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Erectile dysfunction (ED) is the inability to get and maintain an erection during sex. Some men sometimes have trouble getting or maintaining an erection, which may be normal. But when the problem starts recurring or persists for a long time, you should consult a doctor.
There are many causes of ED. Sometimes the cause is some other health problem, including heart disease and diabetes.
Understanding the signs and causes of ED is the first step towards achieving a better sex life.
Signs and Symptoms of Erectile Dysfunction
If you have ED, you may experience:
- Having trouble getting an erection
- Difficulty maintaining an erection for a long time
- Decreased sex drive
- Feelings of embarrassment or guilt
- Low self-esteem
Symptoms of Other Sexual Disorders
Some sexual disorders are related to ED and can cause symptoms similar to ED, such as:- Premature ejaculation (ejaculation too early)
- Inability to achieve orgasm after sufficient stimulation
- Delayed ejaculation (when ejaculation takes too long)
Causes and Risk Factors of Erectile Dysfunction
An erection occurs when the penis fills with blood. Normally, when a man is sexually aroused, blood vessels, muscles, nerves and hormones work together to produce an erection. When this process is disrupted, symptoms of ED can occur.
Some men experience symptoms only occasionally. For others, symptoms remain constant and interfere with their sexual relationships.
ED is a complex condition that can be caused by a variety of factors. Often more than one issue is responsible for ED.
Physical Causes
Other medical conditions can cause symptoms of ED. Common physical causes include:- Heart disease or atherosclerosis (inflammation and narrowing of the arteries)
- High blood pressure
- High cholesterol
- Obesity
- Diabetes
- Strokes
- Parkinson's disease
- Sleep disorders
- Peyronie's disease (scar tissue inside the penis)
- Neurological disorders
- Chronic kidney disease
- Brain or spinal cord injury
If you have any of these ED problems and symptoms, Tell your doctor.
Medications That May Contribute to Erectile Dysfunction
- Some prescription medications can also cause ED. These may include:
- Diuretics (pills that increase urine flow and reduce blood pressure)
- Antihistamines (including H1- and H2-receptor antagonists)
- Antidepressants
- Antiarrhythmics (medicines for irregular heartbeat)
- Tranquilizers and sedatives
- Muscle relaxants
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Hormones
- Chemotherapy drugs
- Prostate cancer medications
- Anti-seizure medications
It is important to tell your doctor about all the medicines you take, including non-prescription medicines, so they can determine if any of your medicines may be responsible for your symptoms.
Psychological Causes of Erectile Dysfunction
Psychological factors that can lead to ED include:
- Depression
- Worry
- Other mental health disorders
- Tension
- Feeling self-conscious or nervous about sex
- Relationship problems
Often, psychological problems accompany medical conditions.
Role of hormones in erectile dysfunction
Sometimes, ED occurs when your hormones become unbalanced. Your doctor may do a blood test to check your hormones.
Other Factors to Consider Regarding ED
ED can also be caused by tobacco or alcohol consumption.
Additionally, surgeries or procedures that target the spinal cord or pelvic area can cause ED. Radiation therapy to the testicles can also cause impotence.
How Is Erectile Dysfunction Diagnosed?
But if underlying conditions are the suspected cause of your ED, you may need certain tests, such as:
Blood Test: A blood sample can help your doctor detect signs of diabetes, low testosterone, or other problems, such as liver or kidney disease.
Urine test: Urine test can detect markers of diabetes.
Psychological Testing: Your doctor may examine you for depression or any other mental health disorder that may be associated with ED symptoms.
What Should You Tell Your Doctor About Symptoms?
When talking to your doctor, be as open and honest as possible about your symptoms. Tell your healthcare provider how often you have symptoms and how long they last.
You should also tell your doctor:
- About all the medicines you take
- If you have any other health conditions
- If you drink alcohol or use tobacco products
Additionally, it's a good idea to share any life changes or stressors that may affect your mental health, such as the death of a loved one, a job change, the birth of a child, or trouble in your relationship. Also discuss recent weight gain.
Prognosis of Erectile Dysfunction
The prognosis for men with ED is generally favorable.
While many cases of ED are caused by medical conditions that cannot be cured, various treatment options can help restore sexual function.
ED caused by psychological factors, hormonal problems, or injury to the penis can usually be treated effectively.
Treatment and Medication Options for Erectile Dysfunction
There are many treatment options available to help with ED. Sometimes, addressing underlying medical conditions will also improve your ED symptoms.
Medicine options
There are several types of ED medications, including:
- Oral Medications: Popular medications such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra) work by increasing the effects of nitric oxide – a chemical that relaxes the muscles in the penis. Note that medications in this class (PDE-5 inhibitors) are not suitable for patients who take nitrates in any other form, as the combination can cause severe hypotension (low blood pressure).
- Injections: Some medications can be injected or placed inside the penis to help produce an erection.
- Testosterone: Your doctor may recommend taking this hormone if your levels are too low.
Instruments and Surgery
Your healthcare provider may recommend a vacuum device, also called a "penis pump," to help you get an erection. The pump helps draw blood into your penis, allowing you to get an erection long enough for intercourse. It is paired with an elastic ring that helps you maintain an erection.
Surgery is also an option for some men with ED. During this procedure, the doctor places a penile implant in the penis. There are different types of procedures depending on your goals and preferences.
Counseling and Therapy
Often, men suffering from ED benefit from talking to a therapist, especially if they suffer from depression, anxiety, or low self-esteem. If relationship problems are a factor, couples therapy may be useful.
Alternative Treatments
There are many complementary and alternative treatments marketed with claims to help men suffering from ED. The US Food and Drug Administration (FDA) warns that these products may contain potentially harmful drugs, contaminated formulations, or unknown doses of medicinally active drugs. They may also interact with other medications you take.
Always talk to your doctor before taking any supplements for ED.
Other alternative treatments that may help reduce stress, and in turn, reduce ED symptoms, include:
- Acupuncture
- Massage
- Meditation
- Yoga
Prevention of Erectile Dysfunction
- Eating a healthy diet
- Stop smoking
- Lose excess weight
- Daily Exercise
- Maintaining normal blood pressure and cholesterol levels
- Getting help for alcohol or drug addiction problems
- Learning about side effects of the medications you take
- If you and your partner are having trouble communicating, consider couples counseling.
Research and Statistics: Who Has Erectile Dysfunction?
According to the American Urological Association, ED affects approximately 30 million men in the United States.
Studies show that about 5 percent of men develop full-blown ED by age 40, and that percentage increases to 15 percent by age 70.
Mild and moderate ED affects about 10 percent of men in each decade of life. This means that 50 percent of men in their fifties are afflicted, 60 percent of men in their sixties, and so on.
Older men are more likely to take medications for health problems, which may affect their risk.
