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Get health news and advice you need to live your best, delivered right to your inbox every month: The [email protected] e-newsletter. men's health center/men's health a-z list/what is the main cause of erectile dysfunction center /what is the main cause of erectile dysfunction article What Is the Main Cause of Erectile Dysfunction? Mental Health What role does mental health play in causing erectile dysfunction? Lifestyle Factors How do lifestyle factors contribute to erectile dysfunction? Health Issues Impact What health issues affect a person’s ability to get an erection? Medications and ED What medications have erectile dysfunction as one of their side effects? Medical Author: Dr. Jasmine Shaikh, MD Medical Reviewer: Shaziya Allarakha, MD Mental Health What role does mental health play in causing erectile dysfunction? Lifestyle Factors How do lifestyle factors contribute to erectile dysfunction? Health Issues Impact What health issues affect a person’s ability to get an erection? Medications and ED What medications have erectile dysfunction as one of their side effects? Center What Is the Main Cause of Erectile Dysfunction? Center Penile erection is a complex process in which the brain, nerves, muscles and blood vessels play a major role. The main causes of erectile dysfunction include psychological and health conditions, medications, trauma and lifestyle factors.
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Male sexual dysfunction can be caused by physical or psychological problems. Common sexual problems in men include erectile dysfunction (impotence or ED), premature ejaculation, and loss of libido. Treatment for sexual dysfunction in men may involve medication, hormone therapy, psychological therapy, and the use of mechanical aids.
It’s recommended that you use the Erectile Dysfunction Test Kit if you’ve experienced erectile dysfunction (ED) for a prolonged period of time and are unsure of the underlying causes. Taking a simple blood test can help identify whether there are any physiological explanations for your ED. We also recommend it to anyone who has been taking ED medication for a long while or relies on it to get an erection during most (or all) sexual encounters. Please keep your GP informed about any medication you’re currently taking and the results of your blood tests. Note: you do not need to order an Erectile Dysfunction Test Kit to receive ED medication from us. Wash your hands in warm water for 4 minutes and then dry them. Use the lancet provided to prick your finger and collect a blood sample. Post your sample to our accredited partner laboratory using the pre-paid envelope included with your Kit. Full instructions are provided with your Erectile Dysfunction Test Kit, which you should read thoroughly before use to ensure the best results. You can also click here to watch an instructional video on how to take a finger-prick blood test.
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For many of the 30 million Americans affected by erectile dysfunction, Viagra, Levitra, and Cialis are the first line of ED treatment — and they’re successful for about 80 percent of men. These drugs, called phosphodiesterase-5 inhibitors, are approved by the U.S. Food and Drug Administration (FDA) and work by increasing blood flow to an erection. Common side effects include nasal congestion and headache. Note: If you take nitroglycerin pills for heart disease, you won’t be able to take ED pills, as they can cause a dangerous drop in blood pressure.
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Blood cell counts Cholesterol levels Blood sugar levels Liver function tests
You’ve probably heard of sildenafil (Viagra), but it isn’t the only pill for ED. This class of drugs also includes avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn). All work by improving blood flow to the penis during arousal. They're generally taken 30-60 minutes before sexual activity and should not be used more than once a day. You can take tadalafil up to 36 hours before sexual activity. It also comes in a lower, daily dose. All require an OK from your doctor first for safety.
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Figures suggest more than half of men over the age of 50 have erectile dysfunction, which gets more common with age.
