What’s really to blame when a man has trouble getting an erection? Common triggers such as stress and anxiety or health issues like high blood pressure, diabetes, or treatment for prostate cancer immediately come to mind. But research shows that certain sneaky culprits may also contribute to or exacerbate erectile dysfunction (ED), which affects 20 to 30 million American men.
“Men might not realize that certain everyday habits can contribute to their risk for erectile dysfunction,” says Salvatore Giorgianni, PharmD, science advisor to the Men’s Health Network, the oldest and largest men’s health advocacy organization in the country. Here, a few less-well known factors that sexual health experts say men — and their partners — should watch out for.
A Pantry Packed With Canned Foods
Many of the cans holding your tomatoes and beans are lined with a material that contains a chemical called bisphenol-A (BPA), which can interfere with hormone systems by mimicking estrogen in women and inhibiting sex hormones in men. One Chinese study found that men who worked in factories where BPA was present had four times the risk of erectile dysfunction compared to workers who weren’t exposed to the chemical. While those workers had BPA levels 50 times that of average American men, follow-up research has found links between far lower amounts of BPA — with everyday, not occupational exposure — and ED and decreased desire. BPA is also found in reusable hard plastic (such as certain water bottles) and even in cash register receipts and white dental sealants.
While more research is needed to understand BPA’s effects on human hormone systems, it’s smart to reduce your exposure. Choose fresh foods over canned ones whenever you can; look for containers, bottles, and toys marked “BPA-free,” and avoid those with the number “7” on the bottom; and don’t put plastic containers in the microwave or dishwasher because the heat can cause chemicals to leach out.
A Bicycling Hobby
One classic study of more than 1,700 men found that those who rode a bike more than three hours a week had higher rates of ED than those who rode less often. In fact, the research found that less-frequent cycling could prevent ED. The culprit, later research from the University of California, San Diego showed, may be the bicycle seat. A hard seat can compress the perineum (the area between the anus and scrotum), squeezing off the vital arteries and nerves necessary for normal sexual function. Bike riders bear weight directly on the area where the nerves and arteries enter the penis.
But you needn’t relegate your bike to the garage. Choose leather seats, which conform more comfortably to the shape of the rider, over plastic, and consider grooved or noseless bike seats, which can minimize pressure to the perineum. Long-distance riders may lower their risk of ED by choosing a road bike over a mountain bike, one study found. And if you ride at the gym, pick a recumbent bike, which puts the body in a laid-back reclining position, and distributes weight more comfortably.
Snoring All Night Long
Disruptive snoring is one of the hallmark symptoms of sleep apnea, a common disorder in which one’s breathing is constantly interrupted during sleep — and recent research has linked sleep apnea and erection issues. One study presented at the American Urological Association's 2011 annual meeting found that men with ED were twice as likely to have sleep apnea as those without it. One possible explanation: Sleep apnea is a sign that the body is suffering from abnormally low baseline oxygen levels, which are needed to achieve or maintain erections.
Men who snore should mention it to their doctors; sleep apnea is a serious health issue that’s also linked to high blood pressure, heart disease, and other problems. Treating sleep apnea — often through wearing a special mask that supplies oxygen during sleep, as well as lifestyle changes like losing weight — can improve overall health and may mitigate ED too.
Car Accidents Or Around-the-House Injuries
Injuries to the pelvis from severe trauma (falling from a ladder and straddling it on the way down) or car, motorcycle, or pedestrian accidents can injure or damage nerves and arteries in the urethra, leading to erectile dysfunction. The main artery to the penis — which supplies the blood needed for erections — is connected to the pelvic bone, and extreme force in this region can crush the artery. Research in the Journal of Urology found an association between pelvic fractures and sexual dysfunction. “I’ve seen a man as young as 18 suffer from ED resulting from a kick to the crotch while doing karate,” recalls Irwin Goldstein, MD, director of sexual medicine at Alvarado Hospital in San Diego and a specialist in erectile dysfunction. Another patient required a penile implant (a type of treatment for ED) when he fell off a surfboard and the board popped up and struck him between the legs. Men who have sustained an injury to the pelvic area should seek immediate medical attention, but know that erection issues may not hit until months after the incident, says Katherine Harvey Kelly, author of a study on pelvic trauma.
Forgetting To Floss
Neglecting your gums is bad for your teeth, your heart, and even, recent research shows, your penis. Israeli researchers found that more than 15 percent of men with chronic gum disease had erectile dysfunction, while only two percent of men without ED had gum problems. Bacteria from the mouth can travel through the bloodstream, which can combine with plaque to clog blood vessels, including those in the penis, and make getting erections more difficult. For healthier teeth (and sexier sex) brush twice and floss once a day.
The Medicine Cabinet
It’s hard to watch TV without seeing a commercial for drugs that treat ED, but you may surprised to learn that many commonly used medications list erection problems as a potential side effect. Among them are the popular hair growth drug Propecia (finasteride); certain antidepressants; and some blood pressure-lowering drugs. SSRI antidepressants, which boost levels of the brain chemical serotonin, can contribute to ED because serotonin is a sexual inhibitor. An older medication, Desyrel (trazodone) can cause spontaneous, long-lasting erections, which over time can injure tissue and lead to ED. And while blood pressure meds can help treat ED in many cases, others (like some diuretics) can actually increase risk. A better bet might be a drug that works by widening blood vessels and increasing blood flow, such as an ACE inhibitor. Bottom line: “If men are taking any medications and experiencing ED, they should talk to their doctor or pharmacist about it,” says Dr. Giorgianni. They may be able to recommend a different type of medication without those side effects.