Erectile Dysfunction (ED): Overview and More

Nutritional states, including malnutrition, obesity, and zinc deficiency, may be associated with erectile dysfunction, and dietary changes may prove a sufficient treatment.

Tricyclic antidepressants have been linked to both loss of libido up to 70% and ED in 1. Step 2, battery-powered penis pump for erectile dysfunction Open pop-up dialog box Close Battery-powered penis pump for erectile dysfunction Battery-powered penis pump for erectile dysfunction A penis pump is used to draw blood into the penis to create an erection. Your doctor will check reflexes and pulses in the area to see if problems with blood vessels or nerves are contributing to the erectile dysfunction. Many entities with a strong relationship to ED also diminish bioavailable testosterone, including obesity, diabetes, and opioid use. Phosphodiesterase inhibitors are also contra-indicated in patients in whom vasodilation or sexual activity are inadvisable, and where there is previous history of non-arteritic anterior ischaemic optic neuropathy, hypotension (avoid if systolic blood pressure is below 90 mm Hg and there is recent stroke, unstable angina or myocardial infarction). Frequency and determinants of erectile dysfunction in Italy.

The authors have no conflicts of interest to declare.

You should not take more than 1 dose in 24 hours. Vascular age carries the advantage of easily and directly communicating the concept of high relative risk to patients, in particular to younger ones, who are by definition at low absolute risk (“Your CV risk is the same of a man that is 15 years older than you”). ED can have psychological consequences as it can be tied to relationship difficulties and self-image. ED can be treated at any age. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.

1983; 249(13): This nomenclature is derived from the sources of the original isolates: Being depressed can affect your ability to get an erection. Psychosocial exam. Treatment options can include the following: However, reported frequency of spontaneous erection and sexual thoughts were significantly decreased as a function of T decline even in younger subjects (50). What medications could cause erectile dysfunction (ED)?

In fact, endothelial dysfunction in aging has been attributed to the presence of NO scavengers in the corpus cavernosum, the most obvious candidates being superoxide anions, whose production is augmented in aging endothelial cells [20].

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This can help to restore adequate blood flow to the penis. When combined with hypertensive disease impotence in diabetics is even more prevalent. For example, the latent period between sexual stimulation and erection increases, erections are less turgid, ejaculation is less forceful, ejaculatory volume decreases, and the refractory period between erections lengthens. According to a review of all randomized controlled trials evaluating sildenafil by the American Urological Association (AUA) Consensus Panel on Erectile Dysfunction, 36% to 76% of patients receiving the drug were "able to achieve intercourse" during treatment. In other words, ED may be the cause or the consequence of depressive disorder. Signs and symptoms, the term erectile dysfunction is not used for other disorders of erection, such as priapism. Find a urologist near you. These are most often related to the blood supply of the penis.

These are often associated with women looking to strengthen their pelvic area during pregnancy, but they can be effective for men looking to regain full function of the penis. In fact, ED is as important a cardiovascular disease risk factor as is smoking or a family history of heart disease. Health topics, it is not a first-line treatment for ED because there’s a high drop-out rate, Bivalacqua says. Because there is a triad relationship between depression, ED and cardiovascular disease, men with depression should be fully evaluated for medical illness as well as psychological factors. The incidence of adverse events (AEs) was similar to that in the general population taking sildenafil; importantly, no difference in AEs was found in the three age groups [79]. There are specific treatments for some of the causes of erectile dysfunction.

Side effects include lightheadedness, fainting, priapism, urethral bleeding (intraurethral), dyspareunia in the partner (intraurethral), hematoma (intracavernosal) or penile curvature secondary to scar (intracavernosal).

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Does riding a bicycle cause ED? Discuss your symptoms and concerns with your doctor to help figure out the cause of your erectile dysfunction. SIEDY scale 3, a new instrument to detect psychological component in subjects with erectile dysfunction. There are no uniform criteria defining how consistent the problem has to be and for what duration it must be present to considered ED. ” and “Are you or your partner experiencing sexual problems? Does severity of ischemic coronary disease correlate with erectile function? However, the final role of T has still to be recognized, since three different meta-analyses have documented an association between low T and CV mortality but not with CV events [30–32].

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. Risks, these pumps are generally much safer than the air-based pumps. Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. ED was shown to be closely linked to depressive symptoms, together with some factors such as life style, smoking, and alcohol [55]. These could suggest the cause of ED. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction.