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As its name suggests, this exercise targets the muscles of the pelvis, strengthening them and increasing their range of motion as they’re rotated clockwise and anticlockwise. However, given that you have to be in a plank while doing this, your core power also improves. The abdominals, chest and back together help you maintain that position. The arms and shoulders are also toned. Go into a plank position. Place your palms firmly on the floor in line with your shoulders. Extend your legs at the back. Keep your elbows and knees straight. Bring your body in one straight line from head to toe. Swing your hips from side to side. Thrust your hips upwards and downwards. Rotate your hips. Repeat in a seamless motion. Cat and cow
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Research in stem cell therapy and gene therapy for erectile dysfunction is also ongoing. Cuzin, B. "Alprostadil cream in the treatment of erectile dysfunction: clinical evidence and experience." Ther Adv Urol 8.4 Aug. 2016: 249-256. Diamond, L.E., et al. "Co-administration of Low Doses of Intranasal PT-141, a Melanocortin Receptor Agonist, and Sildenafil to Men With Erectile Dysfunction Results in an Enhanced Erectile Response." Urology 65 (2005): 755. Jackson G., et al. "The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine." Journal of Sexual Medicine 3 (2006): 28. Kim, E.D. "Erectile Dysfunction Treatment & Management." Medscape.com. Oct. 12, 2015. Matz, E.L., et al. "Stem cell therapy for erectile dysfunction." Sex Med Rev 2018 April 6 epub ahead of print. United States. Food and Drug Administration. "Hidden Risks of Erectile Dysfunction 'Treatments' Sold Online." Mar. 23, 2015. Yafi, F.A., et al. "Erectile dysfunction." Nat Rev Dis Primers 2 (2016): 16003.
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We recommend that ALL of our patients with ED get a heart and stroke screening checkup with their primary doctor. Low testosterone (male hormone) levels Peyronie’s Disease (penile curvature and plaque formation) Neurological diseases - like neuropathy, multiple sclerosis, spinal cord injury Drug Side Effects - most commonly implicated drugs are blood pressure medications (which may cause ED simply by doing what they are intended to do—lower blood pressure) and antidepressants, due to their neurological effects Psychogenic - only 10% of cases are related to a psychological problems like anxiety, post traumatic stress disorder, depression, stress, relationship problems
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Bullet point: The relationship between the risk factors for CVD and ED are intimately interwoven, one with the other. Clinicians need to factor this in when counselling the man with ED.
The penile implant allows men to achieve an erection through an implanted device. These devices can be effective in restoring sexual activity for a man and his partner. At Yale Medicine, our doctors have specialized experience with placing the penile prosthesis.
This is especially important for erections. When a man is sexually stimulated, his penis fills with blood. This blood gives him the firmness he needs for sexual activity. Once he ejaculates, the blood flows out of the penis and back into the rest of his body.
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Currently, three pills (Viagra/sildenafil, Levitra/vardenafil, Cialis/tadalafil) are available and FDA-approved for erectile dysfunction. They are all called phosphodiesterase inhibitors, which means they act by blocking a chemical that stops erections.
You’ll need to take these pills at least four times before deciding if they work for you or not. headache, facial flushing, upset stomach, back pain (Cialis), sensitivity to light, or blurry vision.
When the aforementioned strategies prove insufficient to address ED symptoms, medical therapies are warranted. The simplest treatments include use of a class of oral medications known as phosphodiesterase type 5 inhibitors (PDE5I, e.g. sildenafil, tadalafil, vardenafil, and avanafil). These drugs enhance the effects of nitric oxide, a natural molecule within the body that relaxes the smooth muscle of the penis, to enable increased blood to flow and result in erection. These medications are generally very safe and reliable. Men who use nitrates (found in certain heart medications and in some recreational drugs) should not use PDE5I. Optimal use of PDE5I requires advice on timing and proper use of these drugs for maximal effect.
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Checking the penis for sensitivity determines any nervous system origins. Inspection of penile appearance helps rule out Peyronie's disease. A blood pressure check rules out circulation problems by checking wrist and ankle pulse.
Getting an erection is a process that includes physical, hormonal, and psychological elements. The penis is made of soft, spongy, elastic tissue that fills with blood to make it grow in size and become rigid. Around the spongy tissue and the prostate, there are nerves that send signals so that the blood vessels supply the blood (Fig. 1). These signals are controlled by the male hormone testosterone.
