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Erectile Dysfunction (Impotence)

Erectile Dysfunction (Impotence)
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What is Erectile Dysfunction?

Erectile dysfunction (ED), also known as impotence, is the inability to get or keep an erection firm enough for satisfactory sexual intercourse. ED is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will suffer from it to some degree. Fortunately, treatments for erectile dysfunction have improved significantly over the last few years.

In some cases, treating the underlying health condition or physical issues that's causing erectile dysfunction can help to improve the issue. For others, medical treatments may also be required.

Keep in mind that failing to get an erection a few times doesn't mean that there's an erectile function issue. However, if you're experiencing erectile dysfunction as an ongoing issue, then it'll be important to seek treatment, especially as it may indicate more serious health conditions.

Understanding Erectile Dysfunction

First up, let's clarify one thing: erectile dysfunction is very common, and nothing to be embarrassed about. There are more people than ever before looking to treat erectile dysfunction, an issue that affects 1 in 2 people aged between 40 and 70. Erection problems are the number one sex-related issue for males.

Although erectile dysfunction may be common, that doesn't make it any easier to live with. It can cause a whole host of secondary issues, including relationship problems as a result of the reduced frequency of sexual intercourse. It may also exacerbate mental health conditions if psychological issues such as depression and anxiety are the cause of erectile dysfunction.

While erectile dysfunction is unpleasant to experience, modern treatments have proven to be highly effective at rectifying the problem. From lifestyle changes and sex therapy to vacuum pumps and prescription medication and other medications, treatments have been shown to improve male sexual dysfunction in clinical trials.

Treating erectile dysfunction can look different depending on the individual. It largely comes down to the underlying cause of the erectile dysfunction. Some erectile dysfunction treatments help to increase blood flow, while others address the underlying emotional factors, such as managing weight or removing dependency on illegal drugs.

Different Types of Erectile Dysfunction

Erectile dysfunction may feel the same across all people with the condition, but there are different types that health professionals use to diagnose erectile dysfunction. Understanding the underlying cause is key to prescribing correct erectile dysfunction treatments and improving sexual health. Let's take a look at some of the main different types of erectile dysfunction:

  1. Psychological Erectile Dysfunction
    • Erectile dysfunction can be caused by psychological factors including depression and anxiety. Studies have shown that it's more difficult for men with depression to get an erection, while individuals with a form of anxiety may experience performance anxiety during moments of sexual desire. Individuals with psychological issues may also experience erectile dysfunction indirectly, too, if they're undergoing drug therapy to treat those disorders. For example, some antidepressant prescription drugs can cause erectile dysfunction.
  2. Hormonal Imbalances
    • A hormonal imbalance is one of the underlying medical conditions that can cause erectile dysfunction. For example, males who are low on testosterone may have trouble getting and maintaining an erection, since this is a hormone that has a big impact on sexual desire. Testosterone replacement therapy is one such treatment for these issues. Though less common than low levels of testosterone, some individuals experience erectile dysfunction as a result of issues with their thyroid hormone.
  3. Vascular Issues
    • Vascular ED is the most common form of erectile dysfunction. This occurs when the blood vessels that carry blood to the penis are impaired in some way. There are a number of reasons why an individual may have narrowed blood vessels that make it difficult for the body to transport a blood supply to the penis, including vascular disease, heart disease, and high blood pressure. There are medications that can help to enhance blood flow. In fact, most drugs designed to treat ED do so by preventing arteries from constricting, making it easier to get an erection.
  4. Neurogenic Erectile Dysfunction
    • Issues with the body's nervous system can also cause erectile dysfunction. People who have experienced nerve damage or an injury, particularly the spinal cord or as a result of radiation therapy, often find they are the causes of erectile dysfunction. When the nerves don't work correctly, the brain has difficulty sending a signal to the penis area during moments of intimacy with the sexual partner. This issue can occur during pelvic surgical treatment if the nerves are damaged.

Signs You May Have Erectile Dysfunction

Roughly 50% of men aged 40 - 70 will experience erectile dysfunction. It's also increasingly affecting younger people, with more than 25% of adult males under the age of 40 reporting the condition. Not sure if you have erectile dysfunction? Let's take a look at some of the most common signs:

  • Being able to get an erection sometimes, but not every time you want to have sex
  • Getting an erection, but being unable to maintain it during sex
  • Being unable to get an erection at any time
  • Only maintaining an erection when there is significant stimulation

While it can be unpleasant to live with ED, remember that there's a wide range of treatment solutions available.

Erectile Dysfunction Causes:

The types of erectile dysfunction we've outlined above are used in clinical environments to identify appropriate erectile dysfunction treatments. There are a number of different causes of erectile dysfunction that don't indicate more serious physical causes or physical problems. Sometimes, an understanding of the underlying physical cause, lifestyle changes, and medication are all that's required to effectively manage or eliminate symptoms of erectile dysfunction.

