Erectile Dysfunction Causes, Symptoms & Treatment Explained by an Expert

More than 80 % or chronic alcoholics suffer from chronic impotence.

What should I do if I develop persistent erectile dysfunction? These may be helpful as part of an overall plan to maintain a healthy diet. Men have a higher rate of CVD than women [11]. Effect of lifestyle changes on erectile dysfunction in obese men. If there are no other known medical conditions, a full physical examination is necessary. 36 However, in the majority of patients who receive this treatment, less invasive alternatives have failed and therefore satisfaction with this treatment would be expected to be higher in this subset of patients. 25–26 Vascular reconstructive surgeries are beneficial in certain groups.

There also is some evidence that men with high blood pressure have lower sperm counts and testosterone levels than men with normal blood pressure,   which in turn may lower the hormonal response to sexual stimulation. Impotence means that a man's penis doesn't get hard enough to have sexual intercourse. 5% of the patients had a good tolerance of their sexual dysfunction [68]. Understanding the relationship between testosterone and ED has been impaired by a lack of standardized measurement of this hormone and the cyclic nature of its release and consumption. Parkinson's disease and other diseases of the motor system, stroke, multiple sclerosis, neurosyphilis, hypothalamo-hypophysiary disease, some tumors of the brain and of the pituitary gland, and epilepsy. Today, the pendulum of medical opinion has swung away from both notions.

The device has a tube you place around the penis.

Penile implants are a type of surgery that may be considered. The following are some leading causes of erectile dysfunction: These physical and psychological factors could trigger an episode of ED. Rhodiola rosea:

However, the failure to achieve an erection more than 50% of the time generally means that there is a problem and treatment is needed. But pain after the operation may affect sexual performance for a time. In 1982, he received FDA approval to market the product as the ErecAid®.

  • How long have you been unable to obtain and/or sustain an erection?
  • Obesity, sedentary life and smoke are related to a higher incidence of ED.
  • Rarely is low testosterone responsible for impotence.
  • Porn is killing my erections.
  • For men whose ED is caused by blocked blood supply to the penis because of injury to the penis, pelvic area, or other vascular problems, vascular surgery of the penis may be the solution.
  • But did you know that smoking cigarettes can also lead to ED?
  • ’ This means that erectile function has been normal, but becomes problematic.

Diseases That Can Lead to Erectile Dysfunction

An intracavernous injection should be performed when the penis is in a flaccid state; otherwise, abrupt detumescence may easily occur with passage of the drug into the general circulation. Neurogenic - these conditions affect the nervous system, which consists of the brain, the nerves, and the spinal cord. What are the symptoms of peyronie's disease? Researchers surveyed more than 31,000 health professionals, aged 53-90, about their sexual function. They are not recommended. A man is considered to have ED when these symptoms occur regularly. Antihypertensives (high blood pressure drugs).

An injury could contribute to symptoms of ED.

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Five healthy behaviors characterize a healthy lifestyle -- not smoking, eating a healthy diet, avoiding alcohol (or consuming it only in moderation), getting plenty of physical activity and controlling weight. Injection therapy can treat many men who do not respond to pills. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes. And if you’re already taking certain medications such as nitrites for your heart or alpha-blockers to manage blood pressure, your doctor will discuss whether ED medications are right for you or whether other options may be more appropriate. HuffPost is part of Verizon Media. Primary hypogonadism, in contrast, has normal or even increased levels of FSH. None of the PDE5-Is are dangerously associated with QTc prolongation, although vardenafil has a warning for patients at risk for QTc prolongation [90]. Anything that damages the nerves or impairs blood flow in the penis can cause ED.

Know how you can contact your provider if you have questions. NO causes the smooth muscle cells in the blood vessels of the penis to stretch, which increases the flow of blood. An erection may not happen if something interferes with blood flow to the penis. However, supplements have not been tested to see how well they work or if they are a safe treatment for ED. Common causes of erectile dysfunction for middle aged men may include stress, guilt, or having sex with a new partner after many years of monogamy. O’Leary, the medical editor of the report, says that erections “serve as a barometer for overall health,” and that erectile dysfunction can be an early warning sign of trouble in the heart or elsewhere.