The symptoms include persistent trouble getting or keeping an erection, reduced sexual desire or premature ejaculation. “These symptoms can also be a sign of an underlying health condition. So, one should not be embarrassed and must consult the doctor as treating the underlying condition is sufficient to reverse ED,” Dr Banga explains.
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Depending on the symptoms elicited, further investigations including blood tests will be performed. These blood tests will include a check of testosterone (which is best checked first thing in the morning, preferably after fasting), as well checking other hormones, including thyroid function and blood sugar (or glycosylated haemoglobin, HbA1c, which may be used to check for diabetes).
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Aetna considers implantation of semi-rigid penile prostheses or inflatable penile prostheses (implantable penile pumps) medically necessary for members with documented physiologic erectile dysfunction when all of the following criteria are met Absence of active alcohol or substance abuse; and Absence of drug-induced impotence related to: anabolic steroids, anticholinergics, antidepressants, antipsychotics or central nervous system depressants; and Absence of untreated depression or psychiatric illness; and Nonsurgical methods have proven ineffective or are contraindicated; and Normal prolactin and thyroid hormone levels; and Normal serum testosterone levels (low testosterone suggests treatable endocrine cause of impotence); and History of organic disease including any one or more of the following: Documented injury to perineum/genitalia; or Major pelvic trauma affecting bladder and/or anal and/or erection control; or Major vascular surgery involving aorta or femoral blood vessels; or Neurological disease (eg, diabetic neuropathy); or Peyronie’s disease; or Renal failure; or Secondary to spinal cord injury; or Status-post prostate, bladder, bowel or spinal surgery; or Vascular insufficiency or venous incompetence documented by dynamic infusion cavernosometry and cavernosography (DICC); or Venous leak of the penis.
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Low intensity shockwave therapy(LiST) is a groundbreaking “drug and surgery-free” procedure that uses acoustic waves to stimulate a cascade of biological actions that lead to the healing and regeneration of the sexual organs. Simply…LiST helps your body heal itself! Learn more about Low Intensity Shockwave Therapy. Oral medications for ED are called PDE-5 inhibitors. The drugs in this class include medications like Viagra, Levitra, Cialis, Stendra and more. This class of drugs is considered first line therapy for those men presenting with ED. Learn More About Oral Medications for ED. Penile injection therapy involves an injection of a medication into the shaft of the penis on an as needed basis to produce a rapid erection. It is commonly used by patients who have failed oral medications. Learn more about this very effective treatment. The same medicine used for penile injection may be used as a very small suppository placed into the tip of the penis to provoke an erection.
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Your urine will normally be tested to see whether it contains sugar (which might indicate diabetes), or blood (which may be a sign of infection or require further investigation).
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Exercise is good for the heart, blood pressure, joints, muscles, and improves your mood.
There are a variety of other options to treat erectile dysfunction including medication, surgical options, injections, or vacuum devices:
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Albumin Serum one of the major proteins in the blood and a reflection of the general state of nutrition.
So, what are the options for a man with ED? Well, there are a few. Usually the first option we (urologists and primary care doctors) will try are medications like Viagra, Cialis, Levitra, etc. All those medications function by bringing more blood flow to the penis. They are all pretty similar in their action, and if one of them works for you, chances are the others will, too. Some men will experience side effects, most common being facial flushing.
In 1973, Dr Brantley Scott from Baylor College of Medicine reported on the implantable inflatable prosthesis that urologists still use today.5
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If you are on treatment for a medical or psychiatric problem and you think that this treatment is affecting your sex life tell your doctor. Alternative treatments that may have less likelihood of affecting sexual function are often available.
Collagenases are proteinases that hydrolyze collagen in its native triple helical conformation under physiological conditions, resulting in lysis of collagen deposits. The signs and symptoms of Peyronie’s disease have been found to be caused by a collagen plaque. Injection of collagenase clostridium histolyticum into a Peyronie’s plaque, which is comprised mostly of collagen, may result in enzymatic disruption of the plaque. Following this disruption of the plaque, penile curvature deformity are reduced (Endo Pharmaceuticals, 2021). Measurement of Serum Melatonin Levels for the Diagnosis of Erectile Dysfunction
The stress of erectile dysfunction and its toll on self-confidence and/or a relationship can be hard to deal with. Speaking to a psychologist or counselor about how to cope emotionally can be of great benefit to some people.
