Is Erectile Dysfunction Always Permanent?

Erectile dysfunction is defined as your inability to get or maintain an erection when you want to. Erectile dysfunction is treatable with counseling, medications, injections, physical devices, and other medical treatments.

Erectile dysfunction (ED) is treatable in most men. You might be limiting your sex life unnecessarily if you think that erectile dysfunction is just a normal part of aging.  

How long ED lasts depends on what’s caused the condition. The different causes of ED have their own treatments — each with its own chance of success.

This means that your best chance of treating your ED is to figure out what’s causing your condition. 

Erectile dysfunction isn’t necessarily a normal part of aging. Admittedly, your odds of developing ED increase as you get older. 

It’s normal for testosterone levels to decrease with age. This natural process begins around age 30. Levels then        decrease — at a rate of about 1% a year — for the rest of your life. Plus, your odds of getting a disease that causes ED increase as you age.

These factors combine to mean that more than 50% of all males between the ages of forty and seventy years report some level of erectile dysfunction. But other men are capable of healthy sex lives without any sustained ED well into their eighties.  

Erectile dysfunction is defined as your inability to get or maintain an erection when you want to. There are two main types: primary and secondary. 

Primary ED is very rare. In this condition, you’ve never been able to get an erection at all. Doctors can most often diagnose this condition through clearly visible congenital — birth — defects. 

Secondary ED is by far the more common form of the condition. The rest of this article focuses on secondary ED. In this form of ED,  you were previously able to get and maintain erections to your — and your partner’s — satisfaction but no longer can.

It’s important to remember that everyone occasionally struggles to get an erection. Lack of erection only qualifies as erectile dysfunction when it happens to you frequently or if it’s getting progressively worse.  

Many underlying conditions and lifestyle choices are associated with an increased risk of erectile dysfunction. If you notice problems with your sexual function, check the following lists to see if you have any added risks for ED. 

Lifestyle risk factors include: 

• Smoking
• Using certain drugs — these can be both recreational and prescription
• Heavy alcohol use
• Being obese
• Not getting enough exercise

Underlying conditions with an increased risk of ED include having:  

• High blood pressure
• High cholesterol
• High blood sugar — mainly from an underlying diabetes
• Cardiovascular disease

You’re also at an increased risk if you’re over fifty years old. 

Your erectile dysfunction could have either physical or psychological causes or both. Physical causes include both medical conditions and the use of certain prescription medications. 

Psychological causes can develop at any time and can be due to a number of problems, including: 

• Depression
• Anxiety
• Stress from work
• Stress from your home life
• Guilt
• Fear of intimacy
• Performance anxiety
• Low self-esteem

Medical conditions that can cause ED include:

• Atherosclerosis — where your blood vessels harden and become blocked
• Type 2 Diabetes
• Heart disease
• Chronic kidney disease
• Nearby cancer treatments — including surgery and radiation for prostate, colorectal, and bladder cancer 
• Multiple sclerosis
• Peyronie’s disease
• Injury to your penis or surrounding areas

Sometimes a medication you need to treat a different condition will lead to ED. If this is the case with one of your prescriptions, your doctor should have already discussed this side effect with you. 

Some medications that can cause ED include: 

• Antiandrogens — used to treat prostate cancer
• High blood pressure medications
• Antidepressants
• Sedatives — anything that’s meant to make you calm and sleepy
• Ulcer medication
• Appetite suppressants

The cause of your erectile dysfunction will guide your doctor’s treatment choices. 

If it’s caused by a medicine that you need for a different condition, then there might be alternative prescriptions that you can try. Otherwise, you can try other treatment techniques to manage the ED. 

Counseling and therapy are great treatments for many of the psychological causes of ED. Talking to someone about your worries and stress can be a great relief and is sometimes enough to get your sex life back on track. You can go to sessions by yourself or with your partner.  

Talking to a therapist can even be helpful if your ED has a physical cause. There are many emotional frustrations associated with this condition. These reactions can increase both the ED and secondary complications. Therapy can help you process these new realities and develop coping strategies to reduce the issues.

For most medical conditions, you’ll be able to regain normal sexual function once you get the underlying disease under control. 

While you wait for these more long-term solutions to take effect, there are some ways you can generate an erection when you want to use it. You’ll need to repeat these methods every time you want to engage in sexual activities. 

Treatments include: 

• Medications called oral phosphodiester inhibitors — this is the most common treatment option and can be used along with most other treatments  
• Self-injected medications — applied inside of your urethra, for example
• Physical devices — including vacuum pumps to become erect and tight rings to prevent blood from leaving your erection

The final option for treatment — typically used only when all other options have failed — is a surgical implant in your penis. These can be either solid, semi-rigid silicone prosthetics or devices that inflate with a saline solution. Around 95% of the couples that need this treatment report satisfaction with the prosthetic. 

Also, note that there are numerous natural remedies on the market that claim to treat your ED. Most of these have not been studied well — if at all — and none are FDA approved. Ginseng has had some early success in scientific studies — but we need more research to prove and understand this effect.

Erectile dysfunction can be a sign of a serious underlying condition. It’s best to get your erectile problems checked out by a doctor whenever they become frequent. 

And keep in mind that you deserve a healthy sex life at any age. Get medical help whenever you and your partner begin to experience a decreased quality of life from your bouts of erectile dysfunction. 

Also, make sure you seek medical help if you notice any negative side effects from medications that are meant to treat your condition. For example, if you experience an erection that lasts longer than four hours.