problems you may be having. It’s important for your doctor to know.

Heart Disease

Older age is the greatest risk factor for heart disease.18 Heart disease causes problems as arteries start to narrow and harden (referred to as atherosclerosis). This reduces blood flow throughout the body, including the pelvis and genitals, resulting in sexual dysfunction in both men and women.

Heart disease is one of the leading causes of erectile dysfunction in men. It can also cause women to have difficulty achieving orgasm due to the decreased blood flow to the genitals.

There is no one way to resolve these issues, but there is evidence that statin drugs used to reduce the risk of heart disease can improve erectile dysfunction in some men.19 Some studies suggest that similar approaches may improve sexual function in women with heart disease.20

People with heart disease may also be nervous about sex due to fear of a heart attack. While sexual activity is generally safe, talk to your health provider if you are concerned.21

Obesity

Today, more than 40% of adults over 65 meet the definition of obesity.22 Research shows that women who are obese are more likely to experience sexual dysfunction than non-obese women.23 In addition, obesity increases the odds of erectile dysfunction in men.20

These issues may be directly related to higher rates of diabetes among people who are obese as well as reduced blood circulation due to atherosclerosis.24

Weight loss, achieved with a healthy diet and routine exercise, is considered the best strategy to overcome obesity. It may also improve a person’s self-image and sense of well-being while making sex easier to navigate.

Urinary Incontinence

Urinary incontinence is the loss of bladder control. This becomes more common with age, especially in women.

Incontinence can be embarrassing and make sex awkward. Women who experience stress incontinence may be afraid to orgasm. Extra pressure on the abdomen during intercourse can also cause urinary leakage.

If you have incontinence, empty your bladder before sex. Changing sexual positions can help prevent urinary leakage by avoiding the compression of the bladder. Pelvic floor exercises can also help strengthen the muscles that aid with urine control.

Medications

Some medications used in older adults can cause sexual dysfunction in both men and women. These include:25

‧  Antidepressants
‧  Antihistamines
‧  Chemotherapy
‧  Diuretics (“water pills”)
‧  High blood pressure medicines
‧  Opioid painkillers

If you are having sexual difficulties, let your doctor know and advise them of any drugs you are taking, including over-the-counter, prescription, or recreational.

Lifestyle and Mental Health

Lifestyle and mental health issues can also contribute to sexual problems in older adults. These issues can be just as difficult—and sometimes even more difficult—to overcome than physical ones. If you are faced with any of these issues, there are things you can do to turn them around.
Alcohol

For some people, drinking a glass of wine helps them relax and get in the mood. However, too much alcohol can end up impairing sexual function. According to the National Institute on Drug Abuse, alcohol is the most-used drug among older adults, with 65% of people 65 and older reporting high-risk drinking.26

Alcohol can impair a man’s ability to get an erection, cause premature ejaculation, or delay orgasm.27 In women, too much alcohol can make it difficult to climax.2

Reducing the amount you drink can help, but if you are unable to control your alcohol use, speak to your doctor about treatment options.

Depression

In the United States, between 5% and 10% of adults over 65 are estimated to be depressed.28 This can lead to many health concerns, including sexual dysfunction.29

In people with depression, neurotransmitters—chemical messengers that send signals between the brain and body—are out of balance. This can affect sexual desire, arousal, and orgasm. Ironically, medications used to treat depression can have the same effects.

While the benefits of antidepressants often outweigh the risks, therapy and counseling may offer a reasonable option for those with mild depression.

Stress

Stress can be a contributing factor to sexual dysfunction. Financial worries and health concerns are just some of the common stresses affecting older adults.

To relieve stress (and the effect it has on your sex life), consider stress management techniques like mindful breathing, tai chi, yoga, and meditation. Research shows practicing mindfulness and meditation can ease the effects of stress and improve overall feelings of well-being.30 This alone may help improve sex.

In addition, seek professional assistance from financial advisors, health advocates, and social workers to help better deal with the other stresses in your life.

Relationship Issues

Lack of sexual intimacy is often related to relationship problems. If you are and your partner are not connecting emotionally, it can lessen your desire to be intimate.

On the flip side, studies show that older couples who engage in sexual intercourse with their partner are likely to share a closer relationship. Moreover, closeness to one’s partner has been shown to increase overall well-being.31

While this issue is not unique to older couples, many people find talking to a marriage counselor can help them work through relationship issues and rekindle sexual feelings and attraction.

Self-Image

With age can come weight gain and other body changes that may affect one’s sense of physical attractiveness. Self-consciousness can spill over into the bedroom and affect a person’s confidence during sex.

A 2019 study among older women found that those who were self-conscious about their bodies reported less sexual satisfaction. By contrast, those who had greater self-acceptance of their bodies irrespective of weight or aging-related changes had a more satisfying sex life.32

Self-acceptance is ultimately the key. Working with a therapist, either alone or as a couple, can help you discuss your feelings openly and find a way to embrace a more positive self-image.

How to Maintain a Healthy Sex Life

The benefits of maintaining your sex life as you age are physical and emotional. Being sexually active is associated with a lower risk of medical conditions and a longer life. It’s also associated with a greater sense of happiness and overall well-being.3

If your sex life has become stagnant and you’d like to rev it back up, here are a few things you can do.

Communicate

Good sex begins with good communication. Couples who have been together a long time often think they know what the other is thinking. But no one is a mind reader.