ED is usually easy to diagnose. If you are tempted to self-diagnose, talk to your doctor. He or she will want to make sure it isn’t related to another health condition.
Urethral suppositories, also called intraurethral pellet therapy or medicated urethral system for erections (MUSE®), are a self-administered treatment for erectile dysfunction that may be effective for men who dislike penile injections or for whom oral medications are not effective. Alprostadil, a drug used for penile injection therapy, is also available as a small suppository that is placed directly into the urethra to achieve an erection, usually within five to 10 minutes.
Unlike other treatments for erectile dysfunction, PDE5i medications requires sexual stimulation to function. Without stimulation, these medications will not provide any effect.
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If these fail to improve symptoms, second-line treatments include a topical cream (alprostadil, prostaglandin E1) which works by relaxing the blood vessels, improving blood supply to the penis, and so causing an erection. Alternatively, alprostadil (prostaglandin E1) may also be injected into the penis, to relax blood vessels
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Studies show about 5 percent of men who are 40 years old have full-blown ED, and that percentage jumps to 15 percent for men who are 70.
However, his most recent video delves into erectile dysfunction: a sexual disorder which one in every ten men suffer from at some point in their life, but due to the stigma attached to it, remains largely undiscussed in our society. “It’s time we braved into the topic of sexual health” he wrote in his caption, and then went ahead and demonstrated a range of exercises that will boost the flow of blood and bring sexual energy back to the pelvic region.
Lab tests can help diagnose ED. Blood cell counts, blood sugar levels, cholesterol levels, and liver tests can reveal medical conditions that play a role in ED.
Medication therapy is effective, especially in older men. Additional treatment may include self-injected medication, vacuum erection devices, or urethral suppositories. Surgical interventions include vascular reconstruction for improved penile blood flow. Penile implants are considered for some cases.
It is also more common in older patients, but is not, itself, a natural consequence of aging.
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Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
Other medical therapies under evaluation include ROCK inhibitors and soluble guanyl cyclase activators. Melanocortin receptor agonists are a new set of medications being developed in the field of erectile dysfunction. Their action is on the nervous system rather than the vascular system. PT-141 is a nasal preparation that appears to be effective alone or in combination with PDE5 inhibitors. The main side effects include flushing and nausea. These drugs are currently not approved for commercial use.
[Learn about energy wave therapy at Chesapeake Urology: https://energywave.chesapeakeurology.com/]
You probably already know that aerobic exercise is associated with a range of overall health benefits like weight loss, preventing vascular disease and improving mental health, but did you know that exercise is the lifestyle factor most strongly associated with erectile function and sexual health?
Exercising on a regular basis boosts the blood flow to the pelvis and allows the reproductive organs to function properly. Not just this, exercising also strengthens the core of the body. Exercises that strengthen the muscles of the pelvic floor can benefit the people suffering from erectile dysfunction. The pelvic floor muscles are important in sustaining the blood flow to the penis and maintaining erections. The muscles do this by putting the pressure on the penile veins. The pressure then prevents blood from leaving the area, making an erection possible.
Your doctor may make suggestions to improve your overall health, including the health of your heart and circulatory system. Increasing your amount of exercise, eating well, and ensuring that you get sufficient vitamins and minerals can help with this overall wellbeing. Another recommendation may be reducing or eliminating your use of drugs, tobacco, or alcohol. Your doctor may also recommend losing weight.
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Weight loss (calories are burned as a result of increases in lean body mass and basal metabolism)Prevention and management of diabetes (which is associated with ED)3. Pelvic floor exercises (aka Kegels)
Erectile dysfunction (ED, impotence) is the failure to achieve or maintain an erection. There are many potential underlying causes of erectile dysfunction, including stress and emotional problems, brain dysfunction, problems with blood supply to the penis, and structural problems with the penis.
