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According to statistics, sexual problems in males often begin in their forties. These problems may be associated with aging, but most often there is some underlying cause, other condition, which leads to deterioration of erection. According to the 2001-2002 National Health and Nutrition Examination Survey, prevalence of erectile dysfunction (ED) was 8.2% in men aged 40–49. Contemporary statistics might be even more disheartening. So, what are causes of erectile dysfunction in 40s?

obesity ed

Overweight and Obesity

The sexual motor can fail with overweight and obesity in men. The presence of excess body fat is associated with various health conditions, such as elevated blood triglycerides. This leads to clogged arteries and poor blood flow, not to mention a deterioration in overall well-being.

A related article: Can Viagra (Sildenafil) Be Used As a Weight-Loss Drug?


Diabetes often leads to erectile dysfunction. The mechanism of the negative effect is that diabetes negatively affects blood vessels and capillaries.

According to epidemiological studies (Diabetes, Metabolic Syndrome and Obesity, 2014), both type 1 and type 2 diabetes are linked to an increased risk of erectile dysfunction. It was reported that ED occurs in ≥50% of males with diabetes.

blood pressure and ed


Hypertensive men often have erectile problems. The precise mechanism of this phenomenon is to be more carefully studied, but as for now there is enough data to make a statement: high BP might cause impotence in males.

According to Valter Javaroni and Mario Fritsch Neves (International Journal of Hypertension, 2012), ED is a common complaint in men with hypertension, which can be caused by an antihypertensive medication or a systemic vascular disorder.


Sometimes, midlife crisis may transform into depression, which might be extremely severe. According to Dan Jones, a scientist at Appalachian State University, the crisis might occur anywhere from age 37 to 50s. Midlife transition is considered a normal stage in life, but in some cases, it might be accompanied by serious depression, which, in turn, may lead to erectile dysfunction.

testosterone and erectile dysfunction

Testosterone Deficiency

Libido is a testosterone-driven phenomenon, which is highly important for erectile function in men. Unfortunately, after the age of 35 (approximately), rates of the hormone begin do decrease. This diminishing negatively affects libido which provide an indirect effect on erectile function. Some males may resort to testosterone therapy, but this is not the best solution in many cases (due to potential side effects). Moreover, some patients prefer natural alternatives to the pharmaceutical treatment.

Psychological Causes

As for psychogenic causes of ED, their incidence is low in this age category. Scores of young guys may have psychological problems when it comes to achieving and maintaining an erection, but men in 40s are sexually experienced and is unlikely to develop such a condition. However, a scenario with mixed (organic-psychogenic causes) may happen. This means

Other Causes

The list of other possible causes of ED includes (but not limited to):

  • penis injury (due to major trauma, less dangerous physical injury or surgery)
  • neurological disorders
  • high cholesterol in the blood
  • atherosclerosis
  • kidney diseases
  • heart disease
  • lower urinary tract symptoms (LUTS) induced by benign prostate hyperplasia (BPH)

As you see, the list is quite extensive, so you need to treat any health condition once you’ve noticed it. There is another common truth: any disease is easier to prevent than to cure, therefore, due attention should be paid to a healthy lifestyle and preventive measures.

healthy lifestyle ed

Tips on How to Prevent ED in 40s

The tips are very simple and you probably heard them from your doctor or read in health magazines.

  • Maintain a healthy weight, get slim if you are overweight. Being toned and fit will improve your overall health condition.
  • Be physically active. This will help to improve blood flow throughout the body, including the genital area. Moderate physical activity is needed for health as well.
  • Try to fight stress. Sleeping enough is also important for successful dealing with stressful situations.
  • Visit a psychologist and/or sexologist (if you start to experience severe depression and/or have problems in personal relationships with your sexual partner). The specialist will help you to handle the problem much faster.

In fact, a few lifestyle changes can overcome the problem. Of course, serious erectile dysfunction should be treated with medications, but a healthy lifestyle will help you reduce the degree of frustration.

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I’m an Oncologist and Hematology Specialist primary located in Bryn Mawr, Pennsylvania. I have over 55 years of experience in the medical field and more than 20 years of practice. I’m skilled at the treatment & diagnosis of a large array of ailments & diseases in adults.

Board certifications

  • American Board of Internal Medicine Certification in Internal Medicine
  • American Board of Hematology Certification in Hematology
  • American Board of Medical Oncology Certification in Medical Oncology