What is erectile dysfunction (ED)?
Erectile dysfunction is a medical condition that makes it difficult to achieve and maintain an erection. You may have heard it called impotence, though it’s no longer the preferred terminology.
If you have ED, you may lose your erection before you reach orgasm or have trouble keeping an erection hard enough to have sex. For some people, ED causes a loss of interest in sex altogether.
The occasional inability to get an erection isn’t a big deal. It’s common to have trouble maintaining an erection once in a while. Many men experience ED, and it’s nothing to worry about if it happens less than 20% of the time.
In fact, it’s estimated that as many as 30 million men in the United States experience erectile dysfunction. Men with diabetes are 3 times more likely to develop symptoms, and ED is also more common in older men.
But if it’s happening more frequently than 20% of the time or if your symptoms continue to worsen, you may want to talk with a medical professional about ED.
What causes erectile dysfunction?
There are several different possible causes of ED. They may be physical, psychological, or both. Certain medications put you at greater risk, especially when they interact with your hormone levels, blood circulation, or nervous system.
In addition, some medical conditions inhibit blood flow to the penis, which may interfere with your normal arousal response. Age also impacts your ability to get and maintain an erection.
The most common psychological cause of ED is anxiety. You may experience sexual performance anxiety or have anxiety related to something else that interferes with your ability to achieve or maintain an erection.
Because your state of mind has such a significant influence on your sexual drive, relationship issues, a history of trauma, or mental health issues may contribute to erectile dysfunction.
Certain factors make you more likely to experience ED. These include:
Certain medical conditions also increase the likelihood. These include:
- Cardiovascular disease
- Damage to nerves and arteries
- Kidney disease
- Parkinson’s disease
- Peyronie’s disease
- Multiple sclerosis
Some mental health conditions make you more likely to experience ED, including:
If you’ve undergone any of the following medical treatments, you’ll also be at higher risk for ED:
- Prostate surgery
- Spinal surgery
- Pelvic surgery
- Radiation treatment
Finally, there are a number of medications that increase your risk of ED. These include:
- Hormone therapy
- Parkinson’s disease drugs
- Anti-seizure drugs
- Prostate medications
It’s common for people with erectile dysfunction to experience depression, stress, and anxiety. ED may cause you to feel embarrassed or ashamed, and some patients report relationship issues as a direct result of erectile dysfunction. People experiencing ED may find it challenging to engage in a fulfilling sex life and may experience challenges with family planning goals.
In addition, ED is often the first sign of cardiovascular disease. When it goes untreated, clogged arteries or other cardiovascular concerns may continue to worsen. For this reason, it’s essential to seek medical advice for erectile dysfunction even if you feel uncomfortable talking about your sexual symptoms. If you’ve avoided talking to a professional about your symptoms for this reason, telehealth providers like Lemonaid make it simple and easy.
Erectile dysfunction symptoms include:
- Trouble getting an erection
- Difficulty maintaining an erection
- Loss of interest in sex
If you experience additional symptoms, especially those related to cardiovascular disease or diabetes, talk to a clinician right away. Your symptoms may indicate a more serious medical condition that needs immediate treatment.
Testing & diagnosis
To receive an ED diagnosis, you’ll need to be evaluated by a medical professional.
Your clinician will ask some personal questions in order to best evaluate your situation. We know that these may feel embarrassing or intrusive. But the purpose of these questions is to precisely understand what you’re experiencing in order to tailor treatment to your needs.
Erectile dysfunction treatments
Your treatment options will depend on likely erectile dysfunction causes.
If an underlying medical condition is present, a health care provider will address that first. By treating your health conditions, your clinician may be able to eliminate or reduce your erectile dysfunction symptoms.
When ED is a side effect of a medication, you may be able to resolve your symptoms by switching to a new drug.
In some cases, a health care provider may recommend mental health treatment to reduce your symptoms of erectile dysfunction.
For many people experiencing ED, medication works to reduce or eliminate symptoms. Typically, oral medications take effect within 30-60 minutes.
The most common erectile dysfunction meds include:
These oral drugs function by amplifying the effect of nitric oxide, a chemical that naturally occurs in your body. Because this kind of erectile dysfunction medicine influences how you process nitric oxide, it’s not safe to take them along with nitrate drugs.
Aside from the common oral medications listed above, clinicians also may prescribe alprostadil. This medication is in a class called vasodilators, which help to relax the muscles and blood vessels in and around your penis. However, this medicine is either injected directly into the penis or inserted into the urethra.
Studies show that kegel exercises can significantly improve or, in some cases, eliminate ED. You may be able to enhance penile function by training your pelvic floor muscles.
Research also indicates that aerobic exercise has a beneficial effect on ED. Since it may also help with underlying conditions, adding aerobic exercise to your routine could be a great way to improve your overall health and reduce your symptoms of ED.
Other ED treatment options
Penis pumps, also known as vacuum erection devices, work by manually forcing blood into the penis. Although these devices may help to enable sexual intercourse, they can cause bruising. Plus, the use of a tension ring, which is needed to maintain the erection, often restricts ejaculation.
It’s possible to surgically implant devices to assist with sexual intercourse, as well. Penile implants rely on bendable rods or inflatable devices to create a firm erection. But surgical procedures are not recommended as a first-line treatment for ED. Health care providers typically suggest penile implants only for patients who have tried other treatments without success.
The outlook for erectile dysfunction depends on its primary cause. But here’s the good news: for 70% of healthy men, ED drugs can produce an erection sufficient to engage in intercourse.
If you have an underlying medical condition or mental health condition, you should work with a clinician to address it. Sometimes, eliminating the symptoms of ED can be as simple as losing weight or reducing stress.
Plus, you’ll have the best possible outcome when you pair lifestyle changes, counseling, or both with medication. This kind of approach is more likely to improve symptoms more quickly and provide long-lasting relief.
Since erectile dysfunction can indicate an underlying medical condition, it’s important to talk to your doctor about the symptoms you’re experiencing.
Because ED is linked to some serious medical conditions, we encourage you to seek medical advice right away. Although talking about sexual symptoms can feel awkward, we want you to know that erectile dysfunction is extremely common. An online consultation can help you feel more comfortable talking about your experience.
A short conversation with a healthcare provider could make a significant difference in your sex life and overall health. Talk to an online medical professional about ED now.
- What is ED? The inability to achieve or maintain an erection hard enough for sex.
- As many as 30 million men in the United States experience erectile dysfunction.
- Risk factors for ED can be physiological, psychological, or both.
- The majority of healthy men can successfully treat ED using oral medications.
- Cleveland Clinic. (2019). Erectile dysfunction. https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction
- Harvard Health Publishing. (N.D.) Erectile dysfunction. https://www.health.harvard.edu/topics/erectile-dysfunction
- Harvard Health Publishing. (2020). Which drug for erectile dysfunction? https://www.health.harvard.edu/mens-health/which-drug-for-erectile-dysfunction
- Mayo Clinic. (2021). Erectile dysfunction. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
- Myers & Smith (2019). Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: A systematic review. https://doi.org/10.1016/j.physio.2019.01.002
- The Centers for Disease Control and Prevention. (2019). Diabetes and Men. https://www.cdc.gov/diabetes/library/features/diabetes-and-men.html
- Lamina et al. (2011). Effects of aerobic exercise in the management of erectile dysfunction: a meta analysis study on randomized controlled trials. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275865/
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