Causes of erectile dysfunction

Erectile dysfunction (commonly referred to as “ED”) is defined as a man being unable to achieve and/or maintain an erection firm enough or long enough to engage in sexual intercourse that is mutually satisfactory.

What many men do not know is that erectile dysfunction can be treated and many treatment options are available.

Most men believe erectile dysfunction is a normal sign of aging, that it does not affect younger men, or that erectile dysfunction is caused by psychological problems. In fact, men of all ages can suffer from erectile dysfunction. 

Statistically, this condition does increase with age but it can affect men as young as 20 years old.¹ Erection problems occur in approximately 20% of men over the age of 20.¹ Some men may become embarrassed and reluctant to discuss their condition with anyone, including their partners or medical professionals. 

It’s important for men with erectile dysfunction to talk to their doctors or find a physician who specializes in sexual medicine. Why? Erectile dysfunction can be a symptom of an underlying condition that needs treatment.² Not everyone knows that it can be a sign of a bigger health problem. The most common causes of erectile dysfunction are related to blood flow issues to the penis.² Serious conditions such as diabetes, heart disease, prostate cancer, peripheral vascular disease — and some of the medications prescribed to treat these conditions — can all cause erectile dysfunction.

Not only are diabetes, heart disease, peripheral vascular disease, prostate cancer, and medications to treat these diseases causes of erectile dysfunction, but other factors such as smoking can play a role in the disease.³

Male sexual arousal is a complex function that requires hormones, nerves, blood vessels, and emotions, and an erection can be affected by one or all of these factors. While masturbation and pornography will not lead to erectile dysfunction, some forms of masturbation and pornography may desensitize men, making it more difficult for them to ejaculate, therefore making sexual relations less satisfactory.

If you are concerned about your erections it is important to speak with your doctor. They will use tests to determine the cause of your erectile dysfunction. Treating an underlying condition could be enough to help with your erections. If you continue to have problems with your erections, there are many effective treatment options for erectile dysfunction.

A variety of treatment options for erectile dysfunction are available. Effective treatment options for erectile dysfunction range in approach and patient satisfaction results vary. Most men have heard of oral medications, but pills are not the only option available to treat the condition.

Effective treatment options include pills, vacuum erection pumps, injection therapy, and a permanent solution: the penile implant. Most patients will start with oral medications. These can be effective for some men, but for others the side effects and ineffectiveness will cause them to look for other options. The next step prescribed by a urologist specializing in erectile dysfunction may be to consider using a vacuum pump or injection therapy to treat the erectile dysfunction. These two treatment options can be effective as well, but may not be for everyone. Some men relay that the vacuum erection device or penis pump results in a cold penis erection.⁴ And penile injections can be painful.

The more permanent solution is the penile implant. This treatment option is an implantable medical device that gives men an erection whenever they desire, for as long as needed. This option must be discussed with an erectile dysfunction specialist, a doctor that specializes in penile implant surgery also known as a prosthetic urologist.

Hispanic men are at a greater risk for erectile dysfunction compared to non-Hispanic men due to the increased frequency of health conditions such as heart disease and diabetes within the culture.⁵ Diabetes affects the blood flow throughout the body, including the penis and uncontrolled blood sugar levels can be damaging to both the nerves as well as blood vessels. It is important for men to control their diabetes to ensure minimal damage to these vessels and nerves.

Erectile dysfunction can also be linked to other conditions such as high blood pressure and heart disease. It is important for someone taking nitrates for heart conditions to understand that they are not a candidate for oral medications. When oral medications for erectile dysfunction are not an option, other erectile dysfunction treatments including the penile implant are available.

Erectile dysfunction can impact men’s mental and emotional health as well. The ability to have and maintain an erection can influence men’s self-esteem or sense of manhood. A man may become depressed and relationships may suffer. 

Men with erectile dysfunction tend to emotionally and physically withdraw from their partners. In fact, a common issue among couples dealing with erectile dysfunction starts with failures of sexual advances. This can have an effect on issues of trust, intimacy, and closeness. The man withdraws emotionally and physically because of fear of failure.⁶

If someone is struggling to achieve or maintain an erection, it is important to discuss the problem with their doctor to help determine the cause of the erectile dysfunction. Erectile dysfunction can be an early indicator of a serious medical condition that would need to be treated first.

A prosthetic urologist can provide patients with a complete evaluation or work up and provide them with more detailed information about all treatment options. Supportive partners are encouraged to attend office visits to have their questions about erectile dysfunction treatment options answered too. Regardless of age or health condition, it is important to remember that men are not alone. A successful treatment is available.