Talk to your partner about any concerns you have. You may feel as though your mate is no longer attracted to you because sex has become infrequent, when in fact they are experiencing a decline in sexual interest.

In addition, as sex organs change with age, what felt good before may no longer feel good or may even be painful. Be open with your partner about these changes.

Communicating about sex can be challenging at any age, however. If you and your partner struggle to talk about sex, consider seeing a sex therapist.

Redefine Sex

Sex, as you get older, may need to change. But different can still be good, if not better. With an empty nest and possibly retirement, there’s more time and privacy to explore.

Research shows older adults have a broader definition of sexual activity than younger adults.33 In other words, they better understand that there is more to sex than just intercourse. Foreplay on its own can be quite satisfying.

Be creative and willing to try new things.

Rethink Intimacy

Sex isn’t just physical. It’s an emotional expression of intimacy. As you grow older, sexual intimacy changes. What this means to you and your partner may need to be redefined.

Emotional intimacy can be expressed through non-sexual physical touch. Examples of non-sexual physical touch include:

‧  Back rubs
‧  Cuddling
‧  Holding hands
‧  Hugging
‧  Placing your hand on your partner’s shoulder or arm
‧  Playful nudges
‧  Sitting next to each other
‧  Touching feet under the table

Another non-sexual way to build emotional intimacy is spending quality time together. Things you can do:

‧  Go out on dates with other couples.
‧  Look through old photos and reminisce.
‧  Play cards, board games, or word games.
‧  Read aloud to each other.
‧  Play music together.
‧  Travel, explore new places.
‧  Visit with friends or family.

Just Do It

Instead of waiting for the desire to strike, experts recommend that older adults just go for it. This is because sex has physical and emotional benefits. Orgasms release oxytocin, a hormone that induces a state of calm and improves sleep.

Even if you’re not in the mood, having sex can set the stage for more sex in the future. This is especially true for women. Having sex regularly helps increase natural lubrication and vaginal elasticity. It may also improve erections in men.

Summary

Older age can lead to sexual problems in different ways. Age alone increases the risk of erectile dysfunction, delayed ejaculation, low libido, vaginal dryness, and pelvic organ prolapse. Medical conditions like arthritis, diabetes, heart disease, obesity, and incontinence can also directly or indirectly interfere with sex.

Lifestyle and emotional issues that can impair sexual function in all ages can become even more profound in adults 65 years and older. These include stress, depression, negative self-image, relationship problems, and alcohol abuse.

By working with a doctor or therapist, you can overcome many of these concerns and improve not only your quality of life but your sex life as well. Keeping open lines of communication and embracing change as a natural part of life can also help keep your sex life fresh as you approach your later years.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. University of Michigan Institute for Healthcare Policy and Innovation. Let’s talk about sex.

2. National Institute on Aging. Sexuality in later life.

3. Lee DM, Nazroo J, O’Connor DB, Blake M, Pendleton N. Sexual health and well-being among older men and women in England: findings from the English longitudinal study of ageing. Arch Sex Behav. 2015;45(1):133-144. doi:10.1007/s10508-014-0465-1

4. Shigehara K, Kato Y, Iijima M, et al. Risk factors affecting decreased libido among middle-aged to elderly men; Nocturnal voiding is an independent risk factor of decreased libido. Sex Med. 2021 Oct;9(5):100426. doi:10.1016/j.esxm.2021.100426

5. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of erectile dysfunction.

6. National Institute on Aging. Prostate problems.

7. Abdel-Hamid IA, Elsaied MA, Mostafa T. The drug treatment of delayed ejaculation. Transl Androl Urol. 2016;5(4):576-591. doi:10.21037/tau.2016.05.05

8. National Cancer Institute. Understanding prostate changes: a health guide for men.

9. Harvard Health Publishing. Yes, you can have better sex in midlife and in the years beyond.

10. Szymański J, Słabuszewska-Jóźwiak A, Jakiel G. Vaginal aging—What we know and what we do not know. Int J Environ Res Public Health. 2021 May;18(9):4935. doi:10.3390/ijerph18094935

11. Portman DJ, Brown L, Yuan J, Kissling R, Kingsberg SA. Flibanserin in postmenopausal women with hypoactive sexual desire disorder: Results of the PLUMERIA study. J Sex Med. 2017;14(6):834-842. doi:10.1016/j.jsxm.2017.03.258

12. Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018;10:387-395. doi:10.2147/IJWH.S158913

13. Department of Health and Human Services: Office on Women’s Health. Pelvic organ prolapse.

14. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev. 2017;5(4):470-485. doi:10.1016/j.sxmr.2017.07.001

15. Marudhai S, Patel M, Valaiyaduppu Subas S, et al. Long-term opioids linked to hypogonadism and the role of testosterone supplementation therapy. Cureus. 2020;12(10):e10813. doi:10.7759/cureus.10813

16. Kalvani RR, Golden SH, Cefalu WT. Diabetes and aging: unique considerations and goals of care. Diabetes Care. 2017 Apr;40(4):440–3. doi:10.2337/dci17-0005

17. American Diabetes Association. Sex and diabetes.

18. Steenman M, Lande G. Cardiac aging and heart disease in humans. Biophys Rev. 2017 Apr;9(2):131–7. doi:10.1007/s12551-017-0255-9

19. Kosti JB, Dobrzynski JM. Statins and erectile dysfunction. World J Mens Health. 2019 Jan;37(1):1–3. doi:10.5534/wjmh.180015

20. Nascimento ER, Maia ACO, Pereira V, Soares-Filho G, Nardi AE, Silva AC. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics (Sao Paulo). 2013 Nov;68(11):1462–8. doi:10.6061/clinics/2013(11)13

21. Penn Medicine. Sex and your heart: What to know about intimacy and heart disease.

22. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief. 2020;360.

