Guide to erectile dysfunction: Symptoms, causes, treatments

Guide to erectile dysfunction: Symptoms, causes, treatments

The JAMA Patient Page is a public service of JAMA. Diabetes is an example. If you’re having erection problems, your local doctor or sexual health clinic are good first points of contact. If there is a post-operative infection, the implant will likely be removed. The lack of spontaneity with the use of vacuum devices means that many men find other treatments for ED preferable. Erectile dysfunction should always be evaluated by a medical professional. A diet that’s good for your heart is also good for your erection.

The good news is that ED can usually be treated safely and effectively. Prescription medicines injected into the penis or put into the urethra. Medicinenet, each drug works differently, but they all improve sexual activity by stimulating blood flow to the penis. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication.

Because of the way they work, these medicines are called phosphodiesterase type 5 (PDE5) inhibitors. This hormone regulates the body’s metabolism, thus, a decreased libido can often result from a slow metabolism or sudden weight gain. A problem in the nervous system. A penile prosthesis may be an appropriate option, and requires surgery under general anesthetic for implantation. Urologyhealth extra® articles, you might also discuss the option of lowering the dosage with your doctor. Depending on the results, your doctor may also order blood tests for hormones, fasting blood glucose (sugar), and cholesterol. It’s not easy to talk about erectile dysfunction (ED), but ED is more common than you think.

Operations for the prostate, bladder, and colon cancer may also be contributing factors. ‘Performance anxiety’ is a common cause of erectile problems. The result may be ED or an increase in the risk of ED.


It is possible for a man's stress and anxiety to interfere with nerve impulses from his brain when he attempts sexual intercourse. Urologyhealth extra® articles, additional reporting by Laura Geggel. Gum disease is an indicator of overall poor health, and has been linked to an increased risk of heart disease, another risk factor for erectile dysfunction, the researchers said. 71 Not everyone knows that it can be a sign of a bigger health problem. There are several causes which tend to be grouped into those that are mainly physical and those that are mainly due to mental health issues. This tool does not provide medical advice. Penile implants. NICE (National Institute for Clinical Excellence) defines ED as “the persistent inability to attain and maintain an erection that is sufficient to permit satisfactory sexual performance” - but one man’s idea of what’s persistent can vary greatly to another’s.

The most common causes of erectile dysfunction include: As with all types of surgery, having penile implants inserted carries a risk of infection. Spring uhe highlights, erectile dysfunction is common among men with both type 1 diabetes and type 2 diabetes. Men who are taking medications that contain nitrates, such as nitroglycerin, should NOT use these medications.

These are not ‘allergic reactions'.

The Human Sexual Response

These articles are not a substitute for professional medical advice, diagnosis, or treatment. Remember, occasional erectile dysfunction is not uncommon, but if it’s persistent, erectile dysfunction can be the sign of a more serious health issue, and so you should visit your doctor. The first successful vacuum erection device, or penis pump, was developed by Vincent Marie Mondat in the early 1800s. This anxiety can be enough to stop you getting an erection next time, leading to more anxiety. An example of some of the questions they may ask include: Below are some common causes of erectile dysfunction. This combination therapy called "bimix or trimix" is stronger than alprostadil alone and has become standard treatment for ED. Penile implants:

For additional information see www. The parasympathetic nervous system is primarily involved in sustaining and maintaining an erection, which is derived from S2-S4 nerve roots. When medications do not help, other options include a vacuum erectile device (VED) or a penile implant. Patient medical or sexual history.

Low Testosterone and Obesity

Reported adverse effects include nausea, diarrhea, headache, flushing, numbness, and hypotension. Viagra acts by slowing the breakdown of cyclic GMP (cGMP), and the resultant increase in cGMP dilates the penile arteries and leads to an erection. They will use tests to determine the cause of your erectile dysfunction. Sometimes a combination of physical and psychological issues causes erectile dysfunction. The study also found no link between infertility and cycling.

  • When this happens, the penis becomes firm.
  • It is not the situation itself that is making you unhappy, but how you think about it and react to it.

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We’ve written a comprehensive guide to how recreational drugs can affect erectile function and your sex life in general. Cialis oral jelly 20mg sachets (generic equivalent), while previous studies have found that overdosing on sildenafil citrate can lead to temporary changes in vision, this is the first case where the drug has caused permanent eye damage. Heart disease, atherosclerosis, high cholesterol and high blood pressure can all impact the amount of blood flowing to the penis. Connect with us, back pain and myalgia can occur with tadalafil, but are unusual with sildenafil or vardenafil. If you have ED, you might experience: But, the occasional mishap is not considered as a cause for alarm. According to the Urology Care Foundation, an estimated 30 million Americans experience ED.

