What Is Erectile Dysfunction (ED)?

Erectile dysfunction (ED), commonly known as impotence, is a highly prevalent condition affecting men. It is the inability to have or maintain an erection firm enough for sexual intercourse.

A study conducted by the American Academy of Family Physicians estimated that 12 million men in the United States are affected by ED. And only 30% of them seek help, leaving the majority untreated.

Understanding erectile dysfunction causes, symptoms, and available treatment options can reduce associated risks such as cardiovascular disease.

Causes of erectile dysfunction

Erectile dysfunction can result from:

• Use of certain medicines such as antidepressants and psychiatric drugs
• Physical problems like obesity, high cholesterol, heart disease, and more
• Psychological causes; depression, stress, relationship issues, and mental conditions
• Use of substance; tobacco
• Conditions such as prostate cancer treatment, testosterone deficiency, and anxiety.

To make you understand better, below, we discuss some of the most common physical and psychological causes of ED.

Physical causes of erectile dysfunction

Erectile dysfunction can be a result of an underlying physical condition. Below are some of the most common physical causes of ED:

• The penis not being able to keep blood during an erection.
• Inadequate blood flows into the penis, resulting from many health issues, such as heart disease, hardened arteries, diabetes, high blood sugar, and smoking
• Diabetes: Causes nerve damage or small vessel disease to the penis
• Nerve signals from the spinal cord or brain fail to reach the penis
• Cancer treatments such as surgery and radiation near the pelvis affecting the penis functionality
• Certain diseases such as multiple sclerosis (MS) and injury in the pelvic area harm nerves to the penis
• Drugs such as antidepressants and antihistamines

Psychological causes of erectile dysfunction

The brain plays a crucial role in triggering the physical events that cause an erection, for instance, sexual excitement.

Several things can interfere with how the brain works, causing or worsening your erectile dysfunction.

These include:

• Stress: Related to marital problems, money issues, job problems, among other factors
• Mental health conditions such as anxiety and depression
• Relationship problems which cause stress and poor communication
• Guilt: When a man feels like he is not satisfying his partner or cannot provide for the family
• Lack of interest in sex: Occurs due to aging, medication side effects, or problems in a relationship
• Low self-esteem: This can be due to prior ED episodes (thus feeling inadequacy or due to other issues unrelated to sexual performance

Symptoms of erectile dysfunction

You can tell if you have erectile dysfunction when you notice the following symptoms:

• Reduced interest in sex
• Trouble getting an erection
• Delayed ejaculation
• Premature ejaculation
• Anorgasmia (inability to achieve orgasm after ample stimulation)

When should you see a doctor?

If you present any of the erectile dysfunction symptoms above and have persisted for three or more months, you should visit your doctor.

Diagnosis of erectile dysfunction

Diagnosing ED involves looking at the symptoms that have persisted for at least three months and conducting a psychological exam and a lab test.

Your doctor may ask you a few questions about your erection problem and overall health to determine when your problem began.

Below is what happens during examinations and tests that doctors use to diagnose ED.

Physical examination

During the physical examination, your doctor will examine your penis and testicles, check your blood pressure, listen to your heart and lungs. He/she may also recommend a rectal exam to check your prostate.

Psychological examination

During a psychological examination, your doctor will ask you questions about your mental well-being.

They will also check for anxiety and depression to determine if the condition is rooted in emotional or mental issues.

Doctors recommend that you bring your sexual partner alongside you for a couple of evaluations.

Blood tests

A doctor may conduct blood tests to check for low testosterone levels, thyroid issues, diabetes, and heart disease, which are common causes of ED.

Urine tests (urinalysis)

Urinalysis is a laboratory test conducted to detect problems or diseases in a person’s urine.

The test measures levels of glucose (sugar), testosterone, or protein in your urine.

Doctors can recommend you go for a urinalysis test to check if you have diabetes, kidney problems, or hormonal imbalance. These diseases may cause erectile dysfunction.

Ultrasound

Ultrasound tests are done on your lower abdomen to examine the blood vessels and check if there is a problem with penile blood flow.

Risk factors of erectile dysfunction

Erectile dysfunction can occur due to different risk factors, including:

• Medical conditions such as diabetes or heart conditions
• Use of antidepressants, antihistamines, and medications used to treat pain, high blood pressure, or prostate conditions
• Being overweight
• Psychological problems such as depression, stress, and anxiety
• Tobacco use
• Medical treatments for treating cancer such as radiation and prostate surgery
• Arteries or nerve injuries, especially those that control erections.
• Drug and alcohol use, especially when in excessive use

Treatment of erectile dysfunction

You can treat erectile dysfunction using several methods, for instance the use of oral medications or though assistive devices such as pumps.