However, 2 previously approved devices–the OmniPhase and the DuraPhase penile prostheses–are not considered safe in this environment. It is important to remember that millions of other men are affected by the same problem and that it is very treatable. In some cases, the inability to have an erection also manifests as a symptom of an underlying health condition, making it all the more important to seek medical attention. Furthermore, the safety profile of the currently available PDE5-I is excellent in the elderly too. There is a good chance of success with treatment. If you would like to ask a question, please write [email protected] But some men try complementary therapies. Treatment with 10 mg vardenafil ODT, taken on demand, significantly improved erectile function and was effective and well tolerated.


Instead, bring the muscles together in a squeezing motion. Relaxation of the sinusoidal smooth muscle increases its compliance, facilitating rapid filling and expansion. Stress - for example, due to a difficult work or home situation. What our patients say, compared with the 2020 study, although some risk factors changed (Supplement 3, 4), there was still no change in the prevalence of ED. If you have low testosterone levels, your doctor may recommend these blood tests. Furthermore, due to comorbidities and multiple pathophysiologic changes in the old patient’s penis, vasculature, and nervous system, a fully rigid erection will be hard to be accomplished with the use of the oral pharmacotherapy alone [15]. If you don't want to use medicine, or if medicine doesn't work for you, you may want to talk with your doctor about some of the following options. Young-old people, that is, people aged between 65 and 74 years old, can be mostly concerned in the recreational use of PDE5-I. In many cases, psychological issues develop into performance anxiety which, in and of itself, becomes a self-fulfilling prophecy.

Many doctors take a step-by-step approach to treating erection problems.

Most men who take this medication find that an erection occurs within 4 to 5 hours after taking the pill (slow absorption) and the effects of the medication may last up to 24 to 36 hours. These include cutting back on alcohol, quitting smoking, losing weight, and increasing physical activity. This even occurs in the elderly, especially in healthy young elderly, where keeping a normal sexual life may be a marker of healthy and successful aging.

In fact, there are so many, and for so many conditions, that this should be one the leading causes of organic impotence.

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Neurologic (neurologic impairment or dysfunction) - Possible causes include retroperitoneal or pelvic surgery, spinal cord injury, neurologic disease (such as spina bifida, Parkinson's disease, Alzheimer's disease), diabetes mellitus, pelvic trauma, ETOH abuse, stroke and pelvic irradiation. For most men it is only temporary and an erection occurs most times when you are sexually aroused. Who is at risk for erectile dysfunction?, one patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice. The most common causes of ED are health problems that affect blood vessels and blood flow in the penis. These could stem from relationship conflicts, life's stressors, depression or anxiety from past problems with ED (performance anxiety). Thus, a man's self-esteem may be hurt by occasional impotence and this may lead to anxiety and inhibition of sexual reflexes. Erectile dysfunction can vary. The prevalence of physical problems that can cause ED -- disorders with blood vessels, nerves or hormones -- tend to increase with age and are often lifestyle related.

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This usually interferes with sexual activity. First, a simplified anatomy overview for a rather complicated human process. Some surgeries, such as radical prostatectomy, that involve nerves being cut as part of the operation can also lead to ED. However, some primary care practitioners may recommend vacuum constriction devices.

Some of the treatments that may be used include: Is there any new curve or bend to your penis to suggest Peyronie’s disease? Specific tests for erection problems.

Some ED medicines are injected into the penis.

Erectile Dysfunction Diagnosis: Physical Exam

Topical alprostadil may be prescribed. A recent study published in the Journal of Men's Health concluded that there was no relationship between prolonged cycling and erectile dysfunction. Erectile dysfunction can, however, vary and about 40 to 50% of patients with intact nerves start to see improvements a year after the treatment. These surgeries are not common and they're recommended only for men with very specific conditions.

