ARE YOUR MEDICINES TO BLAME?

IT’S not just age or diseases such as diabetes that can cause impotence — it is also a side-effect of some medicines, including blood pressure pills.

‘You need blood pressure in order to have an erection, and so artificially lowering it can affect your ability to have one,’ says Sid Dajani of the Royal Pharmaceutical Society.

Opioid-based painkillers, such as codeine and morphine, can also have this effect, perhaps because they cause drowsiness and make muscles relax.

So, too, can anti-inflammatories such as naproxen, which affect the blood vessels, restricting blood flow. Antidepressants are another culprit, perhaps because they act on brain chemicals that may have a role in erection. Some antihistamines can have this effect. ‘It tends to be the ones that make you drowsy. If you’re feeling tired you’re unlikely to be stimulated enough to have an erection,’ says Sid Dajani.

Other possible offenders include hair loss treatments such as finasteride and dutasteride, as well as cholesterol-lowering statins, though why is unclear.

‘If you suspect your medication is the cause, don’t stop it, but see your GP or pharmacist about alternatives,’ says Sid Dajani.

Another common cause of impotence is psychological issues, which can trigger erectile problems in men of any age. Between 10 and 20 per cent of impotence cases are thought to be linked to psychological factors.

‘The most common issue is performance anxiety,’ says Ronald Bracey, a clinical consultant psychologist based in London. ‘Men can worry about getting an erection or about how long they will be able to sustain it — this then becomes all the man can concentrate on,’ he says.

Some are more prone to this than others — perfectionists, those who have poor self-esteem or whose confidence has been knocked by previous relationships are especially vulnerable.

Stress and depression can have the same effect. One option is simply to abstain from sex.

‘A good technique is to agree with your partner that you will be intimate, but you won’t have sex for a month, say, so this takes away any psychological pressure on the man to perform,’ says Ronald Bracey, adding that cognitive behavioural therapy can also be especially helpful.