Happy, Healthy, and Hard
Experts explain the connection between a man's overall health and his sexual health.
The Erectile Continuum
ED becomes more common as men age, but aging itself is not the cause.
"We never expect a healthy man to develop ED as a result of aging
alone," Montague says.
A very healthy octogenarian can have erections. But Montague says even in
the fittest men, some changes occur with age. An erection is still possible,
but it may take some coaxing.
"As men get older they require direct genital stimulation from their
partner or from themselves. A young man can just daydream and get an
erection," he says. "Those changes by themselves, though, don't prevent
By definition, having ED means a man cannot get an erection hard enough for
penetration or one that lasts long enough for him to reach orgasm. But in
Lamm's opinion, there are shades of gray between normal sexual performance and
"You don't go from being 'normal' to having ED. What you end up having
is a transition," he says.
Usually doctors assess erectile function by the International Index of
Erectile Function, a set of five questions such as, "How do you rate your
confidence that you could get and keep an erection?" A patient's answers
are scored, and that score determines whether or not he has ED.
Lamm says he thinks a better way to measure erectile function is with a new
tool called a rigidometer. A man presses the head of his erect penis against a
sensor attached to the digital device, which measures the precise hardness of
his penis in grams of pressure. According to the manufacturer, 400 grams is
limp; 400-500 is "borderline," and 500-1,000 is sufficient for sexual
activity. A number over 1,000 is considered optimum.
Living a Hard Life
Lamm thinks men want harder erections, even if they don't have ED. The
rigidometer can show a patient objectively how hard his penis is -- hard enough
for penetration, maybe, but not as hard as it could be. The number might be an
incentive for him to improve his overall health in order to make his penis
Having a very hard erection, Lamm says, can enhance a man's sexual pleasure,
or at least boost his self-esteem. Many men are definitely interested in their
penis size, and a more fully engorged erection is the only thing shy of surgery
that can actually make it bigger.
Sharlip's experience, however, leads him to doubt that degrees of hardness
beyond hard enough matter to most men. "I don't think it's important at
all," he says. "As long as it's hard enough to get it in ... I don't
hear patients complaining about rigidity."
The Hardness Factor details a wellness program that Lamm says will
show positive results on a rigidometer in six weeks. It involves exercise,
eating healthy meals, sleeping well, and taking vitamins and supplements. The
book describes the cases of some patients of Lamm's New York City practice who
followed the six-week program and had good results.