People who suffer from hypogonadism will have abnormally low levels of testosterone Cushing’s syndrome - this condition affects the amount of cortisol in the body. The surgeon or health care expert in the surgeon's office will talk about how to inflate and deflate the implant. Taking prescription medicine that can help you get erections. Also, if you have high blood pressure for which you take a certain type of medication, called alpha-blockers (doxazosin, indoramin, terazosin or prazosin), you need to wait until you are on a stable dose.

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Tricyclic antidepressants have been linked to both loss of libido up to 70% and ED in 1. The man cannot get or maintain an erection. Psychological causes are less common than we thought but more often the cause in younger men. For example, serum testosterone (and sometimes prolactin) is typically only useful when the patient demonstrates hypogonadal features or testicular atrophy, or when clinical history is suggestive.

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Hypersexual behavior occurred in 6 (13%) bvFTD patients compared to none of the AD patients [52].   In this theory, the “push” on the small closing valves of the veins is stronger than the veins’ ability to resist, meaning the veins can't “close” tightly enough to stop blood from passing out of the penis. Treatment can help both older and younger men. Erections occur when your brain sends signals that allow arteries in your penis to open completely.

Secondary premature ejaculation. Occasional failure to perform is also found in many other situations. They include the development of petechiae or ecchymosis, numbness or coolness of the penis, trapping of the ejaculate, and pivoting of the penis at the base. A frank discussion can lead to alternative medications or treatments and a better discussion about ED. As men are sexually aroused, the blood is able to rush due to the erectile nerves, which run alongside the penis and make the muscles relax. Does that mean that ED is a natural part of aging?

(5 mcg to 20 mcg intracavernosal). Or, it may install itself gradually as a result of depression, anxiety and chronic stress. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies. Since the 1990s, whether or not they view porn, men of all ages have become more willing to admit erection difficulties. Should I Try Injection Treatments? About 40% of men will notice some degree of problem by age 40. It gives a measurement of the vascular pressure in the corpus cavernosum during an erection.

It is also the most frequently diagnosed sexual dysfunction in the older male population.


Experts continue to debate this issue. If you are trying to access this site from the United States and believe you have received this message in error, please reach out to [email protected] Review your risk factors for an erection problem. Even though by name alone it sounds like it should help, not hurt, an erection, high blood pressure prevents the arteries that carry blood to the penis from expanding the way they're intended to. Research studies, , Bellizzi, V. Trying pills called PDE-5 inhibitors, such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra). In particular, hypersexual behavior may be a particular feature of behavioral variant frontotemporal dementia (bvFTD), which affects ventromedial frontal and adjacent anterior temporal regions specialized in interpersonal behavior.

Physical problems are often the cause of erection problems in men age 50 or older. Other tests, 20, 24 followed by injections of drugs into the penis, as well as penile implants. According to the Urology Care Foundation, an estimated 30 million Americans experience ED. Many effective treatments are now available, which means that there's a high probability that your ED can be treated successfully.

  • Trying medicines that are injected or inserted into the penis.
  • You are taught how to inject a medicine into the base of the penis.
  • These drugs need to be taken prior to engaging in sexual activity.
  • Yohimbine is a peripherally and central -blocking agent derived from the bark of an evergreen tree; it is also a mild monoamine oxidase inhibitor (MAOI).
  • Men who have diabetes are two to three times more likely to develop ED than men who do not have diabetes.
  • (1%) at 3 years after coronary angiography.

What treatments are available for ED?

Even small amounts of alcohol can cause erection problems. Counselor with special training in sexuality or relationship problems. Stopping smoking and reducing your alcohol intake can also help with ED. The medicines used to treat ED can have dangerous interactions with some common medicines. Vascular disease : If a trial of oral ED therapy and withdrawal of offending medications prove to be ineffective in restoring erectile function, it is appropriate for most primary care practitioners to consider referral to a specialist for additional evaluation and discussion of alternative treatment options. It is defined as the "persistent or recurrent inability to achieve and maintain a penile erection of sufficient rigidity to permit satisfactory sexual activity for at least 3 months. "If you’ve been diagnosed with ED related to performance anxiety, you may be able to have full erections when masturbating or when sleeping, but unable to maintain an erection during intercourse.

