What is erectile dysfunction? – Causes, Diagnosis and Treatments.

The ED means can not obtain adequate erection, most cases are due to narrowing of the arteries that carry blood to the penis, this is due to a buildup of fatty deposits (atheroma) in these arteries in the same manner that the arteries of the heart are affected in people with heart disease.

Usually treatable, most commonly by taking a tablet before sex, you can also receive lifestyle advice and treatments to minimize your risk of heart disease. Most have occasionally experienced some difficulty with the penis becoming hard or firm. However, erectile dysfunction is only considered a concern if satisfactory sexual performance has repeatedly been impossible for a while.

Men who have a problem with their sexual performance can be very self-conscious when talking to their doctor, as it can be a very embarrassing problem for them, so it is important to treat yourself and there are several treatments available.

What is erectile dysfunction?

It is a type of sexual disorder characterized by the inability to obtain and / or maintain an erection. In some cases, the penis becomes partially erect, but not hard enough for proper sexual intercourse. There may also be no swelling or fullness of the penis at all. Sometimes called and known as impotence.

Most men have occasional moments when they cannot get an erection. For example, you may not get an erection if you are tired, stressed, distracted, or have drunk too much alcohol. For most men it is only temporary, however some have persistent or recurring ED and it can occur at any age but becomes more common with increasing age. About half of men between the ages of 40 and 70 have it.

How does an erection normally occur?

Inside the penis there are two long cylindrical chambers called the corpora cavernosa that contain innumerable blood vessels and tissues, as well as a main artery in each of the two.When you are sexually aroused, messages from your brain travel through the nerves to your penis. Chemicals called neurotransmitters are released from nerve ends in the penis, and stimulation can also cause local nerve endings to release neurotransmitter chemicals.

Those neurotransmitters cause the production of another chemical called cyclic guanosine monophosphate, this chemical causes the arteries in the penis to widen (dilate), allowing extra blood to flood into the penis. The rapid flow of blood causes the penis to swell and become an erection, the swollen inner part also presses on the veins closest to the surface of the skin, these veins normally drain the penis of blood. Therefore, the blood flow is also restricted, which improves the erection.

Once you stop having sex, the guanosine monophosphate level drops, the blood flow to the penis returns to normal, and you gradually return to the non-erect state. If the blood flow to the penis is insufficient or if it does not stay inside, it can lead to erectile dysfunction.

Erectile dysfunction symptoms

Men may not always achieve a successful erection, and if this does not occur frequently, it is not considered a medical problem, however it does not only refer to a complete inability to achieve an erect penis. A man is considered to have this problem when these symptoms occur regularly.

What Causes Erectile Dysfunction?

There are several causes that tend to be grouped into those that are primarily physical and those that are primarily due to mental (psychological) health.

Physical causes

About 8 out of 10 cases are due to a physical cause. Persistent erection problems are always worth consulting a doctor as it could be caused by a serious medical condition. Whether the cause is simple or serious, a proper diagnosis can help address any underlying medical problems and help resolve sexual difficulties.

Here are the most common physical or organic causes

  • Reduced blood flow to the penis. This is by far the most common cause in men over the age of 40. Risk factors can increase your chances of narrowing of the arteries, these include getting older, high blood pressure, high cholesterol, and smoking.
  • Diseases that affect the nerves to the penis. For example, multiple sclerosis, stroke, Parkinson’s disease , etc.
  • Diabetes.
  • Hormonal causes. For example, the lack of a hormone called testosterone that is produced in the testicles, this is rare but one cause of a lack of testosterone that is worth noting is a previous brain injury. A head injury can sometimes affect the function of the pituitary gland in the brain, which produces a hormone that stimulates the testicle to produce testosterone. So even if it doesn’t appear to be connected at first glance, a previous head injury can, in fact, lead to erectile dysfunction. Other symptoms of low testosterone include reduced sex drive (libido) and mood swings.

If erectile dysfunction is due to a physical cause, it is likely that you still have a normal sex drive and in some cases, it causes low self-esteem, anxiety and even depression, these reactions can make the problem worse.

Mental health causes (psychological)

Several mental health conditions can cause you to develop erectile dysfunction, these include:

Usually erectile dysfunction develops quite suddenly if it is a psychological symptom, it can resolve when your mental state improves, for example if your anxiety or depression is relieved. However, some people become even more anxious or depressed when they develop it, they do not realize that it is a reaction to their mental health problem, this can make things worse and lead to a vicious cycle of worsening.

Most cases are secondary, this means that erectile dysfunction has been normal, but it becomes problematic, the causes of a new and persistent problem are usually physical.

Less commonly, psychological factors cause or contribute to erectile dysfunction, with factors ranging from treatable mental health illnesses to everyday emotional states that most people experience at some point.

How is erectile dysfunction diagnosed?

Your doctor will ask you questions about your symptoms and health history, they can do tests to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure and examine your testicles and penis, they may also recommend a rectal exam to check your prostate.

Nocturnal tumescence test of the penis

One such test is done using a portable, battery-powered device that you wear on your thigh while you sleep, because nighttime erections are a normal part of a healthy-functioning penis.

If you have a low sex drive, or if you’ve had a previous head injury, erectile dysfunction may be due to a hormonal problem. In this situation, a blood test is recommended to check the level of the hormone testosterone and sometimes prolactin. In a small number of cases, tests to check how blood is flowing through the penis are done using scans or injections of drugs and can be done in hospital clinics.

