Erectile Dysfunction: Causes and Treatment Options

Erectile Dysfunction (ED) is a sexual health problem that affects numerous millions of men across the globe. It is actually more common than many people seem to realize. The reason for this being that those who are affected often find it awkward to discuss with anyone, including a doctor. The reluctance to discuss ED with a physician is especially surprising. These are professionals who are used to discussing a wide variety of embarrassing health issues with patients. It just goes to show how sensitive men can be about discussing this issue with anyone. What causes this awkward problem? And what are the options you have for treatment if you are suffering from the condition? Read on to find out.

What is erectile dysfunction?

For you to better understand ED, it is important to start by explaining how a man gets an erection. Muscles in the penis and walls of arteries that supply the organ blood relax when you are sexually stimulated. This allows blood to rush and fill the chambers of the corpora cavernosa, causing the penis to become erect. Valves lock in the blood to prevent it flowing back until you might have finished with sexual activity. The blood in the penis flows back when the muscles contract, usually after ejaculation or when stimulation stops.

Erectile dysfunction is a male sexual dysfunction characterized by inability to achieve an erection firm enough for sexual intercourse. The condition, which is sometimes referred to as impotence, could also be lack of ability to maintain an erection. It is the result of problems in the natural process by which blood is supplied to the penis when a man is appropriately stimulated. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that ED affects as many as 30 million men in the US.

Temporary ED, which usually results from stress, affects many men. This typically disappears once the underlying problem is addressed. You only need to be worried of possible health issues if this becomes a frequent occurrence. It is also worth noting that erectile dysfunction is not synonymous to male sexual dysfunction – it’s only a type of the latter.

Causes of erectile dysfunction

There are numerous potential causes of ED. This is because the process by which a man achieves an erection is a complex one. It has to do with emotions, the brain, hormones and muscles among others. Any problem with any of these areas could cause you to have this male sexual health issue. The common practice is to categorize the causes of erectile dysfunction as physical and psychological.

Physical causes

Also described as medical or organic causes, these are factors that have to do with underlying medical conditions. Drugs that are used to treat the conditions may also interfere with your ability to get an erection. In fact, anything that you take in and gets in the way of an erection falls among physical causes. The following are some of the physical causes:

Atherosclerosis – This condition which causes artery walls to thicken interferes with the flow of blood to the penis. Atherosclerosis involves damage of artery lining. This causes the arteries to lose elasticity, thereby preventing them from widening sufficiently to facilitate flow of blood.

Diabetes – Some say there is insufficient research showing that diabetes may lead to erectile dysfunction. But the condition is suspected because it can result in neuropathy or nerve damage.

High blood pressure – You may also have ED from elevated blood pressure, according to the American Heart Association. This is because of the damage this condition can do to arteries. The effect on your vascular system gets in the way of efficient flow of blood to the penis.

Surgery – Erectile dysfunction could also arise from complications of surgical procedures. Surgery, such as that for prostate cancer and Peyronie’s, can impact on the delicate blood vessels and nerves that contribute to erection. The damage or trauma thereby disrupts the process by which you get an erection.

In addition to the above, the following are some other possible physical causes of ED:

  • Multiple sclerosis
  • Smoking
  • Alcoholism
  • Aging
  • Radiation therapy
  • Kidney failure
  • Sleep disorders
  • Peyronie’s disease
  • Metabolic syndrome
  • Obesity
  • High cholesterol
  • Drugs for high blood pressure
  • Antidepressants
  • Opioid-based pain relievers
  • Certain anti-cancer drugs
  • Hormone drugs
  • Heart medications

Psychological causes

While physical causes account for majority of ED cases, the problem sometimes result from psychological issues. This is more likely the case in men with primary ED, a condition in which a man never had an erection. But psychological causes can also be at work in men who previously were able to achieve an erection. Few of these causes are discussed below.

Anxiety – A man may find it difficult achieving and maintaining an erection if he nurses fear about his ability to perform sexually. This may be as a result of a past experience.

Depression – Just like anxiety, this impacts on the function of the brain, which plays crucial role in your ability to get an erection. Depression can make you to lose interest in sexual activity and not feel aroused by normal sexual stimuli. So an erection becomes difficult to have and maintain. This condition can lead to a variety of other mental health issues as well.

Relationship problems – You stand at the risk of having erectile dysfunction if the relationship with your partner is strained. This may result from poor communication, stress, financial challenges or even inability to perform sexually to expectation.

Anger and, of course, stress are among other psychological causes of ED.

How is the ED diagnosed?

A variety of approaches may be needed for making proper diagnosis of erectile dysfunction. Your doctor may be able to tell if you have persistent ED merely by asking some questions and doing a physical examination. If he suspects a problem, he may then suggest some tests. There are really no formal tests specific to the diagnosis of erectile dysfunction. Tests that are likely to be recommended are those that check for possible underlying medical conditions.

Blood tests – These are used to detect the presence of medical conditions such as diabetes and heart disease.