23. Mozafari M, Khajavikhan J, Jaafarpour M, et al. Association of body weight and female sexual dysfunction: a case control study. Iran Red Crescent Med J. 2015;17(1):e24685. doi:10.5812/ircmj.24685

24. Ho JH, Adam S, Azmi S, et al. Male sexual dysfunction in obesity: the role of sex hormones and small fibre neuropathy. PLoS One. 2019;14(9):e0221992. doi:10.1371/journal.pone.0221992

25. Conaglen H, Conaglen J. Drug-induced sexual dysfunction in men and women. Aust Prescr. 2013;36(1):42-45. doi:10.18773/austprescr.2013.021

26. National Institute on Drug Abuse. Substance use in older adults DrugFacts.

27. Prabhakaran DK, Nisha A, Varghese PJ. Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: a cross-sectional study. Indian J Psychiatry. 2018;60(1):71-77. doi:10.4103/psychiatry.IndianJPsychiatry_42_17

28. Cheruvu VK, Chiyaka ET. Prevalence of depressive symptoms among older adults who reported medical cost as a barrier to seeking health care: findings from a nationally representative sample. BMC Geriatr. 2019;19(1):192. doi:10.1186/s12877-019-1203-2

29. National Institute of Aging. Depression and older adults.

30. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68. doi:10.1001/jamainternmed.2013.13018

31. Smith L, Yang L, Veronese N, Soysal P, Stubbs B, Jackson SE. Sexual activity is associated with greater enjoyment of life in older adults. Sex Med. 2019 Mar;7(1):11–8. doi:10.1016/j.esxm.2018.11.001

32. Gillen MM, Markey CH. A review of research linking body image and sexual well-being. Body Image. 2019;31:294-301. doi:10.1016/j.bodyim.2018.12.004

33. Hinchliff S, Tetley J, Lee D, Nazroo J. Older adults’ experiences of sexual difficulties: Qualitative findings from the English longitudinal study on ageing (ELSA). J Sex Res. 2018;55(2):152-163. doi:10.1080/00224499.2016.1269308

 

 

 

 

 

 

The Male Sex Drive — How it Changes With Age

Published on July 24, 2023 .
Kristopher Bunting, MD  Author

This article is a repost which originally appeared on healthnews

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

For many men, having a strong sex drive—or libido—can be an important part of feeling healthy and having a good quality of life.

Key takeaways:

‧ Male sex drive and testosterone levels decrease with age.

‧ Less sex does not mean less sexual satisfaction.

‧ Good health improves sexual function and sexual quality of life at any age.

‧ Aerobic exercise can improve sexual function and sexual satisfaction.

However, as men age and their bodies change, so does their sex drive. Sex drive tends to decrease with age after it peaks in men in their 20s, but that does not mean that aging has to have a negative effect on sex.

Age, sex drive, and sexual satisfaction

Most men (and women) are more sexually active in their 20s than in any other decade of life. Men’s sex drives seem to peak in their 20s and begin to decrease in their 30s and onward slowly. Men in their 40s and older are also more likely to have problems with sexual function, including erectile dysfunction.

Men have less sex as they get older, but that is only half the story. Sexual satisfaction does not necessarily decrease with age.

A study in Norway found that although sexual activity decreases with age and sexual dysfunction increases with age, sexual satisfaction is more complex. According to the study, men in their 20s had the highest level of sexual satisfaction, followed by men in their 50s. Surprisingly, despite increased sexual dysfunction and decreased sex drive, men in their 50s reported higher sexual satisfaction than those in their 30s and 40s.

Another study from the US found that overall, sexual quality of life tended to decrease with age but was higher in older people who had a better quality of sex. The authors attributed this to “sexual wisdom”—better sex through past experience. No matter the cause, this is certainly good news for anyone worried about their odds of having a fulfilling sex life as they age.

Testosterone and sex drive

Testosterone levels play a major role in the male sex drive. Testosterone is the primary sex hormone responsible for male sexual development and is also associated with sex drive. Research has shown that men’s testosterone levels decline with age beginning after age 30, and reach their lowest levels after age 70—when sex drive is at its lowest.

Low testosterone in men is called male hypogonadism. Hypogonadism in men can cause or contribute to lower sex drive, erectile dysfunction, infertility, loss of bone mass, loss of muscle mass, and depression.

Testosterone replacement therapy can treat male hypogonadism, and research shows that in older men, it can improve sexual activity, sexual desire, and erectile dysfunction. In a study of men with poorly controlled type 2 diabetes, testosterone replacement therapy was shown to improve not only sexual function but also the quality of life and memory.

While considered a normal part of aging, low testosterone can be caused by various medical conditions, including head injuries and some medications. Certain prescription medications can decrease testosterone levels, including opioids (painkillers), hormone therapy for prostate cancer, and a few other drugs.

Remember, do not stop taking any medication without first talking with your healthcare provider. If you are concerned about your testosterone levels, discuss it with your doctor or another healthcare provider.

Better health means better sex

As men age, health plays an increasingly important role in their sex life. According to research, people in better health are more interested in sex, have sex more often, and have a better sexual quality of life. On the other hand, high blood pressure, heart disease, and other conditions that affect blood flow can affect sex drive and contribute to male sexual dysfunction.

