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Erectile Dysfunction

  1. What is erectile dysfunction?
  2. Erectile dysfunction symptoms
  3. Erectile dysfunction causes
  4. Diagnosing erectile dysfunction
  5. Erectile dysfunction treatment
  6. Erectile dysfunction prevention
  7. Complications associated with erectile dysfunction
  8. Erectile dysfunction FAQs

What is erectile dysfunction?

Erectile dysfunction, otherwise known as ED or impotence, is the condition of being unable to get or maintain an erection. It is a common condition that most males will experience at some stage in their life, though it is most prevalent in older men. Erectile dysfunction is usually temporary, though it can also be recurring.

The potential causes of this condition are numerous, including both physical and psychological factors. In most cases, erectile dysfunction can be successfully managed, with treatment options depending on the root cause of the disorder.[1]

Erectile dysfunction symptoms

The symptoms of erectile dysfunction are:

  • An inability to get an erection
  • An inability to maintain an erection during sexual activity

These symptoms may come and go over time or be situational, for example, not present during masturbation but present with a partner. If symptoms occur regularly or semi-regularly, visiting a doctor is advised.[2]

Erectile dysfunction causes

Erectile dysfunction can be caused by a variety of physical and psychological factors.[3]

Physical causes

Most cases of erectile dysfunction are caused by physical factors, which include:

  • The most common cause for erectile dysfunction is reduced blood flow to the penis. This happens as a result of a narrowing of the arteries in the penis, with ageing, high blood pressure, high cholesterol and smoking making this more likely.
  • Excessive intake of alcohol or drugs can impair the ability to get or maintain an erection.
  • Diabetes, which can affect blood vessels and nerves, is another common cause of erectile dysfunction.
  • Conditions, such as Parkinson’s disease, multiple sclerosis and stroke, can make erectile dysfunction more likely.
  • In some cases, erectile dysfunction can occur as a side-effect of medications, such as antidepressants, beta blockers and some diuretics.
  • A lack of certain hormones, particularly testosterone, can lead to erectile dysfunction, though this is uncommon.
  • Injury to the nerves in the penis as a result of surgery to nearby areas or spinal injury, for example, can lead to erectile dysfunction.

If the causes of erectile dysfunction are physical in origin, the condition is more likely to appear gradually, with the problem occurring intermittently before getting more frequent. An individual’s sex drive is unlikely to be affected, unless the root cause is hormonal in nature.

Psychological causes

A range of mental health issues can lead to the development of erectile dysfunction, including:

  • Depression
  • Stress/Pressure
  • Anxiety
  • Relationship issues

Purely psychological causes for erectile dysfunction are rare, limited to approximately 10 percent of cases.[4]

Psychological causes typically result in the sudden onset of the condition, as opposed to the gradual development caused by physical factors. When an individual is able to sometimes get and maintain a healthy erection (for example, when masturbating or in the morning) it may be a sign that their erectile dysfunction is psychological in origin.

Diagnosing erectile dysfunction

The first stage in diagnosing erectile dysfunction is visiting a doctor, who will typically begin with questions regarding:[5]

  • The symptoms experienced
  • The length of time symptoms have been present
  • General physical and mental health
  • Levels of alcohol and drug intake
  • Whether any other medication is also being taken

It may also be necessary for an individual to answer questions about their sex life. These may include:

  • Details of current and past sexual relationships
  • Information about sexual orientation
  • Whether the dysfunction occurs all the time, intermittently or only in certain situations
  • Whether ejaculation is possible
  • Libido (levels of sexual desire)

As narrowed blood vessels are the most common cause of erectile dysfunction, a doctor will usually examine an individual’s cardiovascular condition as part of the diagnosis. This may involve testing for high blood pressure, checking for heart irregularities, as well as evaluating an individual’s weight or overall level of health.

Blood tests may also be ordered to check for underlying medical conditions that may be causing the condition.

Erectile dysfunction treatment

In most cases, doctors will be able to suggest and prescribe treatment options. An individual may also be referred to a specialist.

Treatment methods will depend on the underlying cause of the problem, meaning the chosen method will differ from case to case.

Common treatment options include:

Treatment of underlying conditions

If an underlying condition is causing erectile dysfunction, treating it will generally be the first step towards resolving the problem.

If medications used to treat other conditions are thought to be causing erectile dysfunction, a doctor may be able to prescribe alternatives.[6]

Lifestyle changes

A range of lifestyle changes can help treat erectile dysfunction, including:

  • Losing weight
  • Reducing stress
  • Quitting smoking
  • Reducing alcohol and drug intake or giving them up completely
  • Getting regular exercise

Counselling, sex therapy and relationship counseling

If stress, anxiety or depression are causing erectile dysfunction, counselling may be an effective treatment. If relationship issues are the cause, some form of sex therapy or relationship counseling may prove successful.

Sensate focus, a type of sex therapy, focuses on building intimacy between partners. It involves totally abstaining from sex and intimate touching for a set period of time, then gradually reintroducing it. The method can be effective in overcoming the psychological issues behind erectile dysfunction.[7]

Relationship counseling, in which partners are prompted to explore the physical and psychological issues behind their sexual problems, may also be an effective method of overcoming erectile dysfunction. Partners are encouraged to become more aware of each other’s needs, allowing them to reach a solution which works for them both.

Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors are the most commonly prescribed medication for treating erectile dysfunction. The most common types are:

  • Sildenafil: Brand name, Viagra
  • Tadalafil: Brand name, Cialis
  • Vardenafil: Brand name, Levitra
  • Avanafil: Brand name, Spedra

These medications work by artificially dilating the blood vessels in the penis, enabling improved blood flow.