ED is the most common sexual dysfunction. These are often used to treat ED. Health & wellness, want to have great sex? Statistically, this condition does increase with age but it can affect men as young as 20 years old. Long hours in the saddle without changing position can cause compression of the perineal nerves and blood vessels, resulting in nerve damage which causes erectile dysfunction.


You should discuss the risks and benefits with your GP. How this works. It is important never to stop taking a prescribed medication unless you are advised to do so by your GP or another qualified healthcare professional responsible for your care. As mentioned, some medicines can cause ED. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Hispanic men are at a greater risk for erectile dysfunction compared to non-Hispanic men due to the increased frequency of health conditions such as heart disease and diabetes within the culture. In many cases, ED is rooted in psychological issues — especially in men under 40 years of age. As the condition progresses, an erection will no longer be obtained as well and men may stop responding to medications such as Cialis, Levitra and Viagra. Johnny, vitamin D that is taken orally needs to go through this conversion, a process that can deplete magnesium stores. Many advances have occurred in both diagnosis and treatment of erectile dysfunction. If you have been having ED for more than two months, you should see a doctor to find the cause. If blood flow to the penis is insufficient or if it fails to stay inside the penis, it can lead to erectile dysfunction. Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs:

There are pros and cons for each of the above and your doctor will advise. Trending on sharecare, our expert team has helped develop new minimally invasive and robotic surgical procedures to treat cancers, incontinence, and more. That’s because erections depend on important components of a guy’s overall health—his blood flow, heart strength, hormone levels, nerve function, even brain performance—all can be causes of erectile dysfunction. Just like some men are uncomfortable speaking about their sexual issues, others are put off by the thought of a physical exam. Depression in children and teens, studies have indicated that tadalafil citrate stays in the body longer than other medications in its class. Chemicals help brain cells communicate to stimulate blood flow to the penis. Specific treatment for erectile dysfunction will be determined by your doctor based on: Sometimes, the culprit is another health issue.

Erectile Dysfunction Treatment and Prevention

(4 nmol/L) who failed monotherapy. They are sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Spedra®). About, previous preclinical animal studies supported the improvement in both erectile function and eNOS by atorvastatin through the inhibition of Rho/Rho-kinase contractile mechanisms of the penis. The first such drug to appear on the market was Viagra (sildenafil).

Psychiatric illnesses such as depression can also cause erectile dysfunction. With diabetes, the blood flow to the penis tends to not occur in sufficient supply. The sexual partner may also be interviewed to determine expectations and perceptions encountered during sexual intercourse. In this method, a silicone tube is implanted surgically into the penis of men with a physical basis of erectile dysfunction. By strengthening and training these muscles, you may be able to reduce the symptoms of erectile dysfunction.


Another cause of ED is damage to the nerves involved in getting erections. Injury or a venous leak in the penis may also cause ED. Like any learned behaviors, it can be unlearned.

As men age, partial obstructions to the blood flow of the penis may become more common. The truth about orgasms, some of the treatments offered for sexual dysfunction include:. Carlson says he felt obligation to meet with trump on virus. Many men have the same problem. Antihypertensives (medication for high blood pressure).


There are lots of different underlying causes for ED - some of which you can control, and some which you can’t. Archive, there are many different types and causes of ED. The most recent study to investigate this found that there was no link between riding a bike and ED, but it did find an association between longer hours of cycling and the risk of prostate cancer. Diabetes, chronic kidney disease, multiple sclerosis, and Peyronie’s disease are some other medical conditions that can increase the risk for ED. Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. Accurate risk factor identification and characterization are essential for prevention or treatment of erectile dysfunction.

Unusual characteristics of the penis itself could suggest the basis of the impotence. Viagra does not directly cause penile erection, but affects the response to sexual stimulation. Around 22% of men older than 60 years and about 30% of men older than 70 years have ED, according to a urologist with Texas A&M University. An elastic ring is then slipped onto the base of the penis. Normally, when a man becomes sexually aroused, blood vessels, muscles, nerves, and hormones work together to create an erection. Inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. 41 Erection problems occur in approximately 20% of men over the age of 20. You are also warned not to take PDE-5 inhibitors if you:

  • 12 These issues can also result in ED problems, because nerve signals and blood flow are necessary to the process of getting an erection.
  • It may mean your blood vessels are clogged.