Oral medications

Oral medications are often the priority treatment for erectile dysfunction.

Some of the medications that work well in treating ED by enhancing the effects of nitric oxide and cause few side effects are:-

• Vardenafil (Levitra
• Staxyn
• Sildenafil (Viagra)
• Avanafil (Stendra)
• Tadalafil (Cialis)

Nitric acid is a natural chemical produced in the body that relaxes muscles in the penis area and increases blood flow.

Other medications

Alprostadil self-injection

Alprostadil (Caverject, Edex, and MUSE) is an injectable solution administered 5 to 20 minutes before having sex. You can use it alone or alongside other medications.

Alprostadil is said to cause side effects such as:-

• Painful erections that last 4 hours or longer
• New or worsening pain in your penis
• Lightheadedness and redness
• Swelling
• Tenderness
• Lumps
• Unusual shape or curving of the erect penis

When such symptoms present, you should report to your doctor immediately.

Alprostadil urethral suppository

Alprostadil is a tiny medicated pellet drug placed in the urethra and works by giving you an erection.

You should test IU Alprostadil first before home-usage. A common side effect of IU Alprostadil is a burning sensation in the penis.

Testosterone replacement

Doctors sometimes prescribe testosterone to treat ED in men with a testosterone deficiency.

They first conduct a test to check your testosterone levels to determine the correct dosage to give you.

Testosterone enhancement comes with risks such as an increased chance of a stroke or heart attack. Your doctor should monitor your testosterone levels afterward to prevent the occurence of other problems.

Penis pumps, surgery, and implants

Penis pumps

A penis pump is a plastic tube fitted over the penis to help it achieve and maintain an erection. It works by drawing blood into the penis through air suction.

Penis pumps are cost-friendly, work well, and present fewer risks compared to other treatments.

They are not a cure for erectile dysfunction (ED) but can help increase your ability to have sexual intercourse.

Penile implants

Penile implants are devices placed inside the penis through surgery to help men with erectile dysfunction. Doctors recommend the use of penile implants in areas where other ED treatments have failed.

There are two main types of penile implants: inflatable, and semi-rigid.

Each type of penile implant works differently and has various benefits and risks.

Exercise

Exercise is one of the best ways to treat erectile dysfunction without medication. It works to strengthen the pelvic floor muscles.

One of the commonly used exercises is the kegel exercise. It is performed by tightening and holding the penis muscles for five seconds and then releasing them for about 10 to 20 reps daily.

Psychological counseling

A doctor may recommend psychological counseling if your ED is related to psychological issues.

It is often good to include your partner in the therapy.

Alternative medicines

Herbs and supplements

Some supplements, food products, and herbal preparations are potential remedies for erectile dysfunction.

Some of the herbs generally considered to be safe include:

• Ginseng
• DHEA
• L-arginine
• Propionyl-L-carnitine

Note: Be careful when purchasing or consuming any alternative products.

Lifestyle and home remedies

Quit smoking and reduce alcohol

According to research, cigarette smokers have a higher risk of experiencing erectile dysfunction. It reduces blood flow to the penis. Quitting smoking reduces your chances of getting ED.

Counseling

Sexual counseling can help patients with ED by addressing underlying issues that cause erection problems.

Some of the issues addressed by counseling include anxiety, family expectations, social pressure, misinformation about sex, and couple issues.

Physical activities

Exercise can help treat ED by improving blood flow, blood pressure, stamina, mood, increasing energy levels, and reducing stress.

You should have 30 minutes of physical exercise every day.

Losing excess weight

The more overweight you are, the higher the risk of having erectile dysfunction. By simply shedding off excess weight, you can save yourself from drugs and surgery.

Complications resulting from erectile dysfunction

Some complications can include:

• Embarrassment or low self-esteem
• An unsatisfactory sex life
• Relationship problems
• Stress or anxiety
• The inability to get your partner pregnant

Prevention of erectile dysfunction

You can prevent erectile dysfunction by managing any existing health conditions associated and making healthy lifestyle choices such as:

• Following a healthy eating plan
• Getting help for depression, anxiety, and other mental health concerns
• Take steps to reduce stress
• Managing diabetes, heart disease, and other chronic health conditions
• Visiting a doctor for screening and regular checkups
• Exercise regularly
• Quit smoking, avoid or limit alcohol and other illegal drugs
• Wrapping up

Erectile dysfunction is usually treatable by medications, surgery, and practicing a healthy lifestyle.

The best treatment depends on the person. Some people find traditional treatment better in addressing ED while others go for medication and surgery.

Leading a healthy lifestyle for instance eating a healthy diet, physical exercises, and avoiding the use of drugs can help you prevent erectile dysfunction.