Erectile Dysfunction (ED)

The vast majority of men – and women – can look forward to a return to sexual activity after advice and or treatment. These events produce an erection with an intracavernosal pressure of 100 mm Hg. Salt bombs: 15 sodium surprises to avoid, fortunately, there are several ways to manage and treat ED. Endogenous blockers of this pathway have been identified.

For IU therapy, a tiny medicated pellet of the drug, Alprostadil, is placed in the urethra (the tube that carries urine out of your body). This is done to help reveal psychological factors that may be affecting performance. Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. Losing weight by dieting and exercising may be all that is needed to improve erections. Finding the right treatment for you may take several tries. Physicians make a diagnosis of erectile dysfunction in men who complain of troubles having a hard enough erection or a hard erection that does not last long enough. Many hormonal conditions can be treated using injections of synthetic (man-made) hormones to restore normal hormone levels. The simplest kind of implant is made from two easy-to-bend rods that are most often made of silicone.

  • When simple honest communication fails to bring couples closer, professional counseling may be needed.
  • It is important for someone taking nitrates for heart conditions to understand that they are not a candidate for oral medications.
  • Exercises designed to strengthen the pelvic floor muscles, such as Kegel exercises, can be effective in treating or preventing erectile dysfunction.
  • In many cases, psychological issues develop into performance anxiety which, in and of itself, becomes a self-fulfilling prophecy.

As well as helping to improve your erectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease (conditions that affect your heart and blood vessels). Many cases of erectile dysfunction have a psychological basis. 54 Statin use seems to improve ED, as measured by IIEF-5 scores. Most cases of impotence have physical causes, but, in some men, psychological factors are the main contributors to impotence. It may be helpful to have your sexual partner involved in this assessment. Erectile dysfunction is when a man either can’t have an erection or can’t keep an erection long enough to have sex. 27–29 Patients with diabetes are three times more likely to develop ED, and a longer duration of diabetes is strongly associated with ED.

Since stress or anxiety can cause or contribute to ED, practicing yoga may be an effective way to ease ED symptoms. Treatment options can include the following: Though it can sometimes be difficult to pin down the specific cause for your erectile dysfunction, it is always worth the effort. You might be worried that you don’t measure up—either physically, skill-wise, or otherwise—leading to performance anxiety around sex. Doctors may inject a "contrast agent" into the person's bloodstream that causes vascular tissues to stand out against other tissues. Lifestyle changes—including exercise, a healthy diet, and limiting alcohol and recreational drugs—may improve ED. Blood testing for sexual health, a significant proportion of men who have no sexual dysfunction nonetheless do not have regular nocturnal erections. For instance, many men have occasional times when they cannot get, or maintain, an erection.

Pelvic floor exercises: Risk factors for atherosclerosis include: The condition becomes easier to diagnose when the patient begins to experience psychological and emotional issues, such as: If you drink, practice moderation. Erectile dysfunction is more common than most people think. 71 Serious conditions such as diabetes, heart disease, prostate cancer, peripheral vascular disease — and some of the medications prescribed to treat these conditions – can all cause erectile dysfunction.

  • Masturbation and excessive masturbation are not felt to cause ED, however, if one notes weak erections with masturbation, this may be a sign of ED.
  • Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.
  • Talk to your health care provider if you think that a drug is having a negative effect on your sexual performance.


They will be able to suggest an appropriate course of treatment for the condition, which may in turn help to relieve erectile dysfunction symptoms. Houstonians under coronavirus quarantine share photos of their, there will never be one single nutrient responsible for any biological function. You are taught how to inject a medicine into the base of the penis. Remember that the most important sex organ (for men and women) is the brain.

If you're having relationship difficulties, consider couples counseling. Other strategies that help: ED can be treated at any age. Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. However, one cause of a lack of testosterone that is worth highlighting is a previous head injury. This usually interferes with sexual activity. This may be linked to the deterioration to the blood vessels that carry blood to the penis, and also to the deterioration of heart or brain arteries. However, the overall risk of PDE-5 inhibitors causing NAION is low, with a risk estimate of 2.

  • When a man is sexually excited, muscles in the penis relax.
  • However, some men have persistent, or recurring problems with sexual function.
  • Who's at risk for erectile dysfunction?

Psychological Causes Of Impotence

Low levels of nitric oxide: After the first week, over- the-counter pain drugs (such as acetaminophen or ibuprofen) may be substituted for narcotic pain drugs. There are many options available, and while none of them are perfect, some may be a better fit for you than others. Taking nitrates with one of these medications can lower blood pressure too much. While BPH isn’t exactly thought to cause erectile dysfunction, the two conditions can often be present at the same time.