  1. Stress
    • Stress is caused by a host of physical and emotional issues, and can have a huge impact on many areas of our lives, including on the ability to sustain and maintain an erection. People with higher than usual levels of stress may experience erectile dysfunction because their mind is too preoccupied to focus on sex. Equally, if you're in a state of 'fight or flight,' your body will inhibit other key functions (such as getting an erection) until things are back to normal.
  2. Tiredness
    • Lack of sleep can cause erectile dysfunction in a number of ways. It can lead to poor circulation, which makes it more difficult for blood to flow to the penis, and also results in lower levels of testosterone.
  3. Anxiety
    • Anxiety, along with stress, is one of the psychological factors associated with failing to maintain an erection during sexual intercourse. As well as impact the amount of blood that can travel to the penis, anxiety can also be attributed to performance anxiety. This is a fear of having to reach a certain standard during sexual intercourse, and can stem from a negative sexual history, including sexual abuse, low self-esteem, or other emotional issues, and can often result in relationship problems. In this performance-related case of anxiety, the experience of erectile dysfunction becomes a mental health matter.
  4. Drinking too much alcohol
    • Consuming too much alcohol can result in erectile dysfunction. This occurs because of impairment to the brain, which makes it difficult for it to send signals to the penis. In most cases, erectile dysfunction caused by alcohol is only temporary, however, it can become a long-term issue for individuals with a medical history of substance misuse.
  5. Narrowing of the blood vessels going to the penis
    • Having narrow blood vessels makes it more difficult for blood to travel to the penis, resulting in weaker or non-existent erections. There are a number of health conditions that can cause blood vessels to narrow and decrease blood flow to the penis, including high cholesterol, high blood pressure, heart disease, and cardiovascular disease.
  6. Hormonal problems
    • Having low levels of testosterone is one of the key risk factors for erectile dysfunction. Lower than normal testosterone levels can be caused by injury to the testicles, medical conditions, alcohol consumption, and poor lifestyle habits, among other factors. Undergoing testosterone therapy and lifestyle changes can help to elevate testosterone levels.
  7. Side effects from prescribed medication
    • A number of prescription drugs and over the counter drugs can contribute to erectile dysfunction. Some drugs used to treat high blood pressure and heart disease, including beta-blockers, have also been shown to restrict blood flow to the penis.

Diagnosing Erectile Dysfunction:

  • The doctor or nurse will ask about your lifestyle, sexual health and relationships, and any problems you might be having.
  • A basic health check will take place, such as taking your blood pressure.
  • They will perform a physical examination of your genitals to rule out any obvious physical cause.
  • If you have symptoms like needing to urinate more often, your GP may also need to examine your prostate, to rule out prostate cancer and other issues.
  • They may also perform a rectal examination
  • Remember that ED is a marker of an increase in cardiovascular risk and has been associated with other high-risk condition such as high blood pressure, diabetes and high cholesterol.

Erectile Dysfunction treatment:

If you're concerned about erectile dysfunction, then it's recommended that you get in touch with your healthcare provider. As mentioned earlier, there are a host of treatment solutions available that help to reduce or eliminate ED.

1. Medications

  • If it is due to narrowing of penis blood vessels, high blood pressure or high cholesterol - then treatment may include medicine to lower blood pressure or statins to lower cholesterol.
  • If the cause is associated with side effects of prescribed medication, then in consultation with your GP to consider a change of medicine may be appropriate.
  • The use of medications such as Viagra Connect or Sidena.

How does VIAGRA connect help treat symptoms of Erectile Dysfunction?

    • Viagra is a brand of erectile dysfunction tablets. Viagra works by helping to increase the blood flow to the penis and enabling an erection when aroused. It will not give you an instant erection. It helps to widen (relax) blood vessels and improves the flow of blood to the penis following sexual stimulation. This helps to maintain an erection.
    • You should take one tablet roughly an hour before you plan to have sex, although it may still be effective up to 4 hours after taking the tablet. But an erection will not be constant and will subside after sex. If an erection persists for longer than 4 hours you should seek urgent medical attention to prevent tissue damage in the penis.
    • Drinking excessive alcohol can temporarily reduce a man’s ability to get an erection and cause VIAGRA CONNECT to be less effective.
    • VIAGRA CONNECT may take longer to work if taken after a high-fat meal.
    • Grapefruit and grapefruit juice can affect the way Viagra Connect works.
    • Reactional drugs should be avoided as they may cause ED. Some reactional drugs known as ‘poppers’ (contain amyl nitrate) must not be taken with Viagra Connect as the combination could result in a dangerous fall in blood pressure.
    • As ED is associated with some high risk medical conditions, e.g. high blood pressure, it is important that you consult with your doctor within 6 months of taking it for the first time.

2. Psychological Treatment

Counselling or other types of psychological therapy can help with emotional issues like stress or anxiety that may be causing your ED. For instance, a person with anxiety may work with a cognitive behavioural therapy expert or a sex therapist, either alone or with their partner.

3. Lifestyle Changes:

It's important to remember that there are plenty of things you can do on your own, too. Improving your lifestyle can minimise the risk of ED, as well as help keep existing symptoms under control. Let's take a look at some of the most impactful lifestyle adjustments that can lead to enhanced sexual performance:

  • Lose weight if you're overweight
    • Being overweight significantly increases the risk of erectile dysfunction, in a number of ways. It's an independent risk factor for erectile dysfunction., and can also lead to other health issues, such as diabetes and high blood pressure, which also increase the risk of ED. People who are overweight also have lower testosterone levels.
    • There are a host of things you can do to lose weight, including joining a gym and improving your diet. Remember that losing weight is a long-term ambition, so it's important to stick with it. By making a few small adjustments to your lifestyle, you should notice a change within a few months. If more drastic weight loss is required, then speak to your healthcare provider.
  • Stop Smoking
    • Smoking has a significant negative impact on an individual's health. It has also been known to contribute to erectile dysfunction. Smoking causes blood vessels to contract, which makes it more difficult for blood to move to all parts of the body, including the penis. As with being overweight, it can also lead to other health complications that increase the likelihood of experiencing ED.
    • There is tremendous support available for people looking to wish smoking, so speak to your healthcare provider to see which treatment is right for you. Some people find it easier to transition to Nicotine Replacement Therapy before stopping completely. There are also a number of apps and books that can help you to quit.
  • Eat a Healthy Diet
    • A number of studies have shown that eating a healthy diet can reduce the likelihood of experiencing ED. For instance, one study found that people who followed a Mediterranean diet were better-protected against ED. Having a healthy diet just generally promotes