What are the treatments for erectile dysfunction?

Your GP is likely to suggest referral if you have been found to have a hormonal problem, if the cause is related to another condition, such as circulatory problems, or if you are young and the condition started after an injury.


The tool to address erection problems is a type of medicine called ‘PDE-5 inhibitors’, these include:

  • Viagra (active ingredient – sildenafil):  Probably the oldest and best-known PDE-5 drug, it comes in a cheap generic form called by the active ingredient’s name, Sildenafil.
  • Cialis (active ingredient – tadalafil):  This is the longest lasting PDE-5 inhibitor, up to 36 hours.
  • Levitra (active ingredient – vardenafil):  Similar to Viagra, but less likely to cause eye-related side effects.
  • Spedra (active ingredient – avanafil):  The newest drug on the market, it becomes the fastest, in some cases as fast as 15 minutes.

You can order any of these drugs as long as you have received an evaluation from a doctor first and they agree that the drug is right for you, this is because they are prescription only. You can get an evaluation by making an appointment to see your local GP, or you can start the evaluation right away by using an online medical service.

These drugs don’t work for everyone, but they are easy to use and work for about 60% of the people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5, this chemical is used in the body to make sure there is not too much blood in the penis during erection, but if you have dysfunction erectile, this chemical ends up being overcompensated.

  • Not everyone can take these medications. You may not be able to test them if:
  • You have some existing health problems (such as heart disease).
  • Are taking certain medications (such as nitrates).
  • PDE-5 inhibitor medications can also cause some side effects.

Cream applied to the penis

Alprostadil topical can be prescribed, the cream comes with a plunger and is applied to the tip of the penis and the surrounding skin. It should be used 5 to 30 minutes before having sex.

Injectable treatment

This was the most common treatment before tablets were available and it works very well, it involves injecting a drug at the base of the penis, which causes an increase in blood flow, developing an erection in 15 minutes. (Unlike tablets, an erection occurs whether or not you are sexually aroused.)


There are several different devices, in which the penis is placed in a plastic container. Then a pump sucks the air out of the container to create a vacuum, this causes blood to enter the penis and cause an erection, when erect, a rubber band is placed at the base of the penis to maintain the erection. The plastic container is removed and remains erect until the elastic band is removed (to be removed within 30 minutes).

Penile prosthesis

It is one where a surgeon can insert a bar permanently into the penis, it is a really expensive treatment, where it can be inflated with a built-in pump to cause an erection. The most basic type has to be straightened by hand.

Talk therapy

If you have psychological erectile dysfunction, you can benefit from talk therapy, this therapy can help you control your mental health. You will likely work with your therapist over several sessions, and he or she will address important factors such as stress or anxiety, sex-related feelings, or subconscious conflicts that could be affecting your sexual well-being.

Alternative treatments

If your ED is caused by stress, yoga and massage can be helpful if you find these activities relaxing.

Prostate massage

Some men use a form of massage therapy called prostate massage, practitioners massage the tissues in and around the groin to promote blood flow to their penis. There are limited studies on the effectiveness of this type of massage.


Acupuncture can help treat psychological erectile dysfunction, although studies are limited and inconclusive, you will likely need several appointments before you begin to notice improvements.


Sometimes couples counseling or sex therapy is helpful, these are more helpful if certain mental health (psychological) problems are the cause or result of the problem. In some cases, sex therapy is used in addition to another treatment option.

Pelvic floor muscle exercises

A small study of 55 men observed improvement in penile function after three months of regular pelvic floor muscle exercises, and after six months, 40 percent of men regained normal erectile function.

Kegel exercises are a simple exercise that you can use to strengthen your pelvic floor muscles. First identify your muscles, to do this stop urinating midway, the muscles you use to do this are the pelvic floor muscles. Your testicles will also increase when you contract these muscles. Now that you know where these muscles are, contract for 5 to 20 seconds and then release them. Repeat this exercise 10 to 20 times in a row, three to four times a day.

Lifestyle changes

Healthy lifestyle habits can prevent erectile dysfunction and, in some situations, reverse the condition:

  • Get regular exercise.
  • Keep blood pressure low
  • Eat a balanced and nutritious diet.
  • Keep a healthy weight.
  • Avoid alcohol and cigarettes.
  • Reduce you are.

Erectile dysfunction is often associated with problems with blood flow, so maintaining healthy blood vessels through exercise and a healthy diet can help reduce your risk of developing this disorder.

What is a good “action plan” for erectile dysfunction?

Step 1. Make the decision to correct your erectile dysfunction: Studies show that many people endure erection problems when it is not necessary, the first step is to make a decision.

Step 2.  Go to the doctor: When it comes to your body not working properly, a doctor has the professional knowledge you need to decide how to treat and fix it, they can give you an evaluation to help you discover which erection strategies are right for you. .

Step 3. Decide your solution (s): Once you have received a doctor’s opinion, you can choose which erection strategies to try. Also, while you should never combine medication unless a doctor agrees that you should, you can try more than one ED solution at the same time, such as medications in conjunction with lifestyle changes.

Step 4. Start your solution (s) and observe the results: Once you are satisfied with your choice and have started, you need to keep an eye on the situation. The amount of time until you see results will differ depending on the solution you are using.

Step 5. If the problem is not solved, don’t give up! – Not everyone finds the right solution for them on the first try, just because their first try doesn’t work, it doesn’t mean that nothing will.

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Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.