- Who Gets ED?
- When to See Your Doctor
Symptoms of erectile dysfunction
ED is a very common condition that affects at least 10% of people with penises.
There are many causes of erectile dysfunction. Whether or not this condition is permanent depends on the cause and how your body responds to treatment.
The main symptom of ED is that you will have trouble getting an erection or maintaining one during sexual activity. You may also experience a decreased desire for sex or feel stressed when you think about having sex.
Many men have trouble with erections once in a while. To be considered as having erectile dysfunction, you must have difficulty with erections on a regular basis for a certain period of time.
Depending on the cause of your erectile dysfunction, you may also have other symptoms. For example, if your ED is caused by depression, you may also feel sad and tired.
Causes of erectile dysfunction
Erectile dysfunction may be caused by physical or mental factors. In some cases, a combination of mind and body will lead to ED.
- Cardiovascular disease: Narrowing or hardening of the arteries can restrict blood flow to your penis, reducing your ability to get or uphold an erection.
- Nerve damage: Conditions like diabetes, stroke, or multiple sclerosis can damage the nerves that send signals to your penis.
- Injury: One study showed that 95% of men who had a spinal cord injury also had erectile or ejaculatory dysfunction within the first two years after the injury.
- Mental health: Conditions like depression, anxiety, and simple stress can contribute to erectile dysfunction.
- Hormones: Low levels of male androgens like testosterone can cause ED in some cases.
- Medications: Some prescriptions, including anti-depressants and other medications, will lower blood pressure and have erectile dysfunction as a side effect.
- Lifestyle: Habits like smoking cigarettes, heavy drinking or drug use, and lack of exercise can contribute to ED.
Who can get erectile dysfunction?
Anyone with a penis can get ED, and it is very common. In the US, about 30 million men have erectile dysfunction.
You are more likely to develop erectile dysfunction as you age. Half of men over the age of 40 experience ED at some point in their lives.
Other risk factors include:
How do doctors diagnose erectile dysfunction?
Doctors can often diagnose ED by getting your medical history and conducting a physical examination. However, they usually also try to diagnose the underlying cause of the condition, so they may also perform:
Erectile dysfunction treatments
Once your doctor diagnoses the underlying cause of your ED, they will recommend a treatment to help.
Common treatments include:
There are four medications available that may help alleviate your erectile dysfunction:
These medications increase the effects of nitric oxide in the body. This allows the muscles of the penis to relax and increases the amount of blood flowing to the area.
These prescriptions don't work without external stimulation, though. Once you have some sexual stimulation, your penile nerves will release some nitric oxide, and you may see an improvement in the strength or duration of your erection.
A prescription injection of Alprostadil expands the blood vessels of the penis, allowing more blood to flow into them. In about 80% of people who try it, this injection results in an erection that leads to successful intercourse. It starts to work five to 10 minutes after injection. With this medication, your erection may continue even after you have had an orgasm, but it should not last longer than one hour.
Alprostadil is also available as a cream that you can rub on the penis or as a suppository that you insert into your urethra. The suppository is not often prescribed because it is not as effective and has more side effects.
If your erectile dysfunction is caused by low levels of testosterone, your doctor may prescribe medication to balance your hormone levels. Once you have a higher level of testosterone, your erectile dysfunction may go away.
A penis pump is a medical suction device that can help draw blood into the penis to create an erection. First, you put a penis ring around the base of your penis or around your testicles and penis to hold the blood in your penis longer.
Then, the suction device goes over your penis. The pump creates a vacuum that sucks blood into your penis, creating an erection that usually lasts long enough for sexual intercourse.
Doctors only recommend surgery for erectile dysfunction when no other treatments have worked. During this procedure, doctors insert either an inflatable or bendable implant into your penis, allowing you to control when you have an erection.
Increasing your amount of exercise, making healthier food choices, and lowering your caloric intake have been shown to treat erectile dysfunction, especially in people who are obese. In general, losing weight if you are obese may help to improve the strength and duration of your erections. Experts believe this is because losing weight reduces your risk for other conditions that can cause erectile dysfunction, such as diabetes.
One study showed that people who followed diets that had higher amounts of whole grains, fruits, and vegetables, and lower amounts of red meat, full-fat dairy products, and sugar also had a lower risk of dealing with erectile dysfunction.
While studies show that modest alcohol use can actually protect against ED, drinking too much over a long period of time can lead to the condition. One study showed that 72% of men who dealt with alcohol addiction also had some form of sexual dysfunction, including erectile dysfunction, premature ejaculation, or a lack of sexual desire.
Mental health treatment
If your erectile dysfunction is caused by a mental health concern like depression or anxiety, seeing a counselor or a therapist may help to address the underlying issue and provide some coping mechanisms to help in sexual situations. If you work with a psychiatrist, they can also prescribe medications to help with your mental health concerns.
When to see your doctor
You should talk to your doctor about erectile dysfunction if it causes you distress or you have any concerns about it. You should also talk to them if you experience ED while having conditions that may contribute to erectile dysfunction, such as diabetes or heart disease, or if you have other symptoms along with ED, like delayed or premature ejaculation.
Even if your erectile dysfunction is persistent, it may not be permanent. Your doctor can recommend one of the many available treatments that can help you.
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Asian Journal of Andrology: "Lifestyle modifications and erectile dysfunction: what can be expected?"
Cleveland Clinic: "Alprostadil (Injection therapy)," "Erectile Dysfunction."
Indian Journal of Psychiatry: "Prevalence of sexual dysfunction in male subjects with alcohol dependence."
Mayo Clinic: "Erectile dysfunction," "Penis pump."
Urology Care Foundation: "What is Erectile Dysfunction?"
Yale Medicine: "Erectile Dysfunction."
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