Erectile dysfunction (ED) is an inability to get or sustain an erection firm enough for sexual intercourse. Occasional ED is common, and many men may experience it when they are stressed. However, frequent ED may be a sign of an underlying health problem that needs treatment. Erectile dysfunction can also be a sign of relationship or emotional difficulties that require medical attention.

Besides, ED may affect your self-confidence and cause relationship problems. It may also act as a risk factor for heart disorders.

So, if you suspect ED, talk to your physician, even if you are embarrassed. Your doctor will examine you to find out the exact cause of your problem. In some cases, even treating the underlying cause helps in reversing ED. Other cases may need direct treatments or medications.

What is erectile dysfunction (ED)?

Erectile dysfunction is a disorder where a man finds it difficult to get or maintain an erection firm enough for sex. An erection occurs when the blood flows into your penis. This blood flow is stimulated by direct contact with the penis or sexual thoughts.

When a man is sexually excited, the penile muscles relax, allowing blood to flow through penile blood vessels and fill two chambers inside the penis. As the chambers are full of blood, the penis turns rigid. The erection ends when the muscles contract and the collected blood flows out through penile blood vessels.

Erectile dysfunction can occur as a result of problems at any stage of the erection process. 

Causes 

There are multiple causes of ED, and they include physical and emotional conditions. Some common causes are:

  • Diabetes
  • High cholesterol
  • Kidney disorders
  • Anxiety
  • Depression
  • Stress
  • Relationship problems
  • Sleep disorders
  • Damage to the pelvic area due to surgery or injury
  • Cardiovascular disease
  • Hypertension or high blood pressure
  • Obesity
  • Low testosterone levels
  • Other hormone imbalances
  • Increased age
  • Consuming too much alcohol
  • Using tobacco products
  • Drug use
  • Certain medications such as those used to treat depression or high blood pressure
  • Health conditions such as multiple sclerosis or Parkinson’s disease
  • Peyronie’s disease (a condition that causes scar tissue to develop in the penis)

Symptoms

You may have ED if you regularly face:

  • Difficulty in maintaining an erection during sexual activities
  • Trouble getting an erection
  • Reduced interest in sex

Some other ED-associated symptoms are:

  • Delayed ejaculation
  • Premature ejaculation
  • Anorgasmia (inability to achieve orgasm after ample stimulation)

If you have any of the symptoms, especially if they have lasted for three or more months, it is a good idea to talk to your doctor. They will help you find out if the symptoms are due to an underlying cause that needs treatment.

Risk Factors

While anyone can get ED, certain factors increase your risk of getting it. These risk factors are mainly related to circulation and blood flow. Injury is another major risk factor. Another important risk factor for ED is increasing age. Many men find it difficult to maintain an erection as they get older. 

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Additional risk factors for ED include:

  • A psychological condition such as depression or anxiety
  • A medical condition such as diabetes or cardiovascular disease
  • Being obese or overweight
  • Injury to or having surgery on your pelvic area
  • Consuming drugs, alcohol, or tobacco products
  • Medications, such as blood pressure medicines or antidepressants
  • Getting a medical treatment such as radiation therapy

Effects

Erectile dysfunction may have the following complications:

  • Stress or anxiety
  • Relationship problems
  • An unsatisfactory sex life
  • Embarrassment or low self-esteem
  • The inability to get your partner pregnant

Tests

Your doctor may undergo various steps to test ED, including a physical examination, and taking your sexual and health history. They may also ask for additional tests to find out if an underlying health condition causes your symptoms.

Physical Examination

You may expect a physical examination where your physician will listen to your lungs and heart, check your blood pressure, and examine your penis and testicles. They may also suggest a rectal examination to check your prostate.

Psychosocial history

Your doctor will ask you certain questions or request you to fill out a questionnaire about your health history, symptoms, and sexual history. Your responses will help them evaluate the severity of your condition.

Some of the common questions are:

  • Having problems with ejaculation, sexual desire, or reaching orgasm
  • Frequency of your sex and if it has changed recently
  • Duration of your symptoms and if they came gradually or suddenly
  • The firmness of your erection and if it is affected by types of stimulation or particular situations
  • Changes in your current relationship and expectations you and your partner have for each other
  • If you wake up in the middle of the night or in the morning with erections
  • History of medications
  • If you consume alcohol, tobacco, or nonprescription drugs
  • History of surgery or injury to your pelvic area
  • History of underlying conditions
  • If you are experiencing stress recently 

Additional tests

Your doctor may also advise additional tests to confirm the diagnosis of ED. Some of them are:

  • Nocturnal penile tumescence (NPT) test: It includes wearing a portable, battery-powered device on your thigh. NPT test evaluates the quality of your nocturnal erections. The device stores the data, which your physician can access later.
  • Ultrasound: It helps to examine blood vessels of the penis and thus aid in determining if penile blood flow is abnormal.
  • Urine tests: They help to check for diabetes or other underlying health conditions.
  • Injection test: This test involves inserting medication into your penis through an injection. It allows the physician to evaluate the firmness and duration of your erection.
  • Blood tests: These tests help your doctor to check for conditions such as heart diseases, testosterone levels, diabetes, or thyroid disorders. 

The mentioned tests can help your doctor to find the underlying condition and guide your treatment.

