What causes erectile dysfunction?

Erectile dysfunction (ED) is the medical term for impotence. Treatments for erectile dysfunction include lifestyle changes, psychotherapy, medications, devices, and surgery.
Erectile dysfunction (ED) is the medical term for impotence. Treatments for erectile dysfunction include lifestyle changes, psychotherapy, medications, devices, and surgery.

Erectile dysfunction (ED) is the medical term for impotence. The term is used when a man can’t get an erection or keep his penis erect for sexual activity. It is not considered a disease but a symptom of other physical or psychological problems.

Sometimes, you may get erectile dysfunction if you drink too much alcohol or experience anxiety, stress, or tiredness. Don't worry if you experience occasional erectile dysfunction at times like these because this is normal. However, if ED continues for a long time, you may need to visit your doctor. 

Can erectile dysfunction be cured? Or is it permanent? Here’s everything you need to know about erectile dysfunction symptoms, causes, treatment, and more.

You are more likely to have erectile dysfunction as you age. It can occur because of hormonal changes, psychological problems, certain health conditions, and other factors. These factors can reduce the blood flow to your penis and prevent it from becoming fully erect. 

Erectile dysfunction causes include the following.

1. Health conditions

Certain health conditions can increase your risk of developing erectile dysfunction. Type 2 diabetes can affect your nerves and blood flow, leading to erectile dysfunction. Also, heart and artery problems can cause erectile dysfunction. High blood pressure and atherosclerosis, or buildup of cholesterol in arteries, can affect your ability to get an erection.  

Apart from this, the following conditions can cause erectile dysfunction.

2. Injury

Injury to the penis, spinal cord, prostate gland, urinary bladder, or abdomen can cause erectile dysfunction. Suppose you undergo prostate cancer treatment, prostate surgery, or bladder cancer surgery. In that case, you may be at a higher risk of erectile dysfunction.

3. Medicines

Erectile dysfunction can be a side effect of certain medicines. They include blood pressure, prostate cancer, and ulcer medications. Appetite suppressants, which reduce hunger, can also lead to erection problems. Medicines like antidepressants, tranquilizers or sedatives, and eye drops for an eye condition called glaucoma can also cause erectile dysfunction.

4. Psychological or emotional problems

Psychological or emotional problems can cause erectile dysfunction. They include:

  • Fear of sexual failure or sexual performance anxiety
  • General anxiety
  • Depression
  • Stress
  • Low self-esteem
  • Feeling guilty about sexual performance or activities

5. Lifestyle factors

Lifestyle factors like drinking too much alcohol, smoking, or doing illegal drugs can lead to erectile dysfunction. If you're overweight and physically inactive, you may be more likely to experience erectile dysfunction. Sleep problems like lack of sleep or insomnia can also cause erection problems. Excessive steroid use is also a risk factor:

6. Other causes

Other causes of erectile dysfunction include poor sexual knowledge, improper sexual techniques, and poor interpersonal relationships.

What are erectile dysfunction symptoms?

Erectile dysfunction symptoms include:

  • Getting an erection sometimes, but not each time you want to have sex
  • Getting an erection but not being able to keep it for long
  • Not getting an erection at all

How is erectile dysfunction diagnosed?

If you have erectile dysfunction, you’ll need to visit a doctor like a urologist. You may feel embarrassed to talk to your doctor about erectile dysfunction. But your doctor needs to understand your condition to help you get better.

Your doctor will check your medical history to find any underlying conditions or injuries. They'll also check your sexual history to diagnose problems with erection, sexual activity, desire, or climax. They'll then conduct a physical exam to check your blood pressure, underlying conditions, and penis abnormalities. 

Erectile dysfunction diagnosis involves using mental health tests to check for mental or emotional problems. Your doctor may order blood tests. They help detect erectile dysfunction causes such as diabetes, hormonal issues, atherosclerosis, or chronic kidney disease. 

Your doctor may use imaging tests like Doppler ultrasound to measure the blood flow in your penis. They may also use the nocturnal or nighttime erection test to monitor the strength, duration, and number of erections you get. They may use an injection test, too. The doctor will inject a medicine into your penis to induce an erection and check its strength and duration.

Can erectile dysfunction be cured?

Erectile dysfunction is a symptom caused by physical, emotional, or lifestyle factors. It is temporary and can easily be cured. Your doctor will diagnose its cause and treat it.

Erectile dysfunction treatment includes the following:

Lifestyle changes

Your doctor will ask you to: 

  • Quit smoking 
  • Reduce or stop drinking alcohol 
  • Do some physical activity 
  • Lose weight or maintain a healthy body weight
  • Stop using illegal drugs 

These are also ways to prevent erectile dysfunction. If you’re unable to make these lifestyle changes, consult your doctor to help you with it. 

Psychotherapy or counseling

If you have erectile dysfunction due to psychological or emotional problems, a counselor can help you manage them. The counselor may ask you to bring your partner to the sessions to understand the issue. 

Change the medicines that cause erectile dysfunction

If a medication you’re taking causes erectile dysfunction, your doctor may change the dose or suggest alternate choices. Don’t stop taking a medicine unless your doctor tells you to. 

Oral medicines

Oral medicines like sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), or avanafil (Stendra) help treat erectile dysfunction. They increase the blood flow to your penis and help you get and keep an erection.

Testosterone replacement therapy

Your doctor may prescribe testosterone replacement therapy if you have low levels. However, it has side effects like increased red blood cell count and problems while peeing.

Injections or suppositories

For more robust erections, doctors prescribe alprostadil injections. They are directly injected into the penis to increase the blood flow. Some people insert alprostadil suppositories into the penis. A suppository is a medicine pellet that is inserted into the body, where it dissolves and acts immediately. 

Vacuum device

Some doctors prescribe a vacuum device. It causes an erection by pulling blood into the penis using a pump. 

Surgery

Doctors use surgery as a last resort. They may use surgery to implant a device to make your penis erect. They may also surgically reconstruct arteries to improve blood flow in the penis. Consult your doctor to know if you need surgery. 

Other considerations

Erectile dysfunction treatment, like oral medicines, can have side effects, especially if you’re on other medications. If you use erectile dysfunction medicines with alpha-blockers used to treat prostate enlargement, you may have a sudden drop in blood pressure. Also, taking testosterone therapy with other medicines may cause severe side effects. 

Consult with your doctor and inform them about your medical history before getting erectile dysfunction treatment. 

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Medically Reviewed on 5/9/2022
References
Sources:

Better Health Channel: "Erectile dysfunction."

Johns Hopkins Medicine: "Erectile Dysfunction."

National Institute of Diabetes and Digestive and Kidney Diseases: "Definition & Facts for Erectile Dysfunction," "Diagnosis of Erectile Dysfunction," "Preventing Erectile Dysfunction," "Symptoms & Causes of Erectile Dysfunction," "Treatment for Erectile Dysfunction."

University of Rochester Medical Center: "Erectile Dysfunction (Impotence)."