Urinalysis – This serves similar purposes as a blood test. A comprehensive urine test helps to double-check for the presence of any ED-inducing medical condition.

Duplex ultrasound – Your doctor may suggest this to see if you have some internal issues getting in the way of blood flow. A device is used to produce image of vessels supplying blood to your penis to check for issues. The stimulator prostaglandin may be injected into the organ to induce erection for proper assessment. Ultrasound can be used to check blood flow as well as possible scarring, calcification, leaks and other issues.

Psychological assessment – Attempt may be made by your doctor to evaluate the state of your mental health. Alternatively, he may refer you to a specialist, such as a psychologist, to rule out issues such as anxiety and depression.

Other techniques that may be used for diagnosing erectile dysfunction include:

  • Penile biothesiometry
  • Magnetic resonance angiography (MRA)
  • Corpus cavernosometry
  • Nocturnal penile tumescence (NPT) tests

How do you treat erectile dysfunction?

You have a wide range of options when it comes to treating your ED. Your doctor is in the best position to tell which ones will serve you best. The right treatment will most likely be determined based on the specific cause and gravity of the problem. But the main target is the underlying problem responsible for your inability to get a firm erection. The following are the common treatment options for erectile dysfunction.

Oral medications

In some men, ED can be successfully treated with the aid of oral medications. A class of drugs known as phosphodiesterase type 5 (PDE-5) inhibitors is used for this purpose. The phosphodiesterase enzymes destroy nucleotides that are essential for an erection. By inhibiting PDE-5, these oral medications help to enhance blood flow to the penis. The most popular ones are sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra). These are known to enhance the effects of nitric oxide, a natural chemical that makes muscles in the penis to relax and improve blood flow. The drugs are usually taken 30 minutes to an hour before sexual activity.

Other ED medications

There are other medication types used for ED that are not taken orally. These may be used topically, as a suppository or injected. Alprostadil is an example of injected medication. The normal practice is to inject this into the side or base of the penis. Papaverine and phentolamine are other examples of injected medications. The drug Vitaros, which combines alprostadil and the permeation enhancer DDAIP, is a topical solution for ED. Alprostadil urethral suppository can also be inserted into the penis to promote erection.

Penis pumps

Also known as vacuum erection device, penis pump is used to draw blood into the penis through negative pressure. It comprises a pump and a hollowed tube. The device can be powered manually or through the use of battery. To achieve an erection, you place the tube over your penis and use the pump to suck out the air. This creates a vacuum to draw blood to the penis. You then wear a tension ring around the base of the sex organ to keep the blood from flowing back and remove the device. The erection thus achieved may last long enough for sexual intercourse.

Surgical treatments

Your doctor may also suggest exploring the surgery options if medications and pumps do not work. The most likely recommendations for surgical treatment are penile implants and vascular surgery.

Penile implants – This procedure involves surgical insertion of penile prostheses into the penis to promote erection. The penile implants may be malleable or inflatable rods. Malleable rods, which are moved into upward position to achieve erection, keep your penis rigid but bendable. The inflatable variants are filled with fluid whenever you need an erection and you can easily control how long to maintain that.

Vascular surgery – The focus of this surgical procedure is to deal with issues affecting blood vessels that may be responsible for you inability to achieve an erection. However, the vascular surgery option is explored in limited cases.

Psychological counseling

Since ED can be caused by psychological factors, your doctor may suggest you speak with a psychologist. This can be helpful in dealing with stress, anxiety, depression or relationship problems that may have contributed to the condition. It may be suggested that you go along with your partner for the counseling.


Research suggests that regular exercise may be beneficial in dealing with erectile dysfunction. Moderate to highly intense aerobics are thought to be especially useful. Brisk walking for half an hour 3-4 times a week can also improve the condition. Exercise is beneficial in reducing the risk of ED because it helps to guard against issues such as high cholesterol and obesity which can impact adversely on blood flow to the penis. Kegel exercises, also known as pelvic floor exercises, also help in combating erection issues.

Alternative medicine

If you are a fan of natural remedies, it will interest you to know there are some that are believed to help in treating ED. The potentially beneficial ones include Korean red ginseng, L-Arginine, dehydroepiandrosterone (DHEA) and gingko biloba. These natural ingredients are usually combined in supplements marketed for treating erectile dysfunction. A good example of such products is the popular * VigRX Plus, which is a blend of natural ingredients.

However, you need to tread with caution when it comes to alternative medicine offerings. Some of these products, often advertised as “herbal Viagra,” are said to contain certain ingredients that are not disclosed on the label. More specifically, they include potentially unsafe drugs. Synthetic chemical compounds resembling sildenafil (Viagra) have been found in many of these products.

Your best bet for overcoming erectile dysfunction is to deal with the underlying conditions responsible for the problem. Your doctor should be able to guard you appropriately in this regard. Ensure you discuss potential side effects of whatever treatment that is suggested. You really need to know what to expect in terms of possible complications, especially from drugs and surgical procedures.


*Individual results may vary!

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