The number of men seeking treatment for erectile dysfunction has soared in recent years amid what some have described as a ‘silent epidemic’.

Viagra – the ‘little blue pill’ – is normally associated with old people but the most recent figures suggest an estimated 30 million American men now live with erectile dysfunction – nearly twice as many in the early 2000s.

Around a quarter of under-40s are though to struggle to get it up in bed, which has been linked to a rise in obesity rates, poor mental health, and an overconsumption of pornography. 

Northeastern states like Maine, Vermont and New Hampshire have relatively high median ages. ED is typically more common in older men

Pill prescribing rates vary by state, but research shows the ones that lean left politically tend to have more little blue pills in circulation which, men’s health experts say, could translate to more open dialogue between patients and doctors about sexual health issues that are taboo in many conservative states.  

Dr Helen Bernie, Director of Sexual and Reproductive Medicine at Indiana University said: ‘What you see from that top 10 list, those are your more progressive states, right? New York, New Jersey, Pennsylvania, California, Nevada. 

‘Those are typically more progressive states where they have better reproductive rights so you would assume that maybe people talk about sex a little bit more, maybe it’s a little bit more ok to prescribe these medicines.’

Overall, Southern states had far fewer pill bottles in circulation, with the exception of Florida, where ED prescriptions made up 0.25 percent of the total filled there. 

‘Then you look at the alternative. Down south, the strong Bible Belt, there’s a lot strong religious tie and, just in general, people don’t talk about sex, we can only talk about abstinence or pregnancy. 

‘And so perhaps doctors aren’t asking their patients about sexual activities so they’re not prescribing as much of the medication. It’s taboo.’

It is for this reason that Dr Bernie said that the true number of men with erectile dysfunction is likely much higher than the estimated 30 million. 

If a doctor living in a conservative-leaning area where sex is not freely discussed does not bring up a taboo subject in the safety of the exam room, the patient likely won’t either.

Erectile dysfunction is often a biomarker for a man’s overall health. An inability to get or maintain erection could be a result of undiagnosed high cholesterol or blood pressure or even a warning sign of cardiovascular disease.

Dr Bernie added: ‘I mean, that’s the most simple question you’re going to have to ask: Do you have any problems achieving or maintaining an erection? And by asking that simple question, you will get an answer and it will open up the dialogue between the patients to be able to actually ask questions and seek treatment options for preventative health.’

Erectile dysfunction is most often considered in older men because of the many age-related changes the body undergoes such as naturally declining testosterone levels, weakened pelvic muscles, and a loss of the necessary nerve function that helps the brain communicate with other systems in the body that leads to an erection. 

But in younger men, the source of the problem is often psychological. Performance anxiety and high levels of stress can affect the delicate balance of hormones in the body and functioning of the nervous system.

Testosterone levels typically peak at around the age of 20 followed by a slow descent throughout the rest of adulthood. At their highest, testosterone levels should be anywhere between 300 and 1,200 ng/dL. Once men hit their mid-thirties, testosterone levels begin declining by at least one percent per year.

Pornography use and overuse can also contribute to ED. Constant exposure to explicit images and videos desensitizes the viewer, making the brain less responsive to sexual stimuli such as your partner standing in front of you naked. 

And repeat exposure to porn can lead to the same disruptions in the brain as do hard drugs. 

The brain’s reward system releases dopamine when something that feels good happens, whether it’s finding food in the middle of a desert, snorting cocaine, or watching hardcore porn. 

Over time, the brain becomes used to the images and videos and does not get the same heavy hit of dopamine when the person presses play. This hinders the brain’s reward system and makes it more difficult for the brain to get excited for the real thing. 

But people’s penchant for porn likely won’t change any time soon. Internet viewing has ticked up consistently over the past two decades, suggesting that the pool of young men with ED will expand. 

And as the US population gets grayer by the year, the prevalence of erectile issues could potentially increase still further, translating to even bigger profit margins for the companies behind blockbuster drugs like Viagra and Cialis. 

CITY WHISPERS: Erectile dysfunction firm Futura Medical is hoping to boost its mojo

By Francesca Washtell, Financial Mail On Sunday

Published: 16:51 EDT, 29 April 2023 | Updated: 16:51 EDT, 29 April 2023

After conquering the aisles of Boots, a groundbreaking erectile dysfunction treatment developed by AIM-listed Futura Medical could be on course for global domination.

Futura’s over-the-counter gel – called MED3000 but marketed as Eroxon – can work within ten minutes and has fewer side effects than pills.

It was launched in the UK this month and is already available in Belgium, but Guildford-based Futura is plotting a series of other launches across the world in the next year.

Groundbreaking: Futura’s over-the-counter gel – called MED3000 but marketed as Eroxon – can work within ten minutes and has fewer side effects than pills

Boss James Barder is staying schtum as to which countries he has lined up, though it is already cleared by regulators for use in the European Economic Area, UK and a swathe of the Middle East including the UAE, Oman and Iran.

The US is the next big goal. After that the focus will turn more to Asia.

Perhaps this will provide a longer-lasting rise in the shares, as a 26 per cent spike in the wake of the UK launch has lost steam.

Short-sellers eye DFS 

Hopefully bosses at DFS were sitting down last time they checked their short-selling data. 

The sofa chain has attracted short bets from hedge funds GLG Partners and Tellworth Investments who will profit if its share price falls. 

Its stock has fallen by 19 per cent so far in 2023, not helped by half-year results in March that showed a drop in profits. 

The value of the bets is just 2.5 per cent of shares on issue but it is hardly good news for a stock that has attracted unwanted attention before. 

Bad news keeps coming for Pazner 

More bad news for Itai Pazner, the former boss of William Hill-owner 888 Holdings.

The Israeli businessman was removed as chief executive of the gambling group in January after 888 revealed failings in anti-money laundering processes.

He also missed out on a bonus last year, seeing his pay halve from £3 million to £1. 5million.

Though he was eligible for a small payout, the board decided, partly ‘in light of business performance’, not to hand him anything.

Part of his bonus was linked to setting up and launching a safer gambling strategic plan.

As 888 – which declined to comment – put it in the annual report, this was ‘not achieved’.

City waiting on merger between Vodafone and Three 

One of two major questions hanging over Vodafone has been answered. 

Interim boss Margherita Della Valle has been appointed chief executive after a trawl lasting almost four months.

As a member of the old guard – she was finance boss during the turbulent reign of previous chief Nick Read – her appointment was greeted with consternation by those who wanted a fresh start for the telecoms group.

But they don’t have time to get too het up about management changes – the second major question, still unanswered, is whether her presence will speed up the anticipated merger between Vodafone and Three.

Right now, the City is waiting for the phone to ring.

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