A: Maybe. Erections help keep tissues in the penis healthy.
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Erection problems are common as men get older. And they’re something no man welcomes.
“When you get erectile dysfunction, there’s this stigma of ‘I can’t perform, I’m not a man anymore’ and it’s quite damaging,” says specialist Dr Doug Lording, who has worked in the field for more than 30 years.
When it comes to a healthy penis though, the principle of ‘use it or lose it’ seems to apply.
There’s even the idea that older men could perhaps use sex as a way to reduce their odds of developing erectile problems in the first place. (If true, this would be one of the more appealing pieces of health advice around. It would certainly trump say, vaccination as a disease prevention practice in most men’s eyes.)
But does regularly having sex really help a man avoid developing erection problems?
While there’s no, ahem, hard proof, the answer is quite possibly yes, says Lording, Honorary Clinical Associate Professor of Medicine at Monash University and an andrologist at Melbourne’s Cabrini Hospital.
“I think it probably does, but I don’t think it’s a proven thing. I don’t think there’s been enough work done to say there’s conclusive evidence that’s the case.”
It’s certainly true however that “getting erections helps keep the penis healthy” he says. But whether sexual intercourse has benefits for the penis over and above those provided by a man’s normal night time erections, or by him masturbating, hasn’t been tested.
Provided the man has no underlying health conditions that would put undue strain on his heart, however, having more sex “would not be harmful at all” and may well be helpful.
“Provided it’s done in a socially appropriate way, I think it’s probably a good thing,” Lording says.
Use it or lose it?
A 2008 study of nearly 1000 older Finnish men supports the idea sex protects against ED. It found those who said they had sex less than once a week were twice as likely to develop ED over the next five years compared to men who had sex at least once a week.
That was after controlling for other health factors such as heart disease, diabetes, obesity and depression which can be linked with ED.
This effectively meant older men who want to preserve their sexual function should “have sex, and have it often” ABC Science Online reported.
“Regular intercourse has an important role in preserving erectile function among elderly men,” the study’s lead author Dr Juha Koskimaki said. “Continued sexual activity decreases the incidence of erectile dysfunction in direct proportion to coital frequency.”
Other support for the “use it or lose it” idea comes from men where the nerves controlling erections were damaged during surgical treatment for prostate cancer.
While the damaged nerves may regrow a year or two later, the chance of erections returning is greatly increased if men have treatment with either tablets or injections to trigger erections artificially in the mean time.
“These men have a better long term outcome if they get erections,” Lording says.
This is because “the penis likes to get blood in and get the oxygen from it” and it “likes to be stretched out. It keeps the tissues in the penis in a more elastic state”.
So erections beget erections – which might explain the unconscious erections men have during sleep and the fact baby boys (or even fetuses) can have erections. They’re important for keeping the penis functioning.
Erections may not all be equal
Koskimaki questions whether all erections would be equally effective at oxygenating the penis.
But Doug Lording points out that in healthy men, the nocturnal erections that occur during the Rapid Eye Movement (REM) sleep phase can be “of quite a good duration”.
“Young males in their 20s are getting three or four REM sleep erections, some lasting half an hour or so.”
Lording acknowledges time spent in REM sleep, and therefore the duration of the associated erections, decreases in older men, but says this doesn’t necessarily mean intercourse has a more important role than night time erections in keeping a man’s penis healthy in later life.
“I don’t think there’s conclusive evidence,” he says.
“If you’re having sex with a partner, there’s a lot more to it than just the erection anyway. It usually means you’re in a relationship and that’s good for your health in a lot of ways.”
Nothing to lose?
So does a man have anything to lose by aiming for more sex in the hope it might do his penis some good?
Probably not, Lording says, but there are exceptions. The exertion of sex is associated with a higher risk of cardiac events for those with certain kinds of untreated heart problems.
“Sex is exercise. Thrusting away is like walking a kilometre or two at a good pace. And having an orgasm is like sprinting up a couple of flights of stairs.
“For most people, it would be safe. But if they have angina [chest pain caused by reduced blood flow to the heart], severe hypertension [high blood pressure] or cardiac failure that’s not been assessed and treated, it would not be a good idea to start promoting having more sex because there is an increased risk associated with that.”
And if you’ve already started noticing erection problems, having more sex is unlikely to be enough on its own to fix things.
“We now know that in fact getting ED is often a window in the circulatory system and men are at three times the risk of having a heart event over the next five years when they get ED compared to men having normal erections.”
You’re much better off talking to a doctor about possible underlying health problems that may be related to your erection issues as well as about treatments for your ED.
“I don’t know that we could really claim in that context that having more sex will make it more likely that your penis will be restored back to normal. But I think in general, sexually active people are probably healthier mentally and physically than sexually inactive people.”
Doug Lording is Honorary Clinical Associate Professor of Medicine at Monash University and a spokesman for Andrology Australia. He spoke to Cathy Johnson.