Erectile dysfunction

Erectile Dysfunction in Your 40s

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Medically approved by Dr Earim Chaudry
Chief Medical Officer
iconLast updated 2nd June 2021
In 30 seconds…

The unfortunate truth is that erectile dysfunction (ED) becomes more common as men get older. Generally, about 40% of men in their 40s will have experienced difficulties achieving or maintaining an erection in the past.

While the condition is increasingly common, the reasons for its onset differ from man to man. The causes of ED in your 40s can be as varied as stress, relationship problems, underlying health conditions, and lifestyle choices. Meanwhile, decreasing levels of testosterone can affect things too.

If you’re experiencing ED in your 40s, it’s important to get a health check-up: ED can be an early warning sign of a serious health problem like cardiovascular disease.

As ED is an easily treatable condition, there’s no reason to live with it, however. With effective treatment options such as Sildenafil and Tadalafil, you and your partner can still enjoy great sex in your 40s and beyond.

Sexual Health at Middle Age

When we hit our fifth decade, life can get quite intense. Your 40s can be a critical time for your career, with promotions or new job opportunities in the pipeline. Of course, there’s a good chance you have kids to care for and support, too. And, although we hate to admit, we’re not quite as sprightly as we once were either.

Yet, unfortunately, there’s another challenge that becomes increasingly common in our 40s too. That’s erectile dysfunction (ED), a condition that becomes ever more common as we age.

We know that’s not something you might want to face. However, if things have been less than satisfactory in the bedroom, you don’t have to ignore it. In fact, you shouldn’t. ED is easily treatable, and it may be the sign of something a little more serious that you should probably pay attention to.

Here, we’re tackling the major causes of erectile dysfunction in your 40s. From underlying health conditions to psychological stresses, there’s a lot to unpack. Let’s get started.

How Common is Erectile Dysfunction in Your 40s?

As a rule of thumb, researchers say that your chances of encountering ED increase by 10% with the change of every decade. By that maths, once you get to your 40s, you have a 40% chance of experiencing some problems with getting and maintaining an erection that’s firm enough for sex. That’s not a number to dismiss very lightly.

Researchers have struggled to pinpoint exactly how prevalent ED is. On the one hand, this is because it’s not something men like to talk about. On the other hand, it’s because men define ED differently as individuals: one man might consider ED to be one failed erection, whereas another might need to have issues on multiple occasions to describe this as ED.

It’s clear, however, that ED does become more common with age – particularly as a result of age-related health conditions. One study found that 52% of men between 40 and 70 had some degree of ED. While clearly that’s pretty broad, the chances are that it is more common than you think. 

Physical Causes of ED in Your 40s

Getting an erection is a complex process with numerous different body systems involved – brain, hormones, nerves, muscles, and blood vessels. So, when one of these systems is affected by disease, that can have consequences for your erections.

Take the blood vessels, for example. As you get into your 40s and beyond, you’re more likely to suffer from heart disease, clogged blood vessels (atherosclerosis), high cholesterol, and/or high blood pressure. When one of these disorders causes a problem with your blood circulation, your penis may not get the blood flow it needs for an erection.

Here are two possible physical causes for ED.

Cardiovascular Disease

ED is often an early warning sign of cardiovascular disease (CVD). One study showed, for example, that men who suffered from ED in their 40s were 50 times more at risk of CVD. The connection here is straightforward: erections depend on blood flow, and, if that blood isn’t flowing properly, this may signal larger problems.

As a result, if you are struggling with ED, it’s important to seek medical advice. Catching an underlying health condition early will make it (and your ED) more treatable.

Important note: The NHS offers a free health check for adults aged 40-74, which screens for a variety of cardiovascular diseases. You will also get direct advice on how to lower the risk. Learn more about this health check on the NHS website.

Low Testosterone

It’s worth thinking about the possibility of having low testosterone levels too. While it’s not a hugely pleasant idea to consider, Low-T is one of the more common causes of erectile dysfunction in older men. It can affect your sexual performance in other ways beyond diminishing erectile function too, by reducing sexual desire, for example, or increasing fatigue.

Get it checked out. There are easy tests, and plenty of effective medical treatment options too.