Partners are encouraged to become more aware of each other’s needs, allowing them to reach a solution which works for them both. Only a small percentage of cases of impotence are caused by hormone deficiency. This anxiety can be enough to stop you getting an erection next time, leading to more anxiety.

Erectile dysfunction exercises Certain exercises can also help with ED. Secondary premature ejaculation. Measurement of testosterone in the blood is often done in men with ED, especially with a history of decreased libido or diabetes. If there seems to be a psychological cause contributing to your erectile dysfunction, the doctor may ask the patient questions to help determine stressor, events, and relationship issues that may be causing your erectile troubles. These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis. A natural supplement that may help to widen the blood vessels in the penis, but should not be taken alongside Viagra. Among those over age 50, it nearly doubles the risk, reports the Mayo Clinic.

  • For example, if impotence is the result of a side effect of medicine or an underlying disease, the anxiety caused by lack of performance may perpetuate the erectile dysfunction even after the physical cause has been dealt with.
  • How can I explain my ED to a new sexual partner?
  • Erectile dysfunction should always be evaluated by a medical professional.
  • Likewise, prolactin levels, hyperthyroidism, or hypothyroidism can also affect erection.
  • Alprostadil is injected into the side of penis with a very fine needle.


An estimated 10. Grocery, because you don't need a prescription, you can go straight to your pharmacist for an assessment for the medication and buy it over the counter. And generally, what’s good for the heart is good for erections—a healthy diet, keeping cholesterol low, not smoking, exercising regularly, and controlling weight. CBT is based on the principle that the way you feel is partly dependent on the way you think about things. The rate of blood flow into the penis can be measured along with an evaluation of problems with compression of the veins. The next most common cause is beta blockers. 04 mmol per L); women < 50 mg per dL (1. Fully restoring sexual health with treatment of a medical condition (such as high blood pressure with diet and/or exercise or by controlling diabetes or other chronic diseases) may not be possible.

If ED is the result of a medication side effect, your physician may recommend alternative medications. If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. Relaxation of the sinusoidal smooth muscle increases its compliance, facilitating rapid filling and expansion. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you.

9 million adult men in the U. Other medical conditions can cause ED symptoms. Vacuum device. Erectile dysfunction can result from pelvic fractures or crush injuries experienced in an automobile, motorcycle, or other accident. Younger men are more likely than older men to keep or regain their erectile abilities.

Request an Appointment

Symptoms of intermittent claudication of the lower extremities with exercise may suggest a vascular problem as a cause of the erectile dysfunction. Another cause of ED is damage to the nerves involved in getting erections. The effects of these latter drugs are longer lasting (up to 36 h). The process of an erection is an intricate one. You should not take more than 1 dose in 24 hours.

At this pressure, both inflow and outflow of blood temporarily cease.

Female health - See all treatments and conditions

Erectile dysfunction related to medical/physical causes is often treatable but less commonly curable. The pills currently available by prescription all work the same way—by boosting the effects of NO in the penis. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both. The gut-brain connection, the process involves premature and unusually severe hardening of the arteries. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements is not under quality control and may differ from pill to pill.

, methotrexate) Diuretics (e.

Lifestyle factors and emotional disorders To achieve an erection, you must first go through what’s known as an excitement phase. This pill causes an erection in the majority (80%) of men who have had difficulty obtaining this result. NO is thought to act in the medial preoptic area and the paraventricular nucleus. Antiarrhythmics (medication for irregular heart action). Foods that help boost nitric oxide will help boost erectile function, and vegetables—especially green, leafy ones—are the best food source of nitric oxide.

Fast facts on erectile dysfunction: Mechanical problems with the implants may occur within five years in five per cent of cases. The 1994 Massachusetts Male Aging Study, for example, found that the prevalence of impotence increases from 5 percent to 15 percent as age increases from 40 to 70 years. You may find that it’s easier initially to do Kegels while lying down. Resultantly, feelings of arousal may be harder to achieve, making erections more difficult. Mildly decreased levels of testosterone are often not due to specific testicular or pituitary problems, but rather stress or depression.

Can over-the-counter (OTC) and/or natural or home remedies treat erectile dysfunction?

If you understand the cause of your ED, as well as the solution, you can enlighten your partner and allow both of you to enjoy sexual intimacy along with everything else you both enjoy about each other. Minor health problems may slow your sexual response, but the accompanying anxiety that comes with the slow sexual response can shut things down entirely. Advanced procedures involve the insertion of an inflatable rod. Diuretics (pills that cause increase urine flow). It is administered in three main forms: These pills are safe and effective when used under the supervision of a physician.

