Erectile Dysfunction (ED)

What is Erectile Dysfunction & what causes it?

Erectile dysfunction is sometimes referred to as impotence. ED is a condition that affects roughly half of all men ages 40 to 70. It is identified as a problem in getting or maintaining an erection, either for sexual intercourse or from responding to sexual stimulation. 

Erectile dysfunction is incredibly common and can affect men of any age, even young and healthy males. Although the condition becomes more prevalent in older age groups. 

Erections are a result of sexual arousal. This arousal is first initiated in the brain, which sends signals to nerves in the penis - these signals increase blood flow which then causes it to enlarge and harden. Any disruption in this process can cause erectile dysfunction - disruption can be physical, phycological, or due to some medications. 

Physical causes of ED: 

• Vascular conditions - Diabetes, high blood pressure, and cardiovascular disease can all negatively impact blood flow to the penis. 
• Hormone conditions - An over or under-active thyroid, hypogonadism, or low levels of testosterone can lead to ED. 
• Neurological Conditions - Conditions like multiple sclerosis and Parkinson’s disease can disrupt the neurological signals needed for erections. 
• Anatomical Conditions - Peyronie’s disease or any condition that directly affects the tissues in the penis can contribute to ED. 

Psychological causes of ED:

• Mental - Stress, anxiety, and depression can lead to ED.
• Emotions - A new partner, confidence, performance anxiety, or past sexual abuse can also lead to ED. 

Medication and ED: 

• Certain medications can contribute to ED, these include; beta-blockers, diuretics, corticosteroids, antidepressants, antihistamines, and cytotoxics. 

How is ED diagnosed? 

In most cases, ED can be easily self-diagnosed, as it’s simply an issue with keeping or getting erections. While it may be easy to diagnose, it’s worth discussing any new symptoms with a medical professional. While it’s a sensitive issue to talk about, ED can be due to underlying health issues, like heart or circulatory problems. 

When discussing ED with your doctor you will be asked questions about sexual history, but it’s important to answer these honestly as it helps in diagnosis and treatment. The doctor may also wish to perform tests to check for more serious conditions like heart disease or diabetes, depending on the overall health of the individual. 

In some cases, the doctor may need to physically examine the penis - this rules out physical abnormalities or anatomical causes. In some cases, blood samples may be taken to see if low levels of hormones are causing the ED. 

In rare cases, you may be referred to a specialist for further testing. 

What treatments are available for ED? 

Overall treatment for ED has hugely improved over time. The majority of men suffering from ED can enjoy normal sexual activity, modern treatment plans that combine medication, lifestyle changes, and addressing phycological problems. 

The main medications involved in treating ED are, Sildenafil (Viagra & generic sildenafil), Taladafil (Cialis & generic Cialis), and Vardenafil (Levitra & generic Vardenafil). 

These medicines will all have a similar effect, however, there are small but important differences between them. The right medication for you depends on your overall health and any other medicine you might be taking. 

To note, Sildenafil and Viagra are the same thing. Viagra is simply a name that one manufacturer has given for this particular medicine, but the terms can be used interchangeably. 

Viagra / Sildenafil

• 25mg, 50mg & 100mg tablets
• Should be taken an hour before sex and the effects should last between 4-5 hours.
• Any food can potentially slow down the action of Sildenafil. As a precaution, it is best to leave a couple of hours in between eating and taking the dose.

Cialis / Tadalafil

• 2.5mg, 5mg (once daily tablets), 10mg & 20mg tablets (when required tablets)
• Should be taken 30 minutes before sex and the effects last for around 36 hours.
• Is not affected by food so no restrictions apply.

Levitra / Vardenafil

• 5mg (generic), 10mg & 20mg tablets
• Should be taken 25 minutes – 1 hour before sex and the effects last for 4-5 hours.
• Heavy meals or food high in fat can affect its action so it is advised to avoid such foods before use.

With most new ED medications it’s recommended to start on medium strength - this balances effective results while minimizing the risks of side effects. Initially, medication should be tried four times to determine effectiveness.

These medications should be taken before sex, as mentioned. The medication should remain effective for several hours after taking it. However, this does not mean you will get an erection that lasts for several hours, sexual stimulation is also required to maintain an erection. 

Treating psychosexual causes of ED

Alternative methods of therapy such as group psychotherapy, cognitive behaviour therapy, counselling, or sex therapy are all helpful in treating ED that may be caused due to psychological problems. 

Lifestyle Changes To Minimize or Prevent ED

Lifestyle changes that improve your general health and promote healthy blood circulation can all aid in the reduction or minimizing of the risk of ED. These changes include:  

• Maintain a healthy body weight
• Reduce alcohol consumption
• Engage in regular exercise
• Reduce stress
• Quit smoking and recreational drug use

Erectile Dysfunction Myths

Various common myths and stigmas surround erectile dysfunction. 

ED is linked to sexual attraction

If a man needs viagra it doesn’t mean he’s not sexually attracted. There are many different causes of ED that have nothing to do with attraction. 

ED is when you never get an erection

There are various degrees of erectile dysfunction. You might be able to get an erection when masturbating but not with a partner, or you can only achieve a partial erection - these are all forms of ED. 

ED only affects old men

There is an increasing number of cases of ED in young males. There is a multitude of different reasons why any man can get ED, but it’s not a condition that happens only to elderly males. It can affect men from any age group. 

ED is something to ashamed of

Many men feel deep shame upon finding out that they have ED. This is due to the way our society, through media like television and film, or comedy makes light of this disorder. There is a multitude of causes of ED and it affects a huge proportion of males.