Get the facts about erectile dysfunction

All men experience erection problems on occasion, so don't panic when it happens to you. But if loss of potency occurs on a regular basis and it’s upsetting your life, talk to your doctor. Safe and effective remedies are available.

Most men don't really think about how an erection happens—until it doesn't. Deeply unsettling, erectile dysfunction (ED), or impotence, is actually quite common, affecting a third of men over age 50.

• Normally an erection occurs when a man becomes sexually aroused, setting off a cascade of chemical reactions in the nervous system.
• One key player is nitric oxide, which helps arteries to widen and relax, increasing blood flow to the penis up to 30-fold and causing it to swell. Veins that normally draw blood away constrict, so that blood is held there and the penis remains erect. After arousal, an enzyme called PDE5 helps reverse this process, returning the penis to a flaccid state.

• Not so long ago, if you had erectile problems, your doctor would probably have attributed it to stress or performance ("honeymoon") anxiety.
• Today, experts believe that 80 percent of cases have medical roots. Anything that diminishes blood flow to the penis can contribute to ED. Atherosclerosis (or "hardening of the arteries" that leads to heart attack and stroke) and diabetes are common culprits.
• Drug side effects, particularly from blood pressure pills and antidepressants, can also reduce potency. Prostate surgery, radiation treatments for cancer, hormone imbalances, injuries and nerve disorders such as Parkinson’s disease are among the other conditions that may be involved.
• In addition, because this condition is fraught with emotional repercussions, it's not surprising that many men with ED become anxious or depressed,adding  a psychological component to ED as well.

• Consult with your doctor to determine the cause of your impotence.
• Medications (probably Viag­ra) may be prescribed.
• Seek counselling to ease depression or anxiety, which may be contributing to your problem.
• Try lifestyle measures such as relaxation techniques to counter stress, and exercise to boost vascular health.

• Talk to your doctor: Don't be embarrassed. Medical help is available. Your primary-care physician can also refer you to a urologist, a specialist in problems of the urinary tract.
• Share concerns and decisions with your partner: Treatment for ED is often most successful when couples work at it together.
• Stop smoking: Smokers are nearly twice as likely to suffer from ED as non-smokers. And smokers with high blood pressure are 26 times more likely to have the problem.
• Drink in moderation: Having an alcoholic drink can loosen inhibitions, but more than one can impair potency.
• Exercise: One report noted inactive men are more likely to have ED than those who exercise 30 minutes a day.

• Diabetes is a common cause of erectile problems. The Canadian Diabetes Association offers information and advice about men’s sexual health (1-800-226-8464 or www.diabetes.ca).
• Counselling can relieve anxiety and enhance treatment. The Board of Examiners in Sex Therapy and Counselling in Ontario (416-485-4073 or www.bestco.info) in Toronto offers online information, and referrals for therapists throughout the province.