Sex: Men: Troubleshoot Your Sex Life (cont.)

The problem is that most men don't know that many of these changes are preventable. They don't do anything about maintaining sexual vitality until a problem occurs, and by then it's closing the barn door after the horse has bolted, says a leading expert in erectile dysfunction (ED).

"The emphasis in this field has been on the treatment, not on the prevention," says Irwin Goldstein, MD, professor of urology and gynecology at Boston University School of Medicine in Boston, in an interview with WebMD.

As a result, doctors know that several medical conditions are associated with erectile dysfunction. About 40% of men with diabetes have some erectile dysfunction. Problems with erections are also common in men with cardiovascular disease, especially those with angina or after a heart attack. And they can be caused by medications used to treat such conditions as high blood pressure. Many doctors think that reversing these problems would also boost a man's sexual vitality. But they don't know for sure.

Your best bet? Prevent the problems before they affect your sex life.

Step 1: Exercise for Sexual Vitality

There is at least one health habit -- exercise -- that has a clear link to sexual vitality, Goldstein says. Among men enrolled in the Massachusetts Male Aging Study, a long-term, community-based study of health and aging, researchers found that men who burned an average of at least 200 calories per day through exercise were far less likely to become impotent over time than men who didn't exercise.

But not all forms of exercise are equal, Goldstein cautions: Men who rode bicycles -- on the road or in the gym -- were nearly twice as likely to be impotent as men in the general population. Researchers chalk it up to continued compression of the nerve and blood supplies to the penis.

Step 2: Kick the Habit and the Fats

The ability to have an erection relies on a complex network of factors, some physical, some psychological. One of the most important factors is healthy arteries. The penis contains an intricate network of tissues that fill with blood during an erection, and if these arteries are blocked by atherosclerosis, there may be trouble in paradise.

"It's incontrovertible that atherosclerosis, the narrowing of arteries because of plaque deposits, begins in youth," Castleman tells WebMD. "The thing is that it usually doesn't cause significant clinical symptoms until guys are in their 40s or 50s. But if you're a man and you're in your 40s or 50s, you can pretty much rest assured that you have some narrowing. Maybe it's not affecting your heart function, but it's there, and the narrowing of arteries doesn't happen just in the coronary arteries of the heart, it happens all over the body, including the pudendal arteries that carry blood into the penis."