By Marc Braman, MD, MPH

MB (Marc Braman, MD, MPH):
A flag flying at half mast is indeed a very sad occurrence. It indicates something is wrong. Likewise, erectile dysfunction, or ED, is also a very sad occurrence, and indicates something is wrong. It is associated with diabetes, heart disease, and a number of other serious conditions as well as simple aging.

ED is the most common sexual dysfunction affecting 8% of 20 year olds, up to 37% of older 75 year old men about 16% on average.

Penile erectile function is actually pretty amazing physiologically. Small limp hanging jello-like tissue transforms automatically in seconds into a much larger rigid upright rocket-like structure. It is designed to stay like that as long as needed and then automatically deflate to its storage form when not in use. Pretty amazing stuff.

There are many systems that need to be working well to make such amazing physiology happen — hormones of the right type in the right balance, mood and mental issues, nervous system regulation and signaling, relationship issues, and of course the final local system of opening and closing the right combination of blood vessels to inflate the rocket ship.

Aging definitely has a progressive impact on erectile function. Nature doesn’t expect most 90 year olds to be in a position to father babies. But lifestyle is THE big factor for erection physiology. The vast majority of men with ED can significantly improve or cure their ED by treating the lifestyle causes.

In the rest of this series on erectile dysfunction, or ED, we will walk you through the science of lifestyle as cause and cure for ED.

The good news: Mother Nature believes in good sex.

Men’s Attitudes to Life Events and Sexuality (MALES) Study. The multinational Men’s Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. Curr Med Res Opin. 2004 May;20(5):607-17.

Can lifestyle modification affect men’s erectile function? Hehemann MC, Kashanian JA. Transl Androl Urol. 2016 Apr;5(2):187-94. doi: 10.21037/tau.2016.02.05. Review.

Marc Braman, MD, MPH

Dr. Braman is board certified in preventive medicine/public health and occupational/environmental medicine. He is founding member, second President and first Executive Director of American College of Lifestyle Medicine and founder and current president of the Lifestyle Medicine Foundation which created He provides lifestyle medicine care in a wide variety of settings as well as initiating efforts to establish professional standards for the field of lifestyle medicine and planning and conducting national professional conferences in lifestyle medicine.

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