Several other factors and conditions can contribute to erectile dysfunction, including the following.

Lose weight, exercise regularly, manage your medical conditions, stop smoking, and avoid alcohol and illicit drugs. However, around three-quarters of men report being satisfied with the results of this type of surgery. Such conditions include Peyronie's disease (a condition of the penis associated with scarring [plaques] in the tunica albuginea that may be associated with penile curvature, pain with erections, and ED), older age, diabetes mellitus, and penile trauma (penile fracture). Treatment methods will depend on the underlying cause of the problem, meaning the chosen method will differ from case to case. Parkinson's disease drugs. Men with urinary symptoms have been shown to have a higher rate of erectile problems as men without them. Generally speaking, causes for erectile dysfunction can be divided into two categories:

Erections occur when there is an increase in blood flow to the penile arteries filling up the corpora cavernosa, which are the two blood chambers in the penis.

Review Date 1/31/2020

You might find that tackling the source of your stress can have benefits in the bedroom as well. 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. If one thing goes wrong in that complicated exchange between your cardiovascular and nervous system—plus your hormone levels, blood vessels, and even your mood—the result can be erectile dysfunction. The ability to achieve and maintain a full erection depends not only on the penile portion of the process but also on the status of the peripheral nerves, the integrity of the vascular supply, and biochemical events within the corpora. Firstly, find the pelvic floor muscles. Vitaros should not be used more than once within any 24-hour period.

This is, by far, the most common cause of ED in men over the age of 40. Testosterone replacement therapy may improve energy, mood, and bone density, increase muscle mass and weight, and heighten sexual interest in older men who may have deficient levels of testosterone. — Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems.

Also, for some of these medicines ED is a very rare side effect. When looking at the potential causes of erectile dysfunction, it's important to understand that often more than one factor is involved or, as the American Urological Association puts it, "erectile function is the result of a complex interplay between vascular, neurologic, hormonal, and psychologic factors. "If you prefer to listen to this article, click on the SoundCloud player below. This creates problems both north and south: Can everyone use ED medications? ED can be caused by a number of factors, including: For some men with ED, using a device such as a penis pump, cock ring, or—in severe cases—a surgically placed penis implant has been effective in restoring sexual function.

Acute illness - See all treatments and conditions

Nerve damage — Nerves must be working normally for a man to get and keep an erection. Although the rate of erectile dysfunction in the male population increases with age, aging itself does not appear to be the cause. A variety of treatment options for erectile dysfunction are available. What is the treatment for ED? It starts with you both agreeing not to have sex for a number of weeks or months. If stress, anxiety or depression are causing erectile dysfunction, counseling may be an effective treatment. Impotence may be a manifestation of a poor relationship, or a problematic time in a relationship. Erectile dysfunction (updated May 2020).

Trending on MedicineNet

Talk to your health care provider if you're experiencing impotence and share your concerns about any underlying causes. 5 inches (90 cm); women ≥ 31. A wide range of treatment options are available and allow physicians to tailor treatment to a patient’s specific goals.

There are many neurological (nerve problems) causes of ED. 5 or 5 mg once daily NA NA NA ($280 for 30 tablets) Vardenafil (Levitra) 10 or 20 mg once daily as needed 60 minutes Four to five hours NA ($465) Table 4. References, in another study, looking at prescription refill rates, sildenafil was associated with a higher likelihood of refilling the initial prescription compared to vardenafil or tadalafil, which had a significantly lower odds of prescription refill. However, some people become even more anxious or depressed when they develop ED. Phentolamine (2 mg) is often added. They point out that ED isn’t a disease; it’s a symptom. What ED Treatment Options Are Available?

And rich oxygenated blood is the foundation of erections. Health information you can trust, the specified medical conditions are:. For example, spinal injury, following surgery to nearby structures, fractured pelvis, radiotherapy to the genital area, etc. But you'll have to have a consultation with the pharmacist to make sure it's safe for you to take it. Before you start a new exercise plan, you should always discuss it with your doctor.

Thanks for visiting!

Although ED is more likely to occur in people older than 50, it has become increasingly common in younger men, i.

Psychological Assessment

Anti-seizure medications. In determining a physical (or organic) cause, your health care provider will first rule out certain medical conditions, such as high blood pressure, high cholesterol, heart and vascular disease, low male hormone level, prostate cancer, and diabetes, which are associated with erectile dysfunction. See your doctor if: If an erection lasts for over four hours, it will need medical attention to make it go down. If low testosterone is responsible for your ED, testosterone replacement therapy (TRT) can boost your testosterone levels via injection, a wearable patch, or gel applied to the skin.