The effects of tadalafil last for up to 36 hours, while the other three varieties generally last for around 10 hours. Each should be taken 30 to 60 minutes before engaging in sexual activity and will only take effect when an individual is sexually aroused. They are taken orally, in tablet form.[8]

A doctor will be able to advise about which type of PDE-5 is most suitable for each individual and the health risks that come with them.

Alprostadil

Alprostadil is an artificial hormone used to stimulate blood flow to the penis. Generally, alprostadil will only be prescribed if other treatments have been ineffective or are unsuitable. It is administered in three main forms:[9]

  • As an injection, directly into the base of the penis
  • As a small pellet, which is placed into the urethra (the opening on the tip of the penis)
  • As a topical cream, applied to the urethra

Doctors will advise on which form of alprostadil should be used and give instructions on how to properly administer it at home. After application, an erection can usually be achieved in around 15 minutes.

Vacuum pumps

Vacuum pumps can relieve the symptoms of erectile dysfunction. To use, the penis is inserted into a plastic container, before the air is pumped out to create a vacuum. This causes blood to flow to the penis, producing an erection. The penis is then removed from the container and a rubber band is placed around its base. For safety reasons, the rubber band should be removed within 30 minutes.

Penile prosthesis

Penile prosthesis is a surgical procedure in which a rod is placed inside the penis in order to simulate an erection. Advanced procedures involve the insertion of an inflatable rod. This is an uncommon treatment method, but is generally effective.

Erectile dysfunction prevention

Though it may not always be possible to prevent erectile dysfunction, certain steps can be taken to reduce the risk of the condition. These include:[10]

  • Staying healthy, with regular exercise and a balanced diet
  • Stopping smoking
  • Avoiding drugs and excessive amounts of alcohol
  • Seeking treatment for conditions such as high blood pressure and diabetes

Complications associated with erectile dysfunction

There are no serious physical complications associated with erectile dysfunction, however, the condition can negatively affect an individual’s mental health, causing issues such as:[11]

  • Stress and anxiety
  • Low self-esteem
  • Embarrassment
  • An unsatisfactory sex life
  • Problems within a relationship

Erectile dysfunction FAQs

Q: Is there a cure for erectile dysfunction?
A: Although there is no guaranteed cure for erectile dysfunction, there are a number of treatment options that can provide long-term relief. Treatment options affect each individual differently, meaning what proves effective for one person may not be the best option for another. Doctors can help advise on the best treatment methods.

Q: Are there any exercises or home remedies that can be used to prevent or treat erectile dysfunction?
A: There are a number of exercises that may help individuals experiencing erectile dysfunction. These include:[12]

  • Pelvic floor exercises: Exercises designed to strengthen the pelvic floor muscles, such as Kegel exercises, can be effective in treating or preventing erectile dysfunction.
  • Yoga: Can be effective in reducing stress and anxiety, psychological problems that can cause erectile dysfunction.
  • Swimming: A good exercise for improving overall health, which can in turn help treat erectile dysfunction.

A number of natural home remedies may be effective in treating erectile dysfunction. They include:

  • L-arginine: A natural supplement that may help to widen the blood vessels in the penis, but should not be taken alongside Viagra.
  • Ginkgo: A natural supplement that may help improve blood flow to the penis and increase sexual desire.
  • Propionyl L-carnitine: May be effective when taken alongside Viagra.

Seeking professional advice before using any home remedy is advised.

What pills are available to help treat erectile dysfunction?
A: Phosphodiesterase-5 (PDE-5) inhibitors are the most common pills used to treat erectile dysfunction. Types include:

  • Sildenafil: Brand name, Viagra
  • Tadalafil: Brand name, Cialis
  • Vardenafil: Brand name, Levitra
  • Avanafil: Brand name, Spedra

A doctor should be consulted before using any of these pills as they may be unsuitable for certain individuals and cause possible side-effects.


  1. Patient. “Erectile Dysfunction (Impotence).” April 1, 2016. Accessed August 25, 2017.

  2. Healthline. “Everything You Need to Know About Erectile Dysfunction.” May 17, 2017. Accessed August 25, 2017.

  3. Patient. “Erectile Dysfunction (Impotence).” April 1, 2016. Accessed August 25, 2017.

  4. The British Association of Urological Surgeons. “Erectile dysfunction (impotence).” Accessed August 25, 2017.

  5. NHS Choices. “Erectile dysfunction (impotence) - Diagnosis.” September 23, 2014. Accessed August 23, 2017.

  6. NHS Choices. “Erectile dysfunction (impotence) - Treatment.” September 23, 2014. Accessed August 28, 2017.

  7. Counselling Matters. “Sensate Focus.” Accessed August 28, 2017.

  8. NHS Choices. “Erectile dysfunction (impotence) - Treatment.” September 23, 2014. Accessed August 28, 2017.

  9. Patient. “Alprostadil for erectile dysfunction.” August 22, 2014. Accessed August 28, 2017.

  10. Urology Care Foundation. “Preventing Erectile Dysfunction - What You Should Know.” Accessed August 28, 2017.

  11. Mayo Clinic. “Erectile dysfunction - Symptoms and causes.” June 23, 2017. Accessed August 28, 2017.

  12. Medical Daily. “4 Exercises To Treat Erectile Dysfunction For Men Struggling With Impotence.” September 15, 2016. Accessed August 28, 2017.