What causes erectile dysfunction and how is it treated?

When our bodies aren’t working the way we want them to, it’s hard to talk about it. Erectile dysfunction (ED) is no exception. But the frustration, confusion, and stress it can cause aren’t things you have to put up with, because ED is very treatable.

Read on for a full definition of ED, explanations of the various causes and contributing factors, and an overview of ED treatment options.

Understanding the symptoms of erectile dysfunction

ED is not limited to the complete inability to have an erection. Although it is one form of dysfunction, symptoms of ED can also include:

  • Inconsistent ability to get an erection during sex.
  • An erection that does not last long enough to satisfy sex.

Causes of erectile dysfunction

There are a number of physical and mental factors that can cause or contribute to ED, mainly by doing one of the following:

  • Affects blood flow to the penis
  • Signaling between the brain and the penis
  • Nerve damage to the penis

Health conditions that can cause ED

Because of the different ways in which ED occurs, there are a number of health conditions associated with it.

For example, blood flow can be affected by problems such as blood vessel and heart disease, high cholesterol, and atherosclerosis. And nerve problems can result from conditions such as diabetes, Parkinson’s disease, multiple sclerosis, and some pelvic cancer treatments.

Other health conditions that can contribute to ED include:

  • Peyronie’s disease
  • Low testosterone
  • Injury to the penis, other pelvic organs, or spinal cord

Medications that can cause ED

Erectile dysfunction can be a side effect of some medications. The most common examples are blood pressure medications, particularly diuretics (such as chlorothiazide and furosemide) and beta-blockers (such as metoprolol and atenolol), which can reduce blood flow to the penis.

Antidepressants are also commonly associated with ED because they can make it harder to get both an erection and an orgasm. They are also generally associated with decreased sexual desire. All antidepressants have the potential to cause ED, but selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Prozac, and Zoloft are the most likely.

Other medications that may contribute to ED include:

  • Antihistamines and H2 blockers In addition to allergic reactions and acid reflux, histamine plays a role in erectile function.
  • Opioids – Long-term opioid use is associated with low testosterone and ED.

Psychological causes of ED

Sex requires the cooperation of your body and mind. Thus, negative emotions such as stress, fear, or guilt can make it difficult to achieve and maintain an erection, even without any other underlying health problems. The same is true for mental health conditions such as anxiety and depression.

Worrying about sexual performance is a common example of a negative emotion that can contribute to ED. And if that anxiety stems from noticing ED symptoms, it can cause additional stress or anxiety. But it’s worth noting that negative emotions don’t have to be related to sex to interfere with it. It can be harder to get in and stay in the mood if, for example, you have a very stressful job.

Lifestyle factors that may contribute to ED

Certain lifestyle factors are associated with ED, similar to certain health conditions. For example, smoking cigarettes has a negative effect on blood circulation throughout the body. And being overweight or inactive means you’re at higher risk for problems like heart disease and diabetes.

Finally, studies have shown that chronic use of alcohol or illegal drugs has negative effects on sexual function for both men and women.

The treatment of erectile dysfunction consists of two parts.

Treatment of underlying health factors

The first step a doctor will take in treating ED is to look for any underlying factors that may be involved.

  • Health conditions – Many health conditions that can contribute to ED, such as blood flow problems and diabetes, can be improved with lifestyle changes such as regular exercise and weight loss. But treatment depends on the condition. If you have low testosterone, for example, testosterone replacement therapy may be recommended.
  • Medicines – If you are taking a medication that may contribute to ED, your doctor may recommend changing the dose or switching to another medication. Always talk to your doctor before doing this.
  • Psychological factors – If an emotional problem or mental health condition seems to be playing a role in your ED, your doctor may recommend seeing a counselor or taking other steps to support your mental health.
  • Lifestyle factors – If necessary, your doctor will encourage you to limit or stop smoking, alcohol, or drug use. It’s important to be honest with your doctor about your substance use because it helps complete the picture of your overall health.

Making it easier to get or keep an erection

In some cases, getting the underlying health factors under control is enough to treat ED. But if you continue to experience ED symptoms, there are additional treatments that can help, such as:

  • Oral medications – Drugs like Viagra and Cialis increase blood flow to the penis and help it respond normally to sexual stimulation.
  • Alprostadil – Alprostadil and similar drugs can cause automatic erection. Alprostadil is either injected into the base or side of the penis or taken as a penile suppository using a special applicator.
  • Penis pumps – If medications are not effective, your doctor may recommend a penis pump. Also known as vacuum erection devices, penile pumps manually draw blood into the penis. A tension ring may then be placed around the base of the penis to maintain an erection.
  • Penile implants – Surgical implants may be an option for some people if medications are not effective. These implants are rod-shaped devices that are placed on either side of the penis. They can be either inflatable or firm but flexible.

Take back control

Erectile dysfunction has many possible causes and is often caused by a combination of factors. But with the right combination of lifestyle changes, medication, and other treatments, you can remove it and any associated stress from your daily life.

If you think you may be experiencing erectile dysfunction, talk to your primary care doctor. They can give you an initial assessment and refer you to a sexual health expert or urologist if needed.

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