Medications can also affect sex drive and sexual performance in men, including some prescription medications for high blood pressure, depression, prostate disease, and hair loss. Common medications that contribute to low sex drive and sexual dysfunction are beta-blockers, diuretics, and finasteride (Propecia, Proscar). Always discuss possible medication side effects with your healthcare provider—the benefits may outweigh the drawbacks.

Erectile dysfunction

Along with a decreased sex drive, aging, poor health, and certain medications can also lead to erectile dysfunction—a known contributor to depression. Fortunately, modern medicine has dedicated a great deal of research to improving men’s erections.

Nowadays, there are several ways to successfully improve erectile dysfunction, including penile implants and medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxn). While these medications are safe for many men, they can cause dangerous side effects in people taking nitrates (such as nitroglycerin, isosorbide, and others).

However, it is possible to improve erectile function with natural means such as CBD oils. The latter is one of the best ways to reduce anxiety and stress interfering with libido. CBD oils and gummies improve blood flow in vessels, thus benefiting erectile function. Full-spectrum CBD oils are believed to be a better choice for erectile dysfunction containing both CBD and THC in moderate amounts.

Exercise can improve sex

It is no secret that aerobic exercise is good for your health. It helps reduce cholesterol, blood pressure, and body fat in addition to decreasing the risk of death from coronary artery disease. Studies also show that aerobic exercise is also important for sexual health.

A study in Japan found that regular aerobic exercise improved sexual function in men aged 43-59. Another group of researchers in the U.S. showed that aerobic exercise—running, cycling, or swimming—improved sexual function in men aged 18-50. The potential for better sex life is excellent motivation to get more exercise,

When do men stop being sexually active?

If you think that people stop being sexually active when they get older, you would be wrong. Research shows that men have a sexual life expectancy well into their 70s. While it is true that sexual activity decreases with age, even the elderly are busy getting busy.

In fact, the 55 and older population has had a significant increase in sexually transmitted diseases (STDs) over the past few decades, including chlamydia, gonorrhea, syphilis, and HIV. While an increase in STDs may be alarming, it clearly indicates that both men and women keep having sex well into old age.

As men age, they tend to have less sex but have high satisfaction with their sex life. Aging and health can have significant effects on sexual function and satisfaction, but medical treatment and exercise can improve both sexual function and sexual satisfaction at any age. If you are concerned about decreased sex drive or sexual dysfunction, talk with your healthcare provider.

Resources:

1. BJU International. Assessment of male sexual function by the Brief Sexual Function Inventory.
2. NIH. Sexual Quality of Life and Aging: A Prospective Study of a Nationally Representative Sample.
3. StatPearls. Physiology, Testosterone.
4. Endocrine Reviews. The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications.
5. Mayo Clinic. Male hypogonadism.
6. The Journal of Clinical Endocrinology & Metabolism. Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels.
7. ENDOCRINE SOCIETY. Testosterone improves quality of life, sexual function, and delayed verbal recall in men with uncontrolled type 2 diabetes.
8. ISSM. Can prescription medications affect testosterone levels?
9. thebmj. Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing.
10. NHS. Low sex drive (loss of libido).
11. Mayo Clinic. High blood pressure and sex: Overcome the challenges.
12. MedlinePlus. Finasteride.
13. NIH. Sexuality in Ageing Male: Review of Pathophysiology and Treatment Strategies for Various Male Sexual Dysfunctions.
14. NIH. Increased incidence of depressive symptoms in men with erectile dysfunction.
15. NIH. Health benefits of aerobic exercise.
16. NIH. Regular aerobic exercise improves sexual function assessed by the Aging Males’ Symptoms questionnaire in adult men.
17. NIH. Exercise Improves Self-Reported Sexual Function Among Physically Active Adults.
18. EmergencyMedicineNews. STI Rate Has Doubled Among Senior Citizens.

Erectile Dysfunction: Signs & Ways To Eliminate Its Risk

How To Detect The Early Signs Of Erectile Dysfunction & Eliminate The Risk Once And For All

Updated on May 04, 2021, 18:00 IST · 4 min read

By Snehal Sharma

This article is a repost which originally appeared on MENSXP

Edited for content.

It’s not easy to talk about sex, especially if you’re grappling with insecurities.

For the longest time, erectile dysfunction was ascribed to psychological origins. Most ancient cultures, including Ayurveda, believed that ED can be treated with the help of natural herbs such as Indian ginseng, sesame powder, Safed Musli and more.

Today, we know more about its causes and have treatments to address the issue. But before we talk about eliminating the condition, we need to dispel the stigma associated with ED.

Studies have clarified that ED is not just “in your head”. According to a 2017 study by the Department of Urology Tulane University School of Medicine, New Orleans, 20% of men across all age groups battle ED in India and 30% of them are younger than 40.

Most of the times, it is experienced due to an underlying cause that can be treated.

But no cure is possible until men accept the problem and stop shying away from asking for help.

What Is Erectile Dysfunction?

Erectile Dysfunction (ED), also known as impotence, is a condition in which a man experiences difficulty in getting or maintaining an erection during sexual performance.

The symptoms may also include reduced sexual desire or libido. If the condition lasts for more than a few weeks or months, your doctor is likely to diagnose you with ED.

Signs Of Erectile Dysfunction

Every piece of the body—including your emotions, hormones, brain, nerves, muscles and blood vessels—plays an intricate role in male arousal. When any of these isn’t aligned, it results in some kind of dysfunction.