Personal Tools

When medications do not help, other options include a vacuum erectile device (VED) or a penile implant. Although alcohol and other recreational drugs may heighten sexual desire initially, they usually sap it the more you indulge. Doctors will usually encourage the affected person to consider resuming sexual activity as soon as the catheter is removed in order to preserve their erectile function. The first step in treating ED is getting a diagnosis of the root cause by visiting a doctor, who will typically begin with questions regarding: The two conditions often occur together. A natural supplement that may help to widen the blood vessels in the penis, but Ginkgo. Using the drug this way means you don't have to give yourself a shot, unfortunately it may not work as well as ICI. This form of primary PE is psychogenic (as opposed to organic or physical) impotence.

5 inches§ Low serum testosterone levels are one factor that may explain the relationship between metabolic syndrome and ED.

Various mental health conditions may cause you to develop ED. According to the National Institutes of Health, having a BMI of 25 or greater can disrupt a man’s hormonal balance, cell function, and insulin resistance, along with promoting physical inactivity and psychological problems. Many medications, including certain blood pressure pills, cold medications, hormones, antidepressants, tranquilizers, alcohol, tobacco, heroin, and cocaine, are associated with erectile dysfunction. ED is usually treatable, most commonly by a tablet taken before sex. If you'd like to learn more about each of our providers that specialize in Erectile Dysfunction, please review the Physicians & Faculty profiles listed at the bottom of this page. When biking, a significant amount of a man's weight rests on the perineum—the area of the body where the nerves and blood vessels of the penis pass—potentially causing injury to these structures. Depression is often associated with sexual dysfunction—and some researchers suggest that if you’re experiencing one, you should be screened for the other (Atlantis, 2020). This may affect the function of the nerve after the ride.

The elevated blood glucose levels caused by diabetes damage blood vessels and nerves throughout the body, including those in the penis.


In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of 100 men. Most often, one small surgical cut is made. Still, it helps to ask your health care provider about side effects that could result from each option: 11 Tobacco, alcohol, and illicit drugs can cause ED. This creates a vacuum that causes the blood to fill your penis, making it erect. Premature ejaculation is a male sexual dysfunction characterized by:

Even if you take the medications, you still need physical and mental stimulation and desire to have an erection. This made a huge impact on the treatment of ED. About half of men between the ages of 40 and 70 have ED. The muscles you can feel working during this process are the pelvic floor muscles, and they will be the focus of Kegel exercises. References ED has vascular, neurologic, psychological, and hormonal causes. It is possible for a man's stress and anxiety to interfere with nerve impulses from his brain when he attempts sexual intercourse. These men were considered nonresponders to sildenafil, and their erections were monitored by assessing nocturnal penile tumescence (NPT). Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not often mentioned.

Penile implants are a type of surgery that may be considered. Three types of implants are used to treat ED, including: This phase can be an emotional response. Diseases that affect the nervous system, such as multiple sclerosis, Parkinson's disease, and Alzheimer's disease can also cause erectile dysfunction. Other potential factors in hypertension that may play a role in ED: Sildenafil citrate (Viagra).

Share This:

The study, performed in mice, suggests a link between gum disease and ED , but the connection in humans and the mechanism by which periodontitis may lead to ED is still unclear. Recreational drug use has been implicated in ED. In the past, erectile dysfunction was commonly believed to be caused by psychological problems. Surgery to organs near the nerve pathways of the penis, such as the bladder, rectum and prostate, can cause nerve or artery damage to the penis, resulting in the inability to have an erection. Psychological causes of ED include depression, anxiety and relationship issues. In this situation a blood test to check the level of the hormone testosterone (and sometimes prolactin) may be advised. What many men do not know is that erectile dysfunction can be treated and many treatment options are available. A full, warm sensation in the penis is not a cause for concern, and may remain for several hours after use.

Researchers said this might be due to social perceptions of masculinity in younger and middle-aged men. There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: Several types of FDA approved vacuum therapy devices are available under prescription. Drugs that may cause impotence (updated 21 Jan 2020).

Age may be the most common denominator of men with ED. Erectile dysfunction can occur at any age, but it is more common in men that are older. Supplements are popular and often cheaper than prescription drugs for ED. Also mentioned in, diabetes contributes to ED by damaging your nerves and blood vessels. 46 ED is a useful marker for assessing cardiovascular risk, particularly in younger men and minorities, for whom global risk assessment calculators may underestimate actual risk. Urination after application will result in cream being expelled from the urethra, lessening its erectile effects. Information from reference 2. Numerous prescription medications can also cause ED, including those below.