All about erectile dysfunction, its symptoms, causes and treatment

Many men have problems with keeping a firm and sustained erection during sex. Men with this problem may have erectile dysfunction and need medical care and therapy to treat the condition. 

A couple having relationship problems due sexual issues

Sex is a commonly discussed topic among younger and older adults. Both males and females worry about whether they are getting it right or not because almost everyone would like to know that they satisfy their partner in bed. But what happens when a person with a penis cannot last long in bed because of erectile issues?

Erectile dysfunction is treatable. However, many people with this condition are reluctant to see a healthcare professional, perhaps due to the perceived stigma attached to it. 

This article will discuss all you need to know about erectile dysfunction, its causes, symptoms, diagnoses and treatment.

What is erectile dysfunction (ED)?

Erectile dysfunction (ED) is when a person with a penis cannot have an erection or sustain an erection firm enough to have sex. This is commonly called impotence.

ED can affect a person’s sexual life and ruin intimate relationships. It can also reduce a person’s quality of life and negatively impact their mental health.

Erectile dysfunction is a common medical problem among the populace. Studies suggest that about 10% of people with male genitalia between the ages of 40 and 70 have erectile dysfunction.

Many people occasionally find it hard to get an erection, for instance, due to occasional stress. And this may not be considered abnormal. However, it becomes a problem if getting and keeping an erection is consistently impossible.

A person can be said to have erectile dysfunction if:

  • They can’t get an erection at all
  • They can get an erection occasionally, but not every time they want to have sexual intercourse
  • They get erections that can’t be sustained enough to have lasting, fulfilling sex

It will be important also to share knowledge about what causes erectile dysfunction.

Causes of erectile dysfunction

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Erectile dysfunction can be caused by a combination of things that affect the nervous system, vascular system and endocrine system. ED can also result from emotional problems, health problems or both. 

Health problems that can cause ED

Health problems that can cause ED include:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Atherosclerosis
  • Multiple sclerosis
  • Cardiovascular diseases
  • Chronic kidney disease
  • Penis, prostate, bladder, spinal cord injury

Emotional causes of ED

Problems that affect a person’s psychology and mental health can cause ED, e.g.

  • Anxiety
  • Depression
  • Stress
  • Family issues
  • Relationship issues
  • Worry about one’s performance in bed

Medications

Some drugs have side effects that may cause ED, e.g.,

  • Antidepressants
  • Ulcer medications
  • Tranquilisers
  • Blood pressure medicines
  • Antiandrogens

Risk factors

Some risk factors can contribute to erectile dysfunction, for instance, age. Even though ageing does not cause erectile dysfunction, older people are more likely to develop erectile dysfunction.

Other risk factors of ED include:

  • Smoking
  • Obesity or being overweight
  • Illegal drug use
  • Not being physically active
  • Excess alcohol use

Symptoms of erectile dysfunction

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ED makes it difficult or impossible for a person to sustain an erection firm enough for sexual intercourse. This can be worrisome when it continues for a long time. However, a healthcare professional can help treat this condition.

Major symptoms of ED include:

  • Constant inability to get an erection
  • Persistent trouble keeping the erection
  • Reduced libido (urge to have sex)

Erectile dysfunction may also cause a person to have depression and low self-esteem. It can also cause relationship issues between spouses. 

Diagnosis of ED

To diagnose and treat you, your doctor would like first to find out the root cause of the problem. The idea is that if the underlying cause is treated, the affected person will be able to start getting and keeping a sustained erection, thus start having an improved sexual life. 

To diagnose ED, your healthcare provider may start by asking you questions about the problem, your cardiovascular health, and when the problem started. 

The doctor may take your family and medical history and ask questions about your lifestyle and general health.

You may expect a physical exam where your doctor will examine your body, particularly your genital areas, for physical problems. The doctor may further order lab tests and other tests to check for health problems that may cause ED, blood flow, testosterone, trauma and sleep erection.

Treatment of ED

There are different paths your doctor may take to treat your erectile issue. 

Medication

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If you are taking any medication with side effects that can cause ED, your doctor may start by changing the medicine or its dosage. 

The doctor may then go ahead and prescribe for you medicines to treat the ED, such as tadalafil (Cialis), sildenafil (Viagra), avanafil (Stendra) and vardenafil (Levitra). These medications increase blood flow (needed for erection) to the penis. 

Injecting alprostadil into the penis may also cause stronger erections as this injectible medicine causes the penis to be engorged with blood. If you don’t want to inject alprostadil, you can insert its suppository into your urethra. Your healthcare provider will recommend the best option for you.

Testosterone therapy

When erectile dysfunction is caused by low levels of the male sex hormone (testosterone), testosterone therapy can help treat the condition. It works better when combined with ED drugs.

However, testosterone therapy may be unhelpful if your ED is caused by other underlying health problems like nerve problems or cardiovascular issues.

Vacuum device

A vacuum device for treating ED is a device that helps create and sustain an erection by pulling blood into the penis. 

It has a plastic tube where the penis is inserted, a pump that creates a vacuum by drawing air out of the tube and an elastic ring that helps maintain an erection during intercourse by preventing blood in the penis from flowing back to the body.

Therapy sessions

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For some people, seeing a therapist can help treat ED. This is particularly true for people whose ED are affected by emotional and psychological issues. 

Emotional and psychological distress can cause stress and anxiety, which can affect a person’s sex life. A therapist will work with you to teach you how to deal with anxiety and lower your stress levels. 

Lifestyle changes

Making some changes to lifestyle can help in ED treatment. You will have to focus on changing certain lifestyle habits that are risk factors for ED. 

Your doctor may suggest that you:

  • Quit smoking
  • Stop the use of illegal drugs
  • Lose some weight
  • Limit alcohol use
  • Exercise more often

Surgery

Physicians often recommend surgery as a last resort (i.e., if other treatment options didn’t yield results). If surgery is the best option for you, your doctor will let you know.  

Surgery may involve:

  • Rebuilding damage to arteries to improve blood flow to the penis
  • Implanting a device that will help make the penis erect

A urologist can perform these surgeries to repair and reverse problems that cause ED.

When to see a doctor

The first person you should consult in a case of erectile dysfunction is your family doctor or primary healthcare provider. 

Consult your doctor if you have an erection issue affecting your sexual and everyday life. If you are persistently experiencing the inability to get or keep an erection, it would be best to see your doctor. 

You should be willing to discuss with your doctor other diseases you have that may be linked to ED and also other symptoms you have along with the condition. 

References

  1. Boston University School of Medicine. (n.d.). Epidemiology of ED.
  2. MedlinePlus. (2022). Alprostadil urogenital
  3. National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Definition and facts for erectile dysfunction