Your mental health impacts your sexual ability equally. Stress, anxiety and other mental health concerns can worsen erectile dysfunction.

Experiencing minor or occasional sexual problems don’t necessarily mean you’re dealing with erectile dysfunction. But lookout for the consistency of these symptoms.

● Reduced or no desire for sex.

● Inability to get an erection.

● Inability to maintain an erection.

Who Is At The Risk?

The risk of ED increases as you age, especially if you have lived a sedentary lifestyle. It can worsen if you:

● Have a psychological condition like anxiety, depression or stress.

● Have an injury that might damage the nerves and arteries that contribute to erections.

● Use tobacco, drugs or alcohol.

● Are overweight.

● Are undergoing radiation treatment for cancer.

● Are taking antidepressants or high blood pressure medications.

● Have heart disease or diabetes.

How To Prevent Erectile Dysfunction

The healthier you are, the easier it’ll be to fight erectile dysfunction. There’s no one-size-fits-all way to prevent ED but you can avoid persistent problems by taking care of its causes and yourself. The following measures may help:

● Reduce stress.

● Take care of your mental health.

● Exercise daily.

● Limit alcohol consumption.

● Quit smoking and stop using recreational drugs.

● Manage diabetes and heart disease.

How Can You Treat Erectile Dysfunction

The causes of ED vary and so does the treatment. Work with your doctor to create a plan that’s best for you.

1. Counselling

If you feel anxious, depressed or have any other mental health concern, seek therapy. Along with consulting a professional, indulge in relaxing activities such as music, painting, poetry or aromatherapy. Geranium oil helps those with low libido.

2. Ayurveda to the rescue

It’s not feasible for everyone to collect and consume the recommended herbs for sexual wellness. But you can always rely on natural supplements that provide men with the right nutrients optimised for better and stronger erections.

3. Lifestyle changes

Manage weight, exercise or do yoga consistently, stop smoking, avoid alcohol and illicit drugs and manage your health with the help of a doctor.

4. Prescribed medication

If the above treatments don’t work, your doctor may prescribe oral medications—like Viagra, Levitra, Aronix, Tadalafil, Stendra and Cialis, self-injection such as an Alprostadil or testosterone replacement.

5. Physical treatments

Penis pump or penile implants. However, these aren’t generally considered until every other treatment has failed.

Final Thoughts

Recognise the symptoms and consult a professional. If you’re diagnosed with erectile dysfunction, your doctor will help you figure out the cause of ED.

Work on the treatment options and before you know it, you’ll start seeing the results.

Vaseline in Place of Viagra: Is It Safe and Effective?

Can You Use Vaseline in Place of Viagra?

Medically reviewed by Matt Coward, MD, FACS — Written by James Roland on March 17, 2021

This article is a repost which originally appeared on Healthline

Edited for content.

If you experience erectile dysfunction (ED), you may be willing to try just about anything to restore healthy sexual function.

However, there are plenty of potentially dangerous options that people have tried, including the injection of Vaseline or other petroleum jelly products into the penis.

For many years and in many cultures, the practice of injecting or inserting something into the penis to make it larger or to improve sexual stamina has been done, often without the guidance of medical experts.

If you’re tempted to use Vaseline in place of Viagra or any other approved treatment for ED, don’t waste your time or take the risk. There are plenty of safer and more effective options available.

You may also have heard of topical gels or essential oils for ED, but there has yet to be any evidence to suggest that applying Vaseline as a topical treatment to your penis will have any effect on sexual function.

The science

Numerous studies have shown that injecting Vaseline into your penis is a danger, rather than a cure. The practice can lead to:

  • infections
  • serious skin and tissue injury
  • other medical complications

In a small 2008 study of 16 people who were treated for Vaseline injections, researchers found that “urgent surgery” was necessary to prevent further injury.

A 2012 case report concluded that Vaseline injections are usually done without medical supervision and can lead to severe complications if the petroleum jelly or other foreign objects aren’t removed promptly.

Clinical treatments

Instead of trying risky self-help solutions for ED, consider proven medications and other treatments that have a track record of success.

Oral medications

While Viagra, known clinically as sildenafil, may be the best known ED pills, there are other FDA-approved medications. They all vary somewhat in their:

  • potency
  • how quickly they take effect
  • duration of effectiveness
  • side effects

Other ED medications on the market include:

  • Tadalafil (Cialis). It’s available in a generic form and can be taken daily at low doses or as needed in higher doses.
  • Vardenafil (Levitra). It’s available in brand-name and generic versions. it tends to remain effective a little longer than sildenafil.
  • Avanafil (Stendra). It’s not yet available in generic form, Stendra is unique among ED medications in that it can become effective in about 15 minutes, while others take between 30 and 60 minutes to take effect.

Your lifestyle may help determine the best ED medication for you.

Vacuum pumps

This treatment involves the use of a tube that fits over your penis and attaches to a pump that withdraws air from the tube to create a vacuum.

The vacuum created around your penis helps draw blood to fill the blood vessels within and produce an erection. An elastic ring is also placed around the base of your penis to help maintain the erection.

A 2013 research review noted that the use of vacuum devices to treat ED is usually safe and effective, particularly when combined with ED drugs known as PDE-5 inhibitors, which include:

  • tadalafil
  • sildenafil
  • other standard medications

Penile injections

Certain medications can be injected into your penis to increase blood flow and create a firmer erection for intercourse. Those include:

  • papaverine
  • phentolamine
  • prostaglandin E1 (PGE1) or alprostadil (Caverject, Edex)

There are also combinations of the above medications available.

