Men's Health & Aging
Erectile Health After 40: A Vascular and Hormonal Approach
Erections are a marker of cardiovascular health. Here is the integrated plan.
9 min read · XT Editorial Team · Reviewed & updated
Erections are a stress test
Erectile quality reflects vascular health, nitric oxide signaling, and hormonal status. Decline in your 40s is rarely 'just testosterone' — it is usually all three.
The vascular foundation
Cardio fitness, blood pressure under 130/85, fasting glucose under 100, and waist under 40 inches do more for erectile quality than any supplement.
The hormonal layer
Free testosterone, healthy estradiol, and adequate prolactin matter. Test before you supplement.
The nitric oxide layer
L-citrulline 6-8g, dietary nitrates (beets, leafy greens), and pomegranate have moderate evidence for endothelial function.
Frequently asked questions
- Are ED medications a problem long-term?
- Sildenafil and tadalafil are well-tolerated for most men. They treat the symptom but do not fix the underlying vascular or hormonal driver.
- Does masturbation cause ED?
- No. Frequency does not damage erectile tissue or hormones.
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