Chronic rhinitis and post-nasal drip symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) usually is caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year-round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependent upon the type of rhinitis condition.
There are also injectable drugs for erectile dysfunction. Some men sustain stronger erections by injecting these medications directly into the penis. These drugs work by widening the blood vessels, causing the penis to become engorged with blood. Another option is a medicated pellet that is inserted into the urethra and can trigger an erection within 10 minutes. Patients should discuss the use of these injections in detail with their doctor before use. Erectile Dysfunction Treatment: Vacuum Devices (Pumps)
In a study of 120 men with varying degrees of E.D., the men with the most severe E.D. had the lowest folic acid levels, despite having normal testosterone levels (Karabakan et al., 2015). Folic acid is abundant in many fruits and vegetables.
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The recommended starting dose of tadalafil for use as needed for most patients is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher to 20 mg or lower to 5 mg depending on efficacy and side effects. Doctors recommended that patients take tadalafil no more frequently than once per day. Some patients can take tadalafil less frequently since the improvement in erectile function may last 36 hours. Patients may take tadalafil with or without food. Tadalafil is currently the only PDE5 inhibitor that is FDA-approved for daily use for erectile dysfunction and is available in 2.5 mg or 5 mg dosages for daily use.
“Street” drugs can dampen a man’s feelings of arousal as well as other sensations. Illicit drugs can take away the pleasure of sex and make a man impotent. Some men use drugs to cope with other issues that could be the root of their penile dysfunction. Using drugs only compounds a man’s difficulty in achieving and maintaining erections.
A penile prosthesis is a pair of malleable (bendable) rods that are surgically inserted into the penis. It allows erections to happen by a mechanism of compressing on a special part by the device. Men disappointed with other treatments might be fit for penile prosthesis. Medical Author: Stephen W Leslie, MD, FACS Medical Editor: Bradley Fields Schwartz, DO, FACS Medical Editor: Mary L Windle, PharmD Medical Editor: Martin I Resnick, MD What to Expect During Your Doctor Visit Sexual, Medical, and Psychosocial History to Diagnose Erectile Dysfunction Physical Examination to Diagnose Erectile Dysfunction Laboratory Testing to Diagnose Erectile Dysfunction Imaging Studies to Diagnose Erectile Dysfunction Further Testing to Diagnose Erectile Dysfunction Diagnostic Testing Results Diagnosing Erectile Dysfunction Pictures Diagnosing Erectile Dysfunction Topic Guide Men are frequently reluctant to discuss their sexual problems, particularly erectile dysfunction or ED, and often need to be specifically asked.You can assist and initiate this process just by telling your doctor directly that erectile dysfunction is a problem for you. Opening a dialogue allows your doctor to begin the investigation or refer you to a consultant.Scheduling enough time with your doctor to conduct a full interview and physical examination is important.After performing a full interview, physical examination, and laboratory testing, your doctor can then discuss your particular situation, the most likely cause, and reasonable treatment options.
The idea of using low-energy shock waves to treat erectile dysfunction comes from studies that show that these types of shocks help heart blood vessels regrow, a process called revascularization. Shock wave therapy may also work on the penis, and there have been some promising results, but it’s not currently an approved ED treatment. "It’s similar to the type of shock waves used to break up kidney stones, and it may cause revascularization,” says Bennett. “However, there are not yet any good controlled studies to recommend it to patients."
This is where Kegels come in: they are pelvic floor exercises that help strengthen these muscles, leading to pelvic floor activation, and can improve erectile function.
While low T isn't the only cause of erectile dysfunction, the two do seem to be connected. However, the connection between low testosterone and erectile dysfunction is complicated. Researchers believe the two are connected because they both seem to coincide as a man ages. However, some men with low testosterone continue to produce healthy erections.
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