Penile implants

Some people choose to treat ED with surgically-implanted, flexible, or inflatable rods that you can activate on demand.

Penile implants are generally reserved for individuals who have not had success with other traditional ED treatments.

Alternative treatments

Many safer and more effective alternatives to Viagra are available, including several prescription medications and over-the-counter (OTC) supplements, as well as complementary therapies, such as acupuncture, according to a 2016 research review.

Some people have had success using herbal supplements to treat ED. Some OTC products that have been supported by research include:

  • Korean red ginseng. It’s a plant that grows in Asia and may help both ED and alertness with relatively few side effects.
  • L-arginine. It’s an amino acid that serves as a building block for certain proteins. A small 2019 research review of 10 studies found that L-arginine used in doses of 1,000 to 1,500 milligrams significantly improved ED symptoms compared with placebo.
  • Yohimbe. It’s an herbal supplement commonly used in West African cultures, proved to be at least partially effective in treating ED in about one-third of people who participated in an old 1989 study.

Lifestyle changes

In addition, improving your health may improve ED symptoms and provide other benefits, including:

  • more energy
  • better sleep
  • greater cardiovascular fitness

The following lifestyle changes may pay dividends in terms of sexual health:

  • regular aerobic exercise, at least 150 minutes per week
  • maintaining a manageable weight
  • no smoking
  • consuming little or no alcohol
  • maintaining a healthy blood pressure
  • getting 7 to 8 hours of sleep each night
  • managing stress through meditation, yoga, or other strategies

When to talk with a doctor

The first step in finding the solution that’s right for you is to talk with your primary care physician or a urologist.

And while ED can be an embarrassing and frustrating topic to discuss with anyone, understand that ED is a common condition, affecting an estimated 1 in 3 adults with penises.

In other words, you won’t be the first person to ask your doctor for advice or treatment in this department.

Occasional concern

If ED occurs occasionally, then you may not need any treatment at all. In this case, it may usually be chalked up to:

  • stress
  • fatigue
  • relationship concerns
  • a side effect of misusing alcohol

Keep in mind that ED can be a symptom of many physical and emotional health conditions, including:

  • cardiovascular disease
  • obesity
  • hypertension
  • diabetes
  • depression
  • anxiety

Sometimes treating an underlying condition can lead to improved sexual function.

Persistent concern

If ED is a persistent concern, then a conversation with your doctor is recommended. Your concerns may be an inability to:

  • achieve an erection at all
  • achieve an erection that is firm enough for satisfactory intercourse for you and your partner
  • maintain an erection for the duration necessary for satisfactory intercourse
  • become erect at certain times or with certain partners

Regardless of the nature of your ED, there is a range of treatments that may be helpful. Psychotherapy and relationship counseling may be very helpful too, so you may want to talk with your doctor about referrals for therapy.

But because medications are generally tolerated, the first approach may be a prescription for Viagra or any of the other approved ED medications.

The bottom line

ED can affect several aspects of your life, including self-esteem and relationships, so it’s not something to ignore — especially when viable treatments are available.

And rather than rely on unproven and potentially very harmful treatments on your own — such as injecting Vaseline or any foreign substance into your penis — address this common medical condition with your healthcare professional.

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Nitroglycerin Gel for ED: Pros, Cons, & Practical Information

About Nitroglycerin Gel for Erectile Dysfunction

Medically reviewed by Matt Coward, MD, FACS — Written by Sara Lindberg on December 16, 2020

This article is a repost which originally appeared on Healthline

Edited for content

Erectile dysfunction (ED) may affect as many as 30 million men in the United States. People with ED experience an inability to get or keep an erection firm enough for sex.

You may be familiar with some of the more common treatments for ED, including lifestyle modifications, oral medications that include phosphodiesterase type 5 inhibitors (PED5 inhibitors), and penis pumps.

But a study published in the Journal of Sexual Medicine also looked at the use of nitroglycerin gel or cream as a topical treatment for ED. Although results look promising, it’s important to note that nitroglycerin gel or cream isn’t approved by the Food and Drug Administration (FDA) to treat ED.

Here’s what you need to know about nitroglycerin as a topical treatment for erectile dysfunction.

What is nitroglycerin?

Nitroglycerin is part of a class called vasodilators, which widen the blood vessels and improve blood flow to allow oxygen-rich blood to reach the heart.

It comes in a variety of forms, including sublingual (under-the-tongue), topical cream or gel, and as a transdermal patch. Nitroglycerin is most often used to prevent angina or attacks of chest pains.

Nitroglycerin for ED

“The idea of treating ED with topical nitroglycerin is not new and was first described in the 1980s,” says Dr. Joseph Brito, a urologist at Yale New Haven Health, Lawrence + Memorial Hospital. Brito is also a member of Healthline’s clinical review network.

In general, Brito says nitroglycerin works by dilating the blood vessels, which is why it’s traditionally used for patients with angina or chest pain due to poor cardiac vessel blood flow.

The concept is the same for ED, although Brito says it may have a dual mechanism of action:

  • It widens blood vessels helps blood flow.
  • It relaxes penile smooth muscle, which in turn compresses penile veins and impedes blood flow out of the penis, which causes rigidity.

How does nitroglycerin gel work?

