According to the National Institutes of Health, “impotence” is a general term that refers to the impaired ability to complete intercourse or reproduction. This term would include such factors such as lack of desire, reduced sperm count, and ejaculation failure. “Erectile Dysfunction” refers specifically to the reduced or absent capacity to maintain an erection in order to complete intercourse. Erectile dysfunction, or ED, occurs when, for a variety of reasons, there is inadequate blood flow to the tissues of the penis and hence less erectile firmness of the organ. The complex neurological and vascular events that allow normal function are being defined in research laboratories throughout the world and the drug sildenafil citrate, i.e. Viagra, is the best-known drug marketed specifically for ED. The principle effect of the drug is to increase arousal-associated blood flow to the penis, increase erection firmness, and allow intercourse to be completed.

How common is ED? That is a difficult question to answer. If we accept the sales information on the Viagra.com website, 9 pills are sold every second worldwide and sixteen million men have taken the drug. Holy Cow! I don’t think that many drink light beer. The study of ED reported in the Annals of Internal Medicine reports that thirty-three percent of men over fifty have some significant ED. If half the U.S. population is near or older than forty, it is reasonable conclusion that fifteen to thirty million males over fifty have ED. Hence, you see the advertising for Viagra nearly everywhere. This is a very common problem. In the coming decades the fastest growing segment of the population will be the over-65 age group. The rate of ED in the 60-70 age group is now forty-five percent. In the over-seventy age group, the incidence of ED is sixty-five percent. Is ED a part of the aging process and are there ways to reduce these nearly inconceivable numbers? From the Annals study and others, the answers to both questions is “yes.” While age alone is the single most significant risk factor for ED, it is also clear that the negative influence of age can be significantly reversed or decreased. Obviously, good health is a major factor. Chronic illness such as heart disease, stroke, diabetes, hypertension and cancer increase the risk of ED. Very importantly, modifiable risk factors that reduce the risk of ED (and chronic disease by the way) over age fifty include physical exercise, lean body weight, limiting alcohol intake, and absence of smoking. Finally, to put a nail in the coffin of every red-blooded American male, watching TV over 8-20 hours per week is a real risk factor for ED. Lord, help us! The Annals study of ED can be summarized for the average American guy as follows: If you enjoy sex, you better get off the sofa, don’t watch more than two ball games on TV each week, cut the drinking to one beer per day, stop smoking, and reduce your weight by diet and exercise. Of course, if you do all this, you will have not only better sex, but you will live long enough to tell your pals about it.

See you at the gym.