25 This class of drugs is also contraindicated in patients who use nitroglycerin or nitrate-containing compounds.

Symptoms of Erectile Dysfunction

It has not yet been clarified which are the possible factors in MetS responsible for the low T [34]. ED, besides being considered one of the clinical manifestations of metabolic and cardiovascular diseases (CVD), is regarded as an early marker of CV events (17). Diagnosing T deficiency in young individuals is not difficult; however, blood sampling must be performed in the early morning, because of a circadian decline later on during the day (61). Loss of desire can be present in different forms of dementia, whereas hypersexuality can be found in the early-to-moderate stages of frontal dementia.

Ignoring the problem tends not to make it better, and can have a significant impact on relationships and self-esteem. In this animation we explain the definition of erectile dysfunction, its causes, symptoms and treatment modalities. How firm are your erections (use a scale of 1 to 10)? How is erectile dysfunction treated? Similar to the general population (58), in subjects consulting for sexual dysfunction, T deficiency is progressively more prevalent as a function of age (50).

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Another systematic review and meta-analysis of randomized controlled trials with a follow-up of at least six weeks evaluated the effect of lifestyle interventions and pharmacotherapy for cardiovascular risk factors on the severity of ED [65]. Psychiatric illness and psychosocial concerns of patients with newly diagnosed lung cancer. 9% in the no testosterone therapy group versus 25. The false organic-psychogenic distinction and related problems in the classification of erectile dysfunction.

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Obesity, sedentary life and smoke are related to a higher incidence of ED. Treatments are based on the cause of the problem and can range from lifestyle changes to prescription medicines to penile implants. External anal sphincter tone can be assessed during this maneuver as well. Antihistamines, nonsteroidal anti-inflammatory drugs, antiarrythmics, and drugs for the treatment of Parkinson’s disease have been linked to ED. Hormone abnormalities can cause ED. Otc treatments and supplements, as the muscles relax, the penis is able to fill with blood and become erect. Since the decrease in T levels is often a consequence of obesity or weight gain (51), the milestone of treating testosterone deficiency in obese men is encouraging substantial lifestyle changes, including physical activity and weight loss.

Sexual Health

Moreover, in elderly psychiatric patients, symptoms related to hypogonadism have a relationship with ED and both of them can influence sexual performance [54]. A prescription medication taken orally for the treatment of ED. They'll carry out basic health checks, such as taking your blood pressure. The most common physical causes of erectile dysfunction are related to circulation and blood pressure. They also include steroid abuse by bodybuilders, too much or too little thyroid hormone, and hormones used to treat prostate cancer. Impotence means that a man's penis doesn't get hard enough to have sexual intercourse.

  • Chemotherapy medications.
  • Hyperprolactinemia of any cause results in both reproductive and sexual dysfunction due to the inhibitory action of prolactin on gonadotropin-releasing hormone secretion, resulting in hypogonadotropic hypogonadism.
  • Penile biothesiometry This test uses electromagnetic vibration to evaluate sensitivity and nerve function in the glans and shaft of the penis.

Risk Factors For Erectile Dysfunction

Caution as several members of this class of medications may cause a sudden drop in blood pressure when taken with an alpha-blocker. Psychooncology. Pt-product-profiler-zulresso.svg, statistical analyses were performed using SAS version 9. What to know about penile implants. Diuretics (pills that cause an increase in urine flow). Results of a multiple ethnic groups investigation.

The multidisciplinary approach included gerontologists, behavioural scientists, endocrinologists and sexual dysfunction clinicians. Diagnosis of neurologic origin of ED is often quite simple, based on medical history and physical exam. A multicentre, randomised, double-blind, placebo-controlled trial. The lack of spontaneity with the use of vacuum devices means that many men find other treatments for ED preferable. The assessment of sexual functions in women with male partners complaining of erectile dysfunction:

Since that time, multiple additional phosphodiesterase (PDE) inhibitors have been approved. Physical exam, diabetes damages blood vessels, especially the smallest blood vessels such as those in the penis. 4 and 12 nmol/L, respectively (60). Response rates are lower for Diabetics and cancer patients. A recent study reviewed 47 patients with bvFTD compared to 58 patients with Alzheimer’s disease for the presence of heightened sexual activity to the point of distress to caregivers and others. The role of the partner in erectile dysfunction and its treatment. Conservative estimates of its incidence have been made at between 10-20 million men. Overall, both a low-calorie diet and bariatric surgery are associated with a significant ( ) increase in plasma sex hormone-binding globulin-bound and -unbound testosterone levels (total testosterone, TT), with bariatric surgery being more effective in comparison with the low-calorie diet (TT increase: )

How Does An Erection Occur?

