(HealthDay)—Men often have a hard time acknowledging erectile dysfunction, or ED. But it can leave their partner feeling confused or even blaming themselves for something not within their control.

First, know that while the odds of ED rise after age 50, many men experience normal physical changes that are not ED. Erections may not be as firm as they once were, and it may take more foreplay to get one. It may help to have sex in the morning, when both partners are full of energy.

True ED is not being able to get or maintain an erection, though this may not happen every time. It can be related to lifestyle habits such as smoking, heavy drinking or being overweight. Stopping harmful habits, losing weight and getting into a regular exercise program can be helpful.

In middle age, ED can often be connected to a medical condition—such as diabetes, heart disease or Parkinson’s—and new or worsening ED may signal that the condition is getting worse. Erectile dysfunction can also be a side effect of some medications and cancer treatments.

It’s also important to know that up to 25 percent men under 40 experience ED, often from a psychological issue, like performance anxiety or depression. But for some, it’s an early warning sign of heart disease.

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