Alcohol And Substance Abuse

If you suffer from erectile dysfunction, don’t be embarrassed – it affects one in 5 men over 40. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them. Nonsteroidal anti-inflammatory drugs. The good news is that ED can often be treated safely and effectively. Sometimes erectile dysfunction related to prostate cancer treatment is only temporary, but many guys experience ongoing difficulties that need to be addressed by other means. Most men believe erectile dysfunction is a normal sign of aging, that it does not affect younger men, or that erectile dysfunction is caused by psychological problems. With the implant, men can control firmness and, sometimes, the size of the erection.

Do Condoms Really Cause Erection Problems?

Organic impotence involves the penile arteries, veins, or both and is the most common cause of impotence, especially in older men. Injury to the nerves going to the penis. You'll still need a prescription to get these medicines. That’s why we call ED your body’s “check engine light. See additional information. Most patients will start with oral medications. It’s a good idea to see a doctor if you have consistent problems with getting or keeping an erection.

Many times, men will not get into sexual situations because they are embarrassed. Obesity also plays a role metabolic syndrome in causing abnormalities in testosterone levels. Other common causes include anxiety or relationship problems, so for some men it can help to talk through these issues with a trained counsellor. This is particularly true for high blood pressure (hypertension). A patient will either go home on the same day or spend one night in the hospital. Men with spinal cord injuries have increased rates of erectile and ejaculatory problems, for example. This just scratches the surface when it comes to all of the details regarding erectile dysfunction. The vascular processes that produce an erection are controlled by the nervous system and certain prescription medications may have the side effect of interfering with necessary nerve signals.

Lifestyle choices. Obesity is also associated with both blood vessel changes and hormone changes that negatively affect erections. Your ca privacy rights, for smoking to be a cause of ED, it clearly has to precede ED onset. Get started with these 13 tips for sleeping better tonight. There are several related drugs now available that can support an erection in men with erectile dysfunction. For each of the medications, headache is the most common side effect. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis.

  • It can work the other way around too - men who report having ED are at higher risk of developing depression than men who don’t.
  • CBT is based on the principle that the way you feel is partly dependent on the way you think about things.

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Effective treatment options for erectile dysfunction range in approach and patient satisfaction results vary. About 75% of diagnosed cases of ED go untreated. Before your visit, write down questions you want answered. It is normal for a man who suffers from erectile dysfunction to have a psychological reaction to a loss of a normal bodily function (erections). You can request an appointment to see a provider via our online form at any time. There is generally no change to a man's feeling or orgasm. Sildenafil works for 4-8 hours; vardenafil works for up to 8 hours; and tadalafil works for up to 36 hours.

This holds the blood in the penis (and keeps it hard) for up to 30 minutes. For one thing, most studies that have found a link between bicycle riding and ED have focused on men who spend long hours astride a bike, such as policemen who spend as many as 24 hours a week riding, and those who do long bike tours as amateurs or professionals. There are several steps men can take to reduce their risk for erectile dysfunction, including: 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. Specialized sexual therapy is also an option at any time during the treatment for erectile dysfunction. ’ This means that erectile function has been normal, but becomes problematic. Testosterone replacement therapy is available in an oral and injectable form, cream or gel, and as a skin patch. Information about the novel coronavirus (COVID-19) is rapidly evolving.

Other causes may include diabetes. Nerve damage from pelvic surgeries can cause ED. If you are concerned about your erections it is important to speak with your doctor. So ED can be the first sign of high cholesterol or high blood pressure before a blockage causes more serious problems, like a heart attack or stroke. If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. What medications could cause erectile dysfunction (ED)?

Support Groups

Rodeo riding can have the same effect. There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: Other common causes of ED include: This creates a vacuum that causes the blood to fill your penis, making it erect. If the trouble disappears with your hangover, then you don’t have anything to worry about. Erectile dysfunction is common among men with both type 1 diabetes and type 2 diabetes. Keep reading to learn about treatment options.

Make an Appointment

The gaseous NO that is produced acts as a neurotransmitter or paracrine messenger. In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. Conozca que nos caracteriza como empresa y lo que tenemos que ofrecer. 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.

What Questions Will the Health Care Provider Ask?

The choice may depend on: Certain diseases, such as kidney failure and liver disease can disrupt the balance of hormones, which control erections. Common causes include: Basically, you put your penis into a plastic container. It is not advised for men who have normal testosterone levels for their age. For many, this is a sensitive issue to discuss, but based on the stats above, you won’t be the first patient to appear in a doctor’s rooms needing help with erection problems. If you’re ready to stop living in embarrassment about your sexual function, become an advocate for yourself and your own health and talk to your doctor.