The male sexual response cycle consists of four major phases: 4 This study surveyed 1,410 men aged 18 to 59 and also documented an increase in ED with age. Vascular surgery repairs arteries that may be blocked.

Mechanical failure rates depend on the specific device being investigated.

Risk factor in medical history (cardiovascular, endocrine or neurological). This prolongation is similar to that observed with sildenafil and is unlikely to be clinically relevant [92]. For example, a patient may develop ED on a thiazide diuretic. It has a 90–98% satisfaction rate [100]. Related causes of ED are variable and can include arterial, neurogenic, hormonal, cavernosal, iatrogenic, and psychogenic causes. On average, men with erectile dysfunction do not have lower testosterone levels in their blood, but administration of androgen to men with this problem can increase their sex drive and their erection capacity. For the first month, men should limit their physical activity. 1998; 10 Suppl 2:


The FDA also offers tips for spotting the dangers of an unsafe website, including watching out for the following clues: Multiple sclerosis (MS). Risks of these devices include surgical and anesthetic risk, device infection, and device malfunction. Although you are more likely to develop ED as you age, aging does not cause ED. – An alternative to oral medications, vacuum constriction devices can create an erection using vacuum pressure — once an erection develops, a constriction band is placed around the base of the penis to maintain the erection. Patients are advised to seek medical advice if the erection has lasted longer than four hours. Most men have occasionally experienced some difficulty with their penis becoming hard or staying firm. The medical term is erectile dysfunction (ED).

Symptoms Of Male Sexual Dysfunction

When is unsuccessful, external vacuum pumps that increase blood flow to the penis or self-injected penile medication that induces an erection may be recommended, although these are not popular options due to the advanced planning and lack of spontaneity involved. Have a look at our other channels as well: If you use sildenafil, tadalfil, or vardenafil and get chest pains, be sure to tell the paramedics, nurses or doctors at the hospital that you use it and when you used it last. 20, 24 followed by injections of drugs into the penis, as well as penile implants. Adjustment does not affect the width or length of the penis. This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. Researchers found that testosterone levels were negatively correlated with levels of body fat and abdominal fat. Surgery to repair arteries can reduce ED caused by blockages.

Many times, men will not get into sexual situations because they are embarrassed. The surgeon will explain when and how much exercise to do during the healing period. Clinical studies have suggested that these devices are effective and acceptable to a large number of patients with ED of varying causes, including psychogenic erectile failure. The cylinder can then be removed and the patient can engage in intercourse with the constriction band at the base of the penis maintaining the erection. Instead, it can also cause back pain and muscle aches. Pathogenetic components of ED in our sample are investigated by the Structured Interview on Erectile Dysfunction (SIEDY), a structured interview including 13 questions, whose answers, organized in a Likert scale, provide three scales, one for the organic subdomain [(SIEDY Scale 1); (22)], one for the relational subdomain [(SIEDY Scale 2); (23)] and one for the intrapsychic subdomain [(SIEDY Scale 3); (21)]. Surgical treatment, the employee, Duane D. And it encompasses a lot. In other cases, medications or other direct treatments might be needed.


Erection begins with sensory or mental stimulation, or both. The improvement of both man and woman sexual function in couples whose male partner is treated with PDE5i has been further confirmed by randomized clinical trials (RCTs) comparing the effectiveness of PDE5i vs. Bring someone with you to help you ask questions and remember what your provider tells you.


In either case, the vascular system responsible for either achieving or maintaining an erection is dysfunctional. 18 Little evidence supports that increased physical activity alone improves erectile quality; however, the strong association between physical activity and lower BMI is well described, and therefore recommended for men with erectile dysfunction and without a contraindication to physical activity. These devices are safe and can restore a man’s ability to achieve penetrative intercourse, with one study suggesting nearly 95% success with adequate instruction and support. Hyperlipidaemia.

[Crossref] [PubMed] Nicolosi A, Moreira ED Jr, Villa M, et al.