Prevention

The good news is that there are several steps you can take to prevent ED. The majority of these steps involve making lifestyle changes. These changes will not only help to prevent ED but also improve your overall health

The following changes can help:

  • Exercise regularly
  • Eat a healthy diet
  • Maintain a healthy weight
  • Manage your medical conditions, such as diabetes and heart diseases
  • Consult a physician if you are experiencing depression or anxiety
  • Manage stress through meditation or yoga
  • Have alcohol in moderation
  • Quit smoking
  • Avoid taking drugs that are not prescribed by your doctor
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You should also visit your doctor and get regular checkups. They will monitor crucial clinical measurements, such as cholesterol levels and blood pressure. All this will help in the early diagnosis and treatment of conditions that may increase your risk of getting ED.

Natural treatments

Some natural treatment options, with or without conventional therapy, may help you manage ED.

Herbs and supplements

Some common herbs and supplements that help to manage ED are:

  • Dehydroepiandrosterone (DHEA)
  • Asparagus racemosus
  • L-arginine
  • Ginseng
  • Yohimbe
  • L-carnitine
  • Horny goat weed
  • Zinc

It is recommended to talk to your doctor before taking supplements and herbs and proceed with caution. Some of these herbs are not regulated and may contain additional ingredients not listed on the label.

Acupuncture

It is a traditional Chinese medicine where a therapist inserts needles into the skin at acupoints (specific skin locations). This treatment is believed to work through nerve stimulation, which influences the release of neurotransmitters.

Studies have shown that acupuncture may be effective in treating psychological ED

Massage

Prostatic massage, a type of massage therapy, may be effective for ED. This type of massage is used in combination with other types of treatment.

During a prostatic massage, the practitioner will massage the tissues around your groin to promote blood flow to your penis. The duration and frequency of prostate massage depend on your symptoms.

Treatments

Multiple treatment options are available for ED, and the ideal treatment type depends on your symptoms and the underlying cause. You may also need a combination of the mentioned treatment options.

Talk Therapy

Various psychological factors may cause ED, such as anxiety, stress, depression, and post-traumatic stress disorder (PTSD).

If you are facing psychological ED, talk therapy may benefit you. Your therapist may discuss your feelings around sex, anxiety or stress factors, and subconscious conflicts that could affect your sexual well-being during sessions. 

Besides, a relationship counselor will also help if the ED is affecting your relationship. This may also help you and your partner to connect emotionally, which may benefit ED.

Vacuum Pumps

This type of treatment includes the creation of a vacuum to trigger an erection. Using this device causes blood to enter your penis, resulting in an erection.

This vacuum pump device consists of the following components:

  • A pump that offers to create a vacuum by drawing air
  • A plastic tube to be placed over your penis
  • An elastic ring that needs to be moved to the base of your penis as you take off the plastic tube. This ring helps to maintain an erection by holding the blood in your penis and prevent it from returning into circulation. You can leave it in place for 30 minutes.

Exercises

In addition to the above treatment options, certain exercises also help in managing ED.

Kegel exercises

Kegel exercises are simple movements that strengthen your pelvic floor muscles.

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To identify the pelvic floor muscles, stop peeing during midstream. The muscles you use to stop urination are your pelvic floor muscles.

To do this exercise:

  • Contract your pelvic muscles for three seconds
  • Now, release them
  • Repeat it 10 to 20 times in a row, three times a day

According to studies doing Kegel exercises for three months has a significant effect on ED.

Aerobic exercise

Vigorous or moderate exercise improves your blood flow, which may benefit ED. Some examples of aerobic exercises include swimming and running.

It is seen that 160 minutes of weekly exercises for six months may reduce your erectile problems. Research also suggests that exercise may improve testosterone levels in addition to reducing your body fat.

If you start a new exercise regimen, it is a good idea to consult your doctor, especially if you have heart diseases or other underlying conditions aggravated by vigorous activity.

Yoga

Yoga relaxes your mind and body. As anxiety and stress are risk factors for ED, practicing yoga can effectively manage ED symptoms.

Studies have shown that a 12-week yoga program may improve ED symptoms

Medications

Your doctor may also prescribe medications to manage ED symptoms. You may need to try various remedies to see what suits you the best. 

Some common medications used in Canada to treat ED are:

  • Sildenafil (Viagra)
  • Avanafil (Stendra)
  • Vardenafil (Levitra, Staxyn)
  • Tadalafil (Cialis)

Alprostadil may also be useful to manage ED. It can be used in two ways, a self-injection or penile suppository. Mostly people are embarrassed with ED and avoid to discuss ED even with their doctor. These days an online pharmacy is a great way to virtually connect with your doctor and get your medication delivered.

Your doctor may also recommend testosterone therapy if your testosterone levels are low.

Surgery

In cases where only medications are not effective, your physician may recommend surgical treatment. There are two primary types of surgical procedures:

  • Vascular surgery: It repairs blocked blood vessels and helps to restore adequate blood flow to your penis. Younger men are better candidates for this procedure.
  • Implant surgery: Here, a penile implant or prosthesis is placed in the penis. There are two different types of implants, a malleable implant, and an inflatable implant. The malleable implant offers to adjust the position of your penis manually, while the inflatable implant includes the use of a pump to make your penis larger.

Final Thoughts

Erectile dysfunction is a common occurrence, especially when stressed. But if it lasts longer, it may suggest an underlying disorder. In the majority of the cases, ED symptoms improve just by managing the condition.

For the rest of the cases, various treatment options and medications are available. Your doctor will decide the best treatment plan based on various factors, including the underlying cause or severity of your condition. They will also explain the risks and benefits of each treatment type.

It is important to understand that ED is a common disorder, and it is important to consult your doctor, even if you are embarrassed. It helps to diagnose the underlying cause and manage it accordingly.

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