Struggling to keep it up? Here's what it might say about your health

Struggling to keep it up? Here’s what it might say about your health…

  • 78 per cent of men not aware that erectile dysfunction is linked to heart disease
  • Doctors blame stigma for men not visiting GP with erectile dysfunction

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

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

Impotence — estimated to strike half of all men over 40 — can be triggered by high blood pressure and diabetes, according to the NHS. 

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

Around 4.3 million men in the UK struggle with erectile dysfunction. many do not realise it could be a sign of heart disease, circulatory problems and diabetes

Cardiovascular disease

Although usually down to stress, being unable to perform in the bedroom may be a warning sign of heart disease.

For a man to get erect, vessels carrying blood to his penis need to dilate. As a result, more blood flows into the penis and it swells.

But heart and circulatory diseases can narrow arteries supplying the blood, meaning less is able to flow through.

This then causes problems getting or maintaining an erection.

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

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

Professor Albert Ferro, a specialist in cardiovascular clinical pharmacology at King’s College London, told MailOnline: ‘ED can be due to 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 more common in the over-40s but affects men of all ages.

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

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

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

Source: NHS Choices

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

‘Prompt diagnosis of silent heart disease is important because it will allow preventative treatments to be started at an earlier stage, thereby helping those individuals to live longer healthier lives.’

Three quarters of men are not aware that struggling to keep it up is a recognised sign of heart disease, according to a poll of 2,000 by The Urology Foundation.


Diabetes is usually just related to having high blood sugar levels and not producing enough insulin.

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

And men with diabetes are thought to develop erectile dysfunction up to 10 to 15 years earlier than men who don’t, according to Diabetes UK.

Diabetics can have damaged blood vessels and nerves — making it harder to keep it up.

Other factors that can make it harder to keep it up related to diabetes include being overweight, smoking and not doing enough exercise.

‘Bad lifestyles, such as unhealthy diet, lack of exercise, smoking, chronic stress and lack of sleep, can also cause ED,’ said Amr Raheem, consultant andrologist at International Andrology London. 

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

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

‘This is why it is 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.’

Having a hormone imbalance such as low testosterone levels can also decrease blood flow, which is vital for maintaining an erection

Hormone imbalances

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

Testosterone regulates sex drive and blood flow in men.

If you do not have enough of it, your libido can be dented, says EDclinics. It states that it can also decrease blood flow, which is vital for maintaining an erection.

Having low levels can also cause stress and weight gain, both of which may contribute to ED, according to the Cleveland Clinic. 

Low levels can be caused by a multitude of factors — including drinking too much alcohol, diabetes, ageing 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 apnoea, TRT is not for everyone.

‘As a society, we need to break down the stigma associated with ED and open up conversations,’ says Rebecca Porta of The Urology Foundation. 

She added: ‘ED can have a big impact on someone’s mental health, especially in cases where it impacts fertility and intimacy.’

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