According to Brito, nitroglycerin gel or cream differs from other ED treatments such as oral medications:

“[Topical nitroglycerin] acts as a nitrogen donor to increase local levels of nitric oxide, which works through molecular signaling (cGMP pathway) to cause this response,” he says.

On the other hand, Brito says PDE5 inhibitors (like tadalafil and sildenafil) work at a later step in the chain by inhibiting the breakdown of cGMP.

Nitroglycerin for ED doesn’t have enough research

That said, Brito points out that nitroglycerin gel or cream is currently not approved by the FDA to treat ED.

Moreover, Brito points out that the American Urological Association guideline on erectile dysfunction published in 2018 didn’t include topical nitroglycerin as a suggested treatment for men with ED.

“Though this therapy was not specifically mentioned, the authors did state ‘the use of these treatments may preclude the use of other treatments known to be effective,’ and felt more research was needed,” he explains.

And there’s another factor to consider: Nitroglycerin cream on the outside of the penis might be transferred to your partner.

Why are people interested nitroglycerin gel for ED?

“Nitroglycerin may have some benefits over standard oral ED medications,” Brito says.

The onset of topical nitroglycerin is between 10 and 20 minutes, which Brito says is better than the quickest acting oral agents, with sildenafil taking at least 30 minutes.

In fact, the 2018 study published in the Journal of Sexual Medicine found that 44 percent of patients saw erection beginning within 5 minutes of application. Seventy percent of the men noticed an erection within 10 minutes.

The randomized, double-blind, placebo-controlled study included 232 men with ED who participated in two 4-week trials. One trial used a 0.2 percent glyceryl trinitrate topical gel before sex, and the other used a placebo gel.

“This may help with spontaneity, which can be an issue for couples using oral agents,” Brito explains.

Another benefit, Brito says, is that unlike other ED treatments like oral agents, nitroglycerin doesn’t need to pass through the gastrointestinal (GI) tract.

“Since absorption of oral agents like sildenafil is strongly affected by food intake, the medications are much more effective when taken on an empty stomach,” he says. This requires more planning and doesn’t always allow for spontaneity.

Where to buy nitroglycerin for ED

Nitroglycerin gel or cream is currently not approved by the FDA to treat ED.

If you have questions about this topical treatment, you need to talk with a doctor who knows your medical history. A prescription is needed for nitroglycerin.

How to take nitroglycerin gel for ED

Nitroglycerin use is managed by your doctor. Don’t use or apply this topical treatment without guidance.

According to the Journal of Sexual Medicine, the concentration studied was 0.2 percent, which Brito says likely explains why the effect was best for men with mild ED.

He also points out that other studies used concentrations of 0.2 to 0.8 percent for patients with more severe ED, who likely needing higher concentrations.

In general, Brito says people prescribed nitroglycerin by their doctor should apply a small amount (pea-sized) to the head of the penis.

Side effects and contraindications

Nitroglycerin is certainly not for everyone. According to a 2018 review, taking nitroglycerin-based medications with certain PDE5 inhibitors like Viagra is contraindicated. Using them together can result in a sudden and serious decrease in blood pressure and potentially death.

According to Brito, some drawbacks of topical nitroglycerin include possible transmission to the partner, which can lead to the partner sharing in side effects, especially low blood pressure. This can lead to headache and nasal congestion.

Other treatments for ED

There are several treatments available for ED, including:

  • oral medications that include PDE5 inhibitors such as sildenafil (Viagra) and tadalafil (Cialis). Other oral medications include vardenafil HCL (Levitra), and avanafil (Stendra)
  • erectile dysfunction pump (penis or vacuum pump)
  • penile injections
  • inflatable penile prosthesis
  • psychotherapy (talk therapy) for emotional or psychological issues related to ED
  • suppositories (Alprostadil)
  • counseling
  • diet modifications
  • exercise
  • stress reduction

The takeaway

Although some research points to the effectiveness of nitroglycerin gel or cream for improving the symptoms of ED, it’s currently not approved by the FDA as a treatment for erectile dysfunction.

If you have ED or think you may have ED, it’s important that you talk with a doctor about any treatment options. They can talk with you about the range of options, including lifestyle modifications, counseling, oral agents, penis pumps, surgery, and implants.

Premature Ejaculation

Premature Ejaculation

What Is It?

Published: February, 2020

This article is a repost which originally appeared on Harvard Health

Edited for content

Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition.

As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.

Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.

Symptoms

The key symptoms of premature ejaculation include:

  • Ejaculation that routinely occurs with little sexual stimulation and with little control
  • Decreased sexual pleasure because of poor control over ejaculation
  • Feelings of guilt, embarrassment or frustration

Diagnosis

Premature ejaculation is diagnosed based on typical symptoms. To understand your problem, your doctor will need to discuss your sexual history with you. Be frank and open. The more your doctor knows, the better he or she can help you.

If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation.

Expected Duration

Sometimes, premature ejaculation goes away on its own over weeks or months. Working to relieve stress or other psychological issues may help the situation to improve.

Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period. Effective treatment is available.

Prevention

There is no known way to prevent premature ejaculation. However, you should consider the following advice:

  • Maintain a healthy attitude toward sex. If you experience feelings of anxiety, guilt or frustration about your sex life, consider seeking psychotherapy or sexual therapy.
  • Keep in mind that anyone can experience sexual problems. If you experience premature ejaculation, try not to blame yourself or feel inadequate. Try speaking openly with your partner to avoid miscommunication.

Treatment

Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the “squeeze technique” is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.

Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil).

Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose.

Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.

When To Call a Professional

Speak with your doctor if you consistently ejaculate before you want to. Remember, one instance of premature ejaculation does not mean that you have a condition that requires treatment. Your doctor may refer you to a sex therapist if premature ejaculation is causing major problems in your sex life or personal relationships or if you would like to consider behavioral therapy.

Prognosis

Many men experience a brief period of premature ejaculation, then improve on their own. Even for men who require medical treatment, the outlook is usually good.

Zapping the penis with sound waves could tackle erectile dysfunction ‘by stimulating the growth of nerve fibres and blood vessels’

Zapping the penis with sound waves could tackle erectile dysfunction ‘by stimulating the growth of nerve fibres and blood vessels’

  • Scientists tested low-intensity extracorporeal shockwave therapy 
  • It delivers up to 2,400 pulses of sound to the shaft of the penis over 20 minutes
  • It worked significantly better than a standard erectile dysfunction pill alone 
  • Italian researchers said the pulses boost growth hormones to heal damage 

By Vanessa Chalmers Health Reporter For Mailonline

This article is a repost which originally appeared on DailyMail

Zapping the penis with sound waves could tackle erectile dysfunction, a study suggests.

Scientists tested the relatively new treatment alongside a standard pill on a group of men struggling with impotence.

They found six sessions of up to 2,400 pulses of acoustic energy to the penis gave significantly better results than the pill alone.

It is believed to work by stimulating the growth of new nerve fibres and blood vessels, restoring penis function.

The intense vibrations to the shaft during the 20-minute sessions are not painful, according to the researchers.
Shockwaves fired through the penis could be used to treat erectile dysfunction

Shockwaves fired through the penis could be used to treat erectile dysfunction

Paolo Verze, of University of Naples Federico II, Italy, said low-intensity extracorporeal shockwave therapy (LiESWT) is a ‘promising’ therapy for erectile dysfunction (ED).

The 156 study participants all had type 2 diabetes, as ED is a common problem often with more severity among those with diabetes.

It can stem from damage to nerves and blood vessels caused by poor long-term blood sugar control.

In the study, patients took a daily pill of tadalafil, branded Cialis, a standard treatment for ED, for 12 weeks.

However, half of them also had LiESWT twice a week for three weeks at the beginning of the study.

The severity of participants’ erectile dysfunction was measured using the 5-Item International Index of Erectile Function test.

WHAT IS ERECTILE DYSFUNCTION?

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

It is more common in the over-40s but affects men of all ages.

Erectile dysfunction affects half of men aged between 40 and 70 years old, according to the British Association of Urological Surgeons.

A psychological component, often called ‘performance anxiety’ is common in men with impotence. However, a purely psychological problem is seen in only 10 per cent.

It can be a sign of an underlying medical condition such as high blood pressure or cholesterol, side effects of medication, or hormonal issues.

Of the 90 per cent of men who have an underlying physical cause, the main abnormalities found are cardiovascular disease (40 per cent), diabetes (33 per cent) and hormone problems and drugs (11 per cent).

Failure to stay erect is usually due to tiredness, stress, anxiety or alcohol, and is not a cause for concern.

Treatment usually involves lifestyle modification first, as obesity, smoking, cycling too much, drinking too much, and stress can trigger ED.

Medication with a phosphodiesterase inhibitor such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Spedra) is the second choices.

Scores of 25–22 indicate no erectile dysfunction while five to seven indicate severe erectile dysfunction.

At the beginning, the men aged 57 on average, had an erectile dysfunction score of 15.5. Their score was measured four weeks, 12 weeks and 24 weeks after the study.

The scores improved significantly in both groups at four weeks, by 2.9 in the tadalafil only group, and 3.9 in the LiESWT group.

At 12 weeks, scores had improved by 3.3 in the tadalafil only group, and 4.3 in the LiESWT group.

By 24 weeks, the differences were more evident. Those who had the LiESWT had seen their erectile dysfunction improved by 3.8 compared to the 1.8 who did not have it.

A second study investigated what number of shockwaves were most effective – 1,500, 1,800 or 2,400 pulses per session.

Those who had the most intense shockwave therapy of 2,400 saw their erectile dysfunction improve the most, by 4.7 points.

Overall, the combined approach of tadalafil and LiESWT at 2,400 pulses gave ‘significant advantage’ compared to those who only had tadalafil, the researchers said.

Writing in the Asian Journal of Andrology, the authors shockwave therapy is believed to stimulate pathways that encourage growth factors.

A growth factor is a natural substance in the body which helps with healing and cell growth.

This, Dr Verze and colleagues said, may regenerate nerve fibres and blood vessels in the penis, improving blood flow.

‘Consequently, LiESWT has the potential to restore natural erections and cure the disease,’ they claim.

The study was welcomed by sexual health expert Dr Diana Gall, from online ­service Doctor 4 U.

She told The Sun: ‘Drugs such as tadalafil have long been used to treat erectile problems.

‘But shockwave therapy is an emerging weapon in the sexual health armoury and this new study offers some encouraging results.

‘When combined with erection medication, it could now offer real hope for those who suffer erectile dysfunction, particularly among the one in ten men over 40 in the UK who also have diabetes.’

Erectile dysfunction affects half of men aged between 40 and 70 years old, according to the British Association of Urological Surgeons.

Of the 90 per cent of men who have an underlying physical cause, rather than a mental struggle, a third have diabetes.