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Know the basics

What is erectile dysfunction (ED)?

Erectile dysfunction is when you cannot get or keep an erection firm enough to have sex. You may have ED if you

  • can get an erection sometimes, though not every time;
  • can get an erection, yet it does not last long enough for sex;
  • are unable to get an erection at all.

How common is erectile dysfunction?

Erectile dysfunction affects men of all races and in all parts of the world. Men are more likely to have ED as they get older. For example, ED occurs in

  • about 12 percent of men younger than 60;
  • 22 percent of men age 60 to 69;
  • 30 percent of men age 70 or older.

It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Know the symptoms

What are the symptoms of erectile dysfunction?

The main symptom of ED is the inability to get or keep an erection until the end of sexual activity.

If the cause is psychological, men may have associated anxiety, mood swings, depression, insomnia, and concerns about sexual performance.

If the cause is physical, symptoms of medical illness may include poor  circulation in the legs, chest pains, or shortness of breath with exercise (possible heart disease). Diabetes is frequently associated with ED.

There may be some signs or symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

A family doctor is a good place to start when you have erectile problems. See your doctor if:

  • You have concerns about your erections or you’re experiencing other sexual problems, including ejaculatory dysfunction, such as premature or delayed ejaculation.
  • You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction.
  • You have other symptoms along with erectile dysfunction.

Know the causes

What causes erectile dysfunction?

Causes of ED include:

  • Disorders that make blood flow lower or damage nerves in the penis.
  • Penis’s nerves can result from pelvic or abdominal surgery ( especially prostate surgery), radiation therapy, spinal disease, diabetes.
  • Hormone disorders

Other factors include stroke, smoking, alcohol, and drugs. Drugs often cause erectile dysfunction (especially in older men) include antihypertensives, antidepressants, some sedatives, cimetidine, digoxin, diuretics and illegal drugs.

Know the risk factors

What increases my risk for erectile dysfunction?

Various risk factors can contribute to erectile dysfunction, including:

  • Medical conditions, particularly diabetes or heart conditions;
  • Tobacco use, which restricts blood flow to veins and arteries, can — over time— cause chronic health conditions that lead to erectile dysfunction;
  • Being overweight, especially if you’re obese;
  • Certain medical treatments, such as prostate surgery or radiation treatment for cancer;
  • Injuries, particularly if they damage the nerves or arteries that control erections;
  • Medications, including antidepressants, antihistamines, and medications to treat high blood pressure, pain or prostate conditions;
  • Psychological conditions, such as stress, anxiety or depression;
  • Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker;
  • Prolonged bicycling, which can compress nerves and affect blood flow to the penis, may lead to temporary or permanent erectile dysfunction.

Understand the diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is erectile dysfunction diagnosed?

  • Medicine by mouth. Your doctor may be able to prescribe a pill to treat ED. Common medicines include sildenafil (®Viagra), vardenafil (®Levitra, ®Staxyn), tadalafil (®Cialis), avanafil (®Stendra). If your health is generally good, your doctor may prescribe one of these medicines. You should not take any of these pills to treat ED if you take any nitrates, a type of heart medicine. All ED pills work by increasing blood flow to the penis. They do not cause automatic erections. Talk with your doctor about when to take the pill. You may need to experiment to find out how soon the pill takes effect.
  • Testosterone replacement. Some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step.

  • Prescribing a Vacuum Device: Another way to create an erection is to use a device with a specially designed vacuum tube. You put your penis into the tube, which is connected to a pump. As air is pumped out of the tube, blood flows into your penis and makes it larger and firmer. You then move a specially designed elastic ring from the end of the tube to the base of your penis to keep the blood from flowing back into your body. You may find that using a vacuum device requires some practice.

  • Other treatments: Penile implants involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or semirigid rods. Inflatable devices allow you to control when and how long you have an erection. The semi-rigid rods keep your penis firm but bendable.

Besides doctor also may use psychological therapy to improve mental factors and feelings if they are the cause of erectile dysfunction.

Your condition may take a long time to be improved and need to use multiple methods. You and your partner should cooperation with your doctor in order to achieve the best treatment’s result.

How is erectile dysfunction treated?

For many men, a physical exam and answering questions (medical history) are all that’s needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

  • Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions. 
  • Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
  • Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.

This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.

  • Overnight erection test. Most men have erections during sleep without remembering them. This simple test involves wrapping a special device around your penis before you go to bed.

This device measures the number and strength of erections that are achieved overnight. It can help to determine if your erectile dysfunction is related to psychological or physical causes.

  • Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction. 

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage erectile dysfunction?

For many men, erectile dysfunction is caused or worsened by lifestyle choices. Here are some steps that might help:

  • If you smoke, quit. If you have trouble quitting, get help. Try nicotine replacement, such as over-the-counter gum or lozenges, or ask your doctor about a prescription medication that can help you quit.
  • Lose excess pounds. Being overweight can cause — or worsen — erectile dysfunction.
  • Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
  • Get treatment for alcohol or drug problems. Drinking too much or taking certain illegal drugs can worsen erectile dysfunction directly or by causing long-term health problems.
  • Work through relationship issues. Consider couples or marriage counseling if you’re having trouble improving communication with your partner or working through problems on your own.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: January 4, 2017 | Last Modified: January 4, 2017

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