Lifestyle Choices and ED

Heart problems in your 40s, along with other conditions like type 2 diabetes and obesity, are frequently linked to lifestyle choices. These include: smoking, excessive alcohol consumption, a poor diet, and insufficient exercise. All these lifestyle factors have also been linked to an increased risk of ED.

Interestingly, several studies have demonstrated that men following a Mediterranean diet are less likely to suffer from ED. A Mediterranean diet is rich in vegetables, whole grains, olive oil, and fish – all foods that are good for your heart and brain health, and consequently for healthy erections! 

Your 40s tend to be the decade when lifestyle decisions made when you were younger catch up with you, and ED can be one symptom of this. However, you can still turn things around by starting to make healthier choices now. If you give your body a little TLC, your sex life might appreciate it.

Psychological Causes Behind ED

With all the pressures life heaps on you in your 40s, it’s common to find yourself experiencing stress or even more serious mental health issues. Sexual arousal is not just a physical response; it’s mental or emotional too. If you’re struggling to get in the mood, then it’s natural for your erections to suffer, too.

The stress and fatigue of juggling so many different responsibilities in your 40s can contribute to ED. Moreover, depression – perhaps as the result of relationship breakdown or losing a job – can take its toll on your ability to get an erection. Antidepressant medications may also have adverse effects in this area.

You might also find that relationship problems are contributing to your ED. If you and your partner are arguing a lot or struggling to communicate, then this could be affecting your sex life as well.

When there’s a psychological cause for your ED, you may find that counselling, psychotherapy, or relationship counselling will help. Talking about your problems might seem daunting, but remember that ED is a common condition that counsellors hear about regularly. Seeking therapy could be the first step towards getting your life back on track – both in and out of the bedroom.

Erectile Dysfunction Treatment in Your 40s

Despite the diversity of different causes of erectile dysfunction, there are treatments available that are safe, effective, and medically approved. These can help you overcome the symptoms of sexual dysfunction in the short term – and get back to having satisfying sexual intercourse. The chances are you’ve heard of them.

Sildenafil (which is the active agent in Viagra) and Tadalafil (otherwise known as Cialis) are two of the most popular options for ED treatment. These are similar drugs known as PDE5 inhibitors. They work by targeting an enzyme (PDE5) that is responsible for smooth muscle contraction in your penis. By inhibiting the enzyme, they increase blood flow to the penis, thereby boosting your chances of achieving and sustaining an erection. 

Sildenafil reaches the peak of its power an hour after you take it, and lasts usually for 4 hours. Tadalafil, alternatively, stays in your system for 36 hours, giving any sexual activity a bit more spontaneity.

While Sildenafil and Tadalafil are the most effective options, alternatives such as Vardenafil (Levitra) and Avanafil (Stendra) exist. Importantly, though, these drugs will not help the underlying causes of any erection problems. So, if you are concerned about your cardiovascular health, do speak to a doctor nonetheless.

Key Takeaways

Erectile dysfunction might be more common once you reach your 40s, but that’s no reason to shrug your shoulders and ignore it. ED can be an early warning sign of a serious medical condition such as cardiovascular disease, so it’s important to get yourself checked out. It could also be an indication that you need to make some lifestyle changes, such as exercising more or eating a healthier diet.

If the stress of life in your 40s is getting to you then there may be a psychological cause for your ED. Talking through the problem with a counsellor or therapist could make all the difference.

Whether you need to improve your physical health, get some counselling, or just take a pill – ED can be treated. Tackle the issue and there’s no reason you can’t have great sex in your 40s, 50s, and beyond…


Monica G. Ferrini, Nestor F. Gonzalez-Cadavid, and Jacob Rajfer (2017). Aging related erectile dysfunction—potential mechanism to halt or delay its onset:


David F Mobley, Mohit Khera, Neil Baum. Recent advances in the treatment of erectile dysfunction:


Simona Di Francesco and Raffaele Lanfranco Tenaglia (2017). Mediterranean diet and erectile dysfunction: a current perspective:


Agnes Higgins, Michael Nash, and Aileen M Lynch (2010). Antidepressant-associated sexual dysfunction: impact, effects, and treatment:


While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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