Men with urinary symptoms have been shown to have a higher rate of erectile problems as men without them. You also should not take certain alpha-blockers—used to lower blood pressure and to treat an enlarged prostate gland—with these medicines. Histamine H2-receptor antagonists. Research indicates that ED is common, and it is suggested that approximately 40% of males experience symptoms compatible with ED, at least occasionally.

Various mental health conditions may cause you to develop ED. They analyzed porn watching and ED risk among a reasonably representative sample of 877 American men age 18 to 60. A healthy erection requires healthy blood flow.


Learn more about how we use your data in our Privacy Centre. However, these drugs are given for significant conditions so you should talk to your GP for advice. Moral or religious convictions that porn is reprehensible or sinful. Impotence often has a negative effect on a your sex life, and it can cause depression, additional stress, and low self-esteem. Commonly prescribed selective enzyme inhibitors are: Examples of this include multiple sclerosis, Parkinson’s disease, a spinal injury or disorder & stroke.

What's The Average Age For Erectile Dysfunction?

Men who are taking medications that contain nitrates, such as nitroglycerin, should NOT use these medications. Some patients are unwilling to undergo a long evaluation and testing process to obtain a better understanding of their sexual problem. The autonomic nervous system is involved in erection, orgasm, and tumescence. The possible culprits appear to be T, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEAS), and their metabolites [11]. Laboratory tests, such as routine blood and urine tests that can check your level of male hormones, cholesterol, blood sugar, and liver, kidney and thyroid function. These are often used to treat ED.

This is one of the most common causes of ED. Drugs used to treat mental ailments are among the common medicines which cause ED — antipsychotics and antidepressants both being examples of this. Anatomical - these conditions affect the physical structure of the penis. For a successful erection, a man should have a healthy and properly working nervous system, healthy arteries leading to the penile chambers, and healthy muscles and a sufficient amount of nitric oxide in the penis. Careful genital examination, noting testicular size (to screen for hypogonadism) and palpating the penis for Peyronie’s plaques. Erectile dysfunction can result from a problem with any of these. It is best to see your GP. These pills are safe and effective when used under the supervision of a physician.

For most men, improving erectile dysfunction means improving blood flow to the penis.

Surgery Can Cause Erectile Dysfunction

Antidepressants: The treatment for ED starts with taking care of your heart and vascular health. A crucial role is also played by NO, which is able to mediate urinary function through a number of pathways.

Injuries to the spinal cord or nerves leading or coming from the genital area, of course, are also very common, such as in vertebral disc compression, and in traumatic injuries, such as in paraplegy or tetrapley, or in regional paralysis. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction. What are some of the myths about prostate cancer, , and Yadav, H. Hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. Feeling embarrassed about ED may prevent many men from getting the medical attention they need.

Primary premature ejaculation. Blood loss is typically small. In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of 100 men. Rarely, some men need special tests to check nerve function, blood vessels, and blood flow. Common medications that may list ED as a potential side effect include: In fact, ED is one of the main reasons some men stop taking medication for conditions such as high blood pressure and depression.

How is ED diagnosed?

The aim of the present review was to examine the main aspects of erectile dysfunction going through epidemiology and pathophysiology and revise most of ED in elderly disabled men and in those affected with psychiatric disorders. Antiviral drugs: Angiotensin receptor blockers such as candesartan, losartan, and valsartan seem to have beneficial effects on erectile function [15]. Increased systolic flow and reverse diastole 25 min after injection of prostaglandin. Making poor health decisions on a daily basis may affect your ability to get an erection. There are pros and cons for each of the above and your doctor will advise. Erectile dysfunction (ED) is an extremely common condition that can have far-reaching consequences on the self-esteem and relationships of those involved. Vardenafil orodispersible preparation is reported to have the fastest onset of action, while tadalafil is reported to have the longer duration of action.

The symptoms of erectile dysfunction include difficulty achieving an erection, trouble maintaining an erection and a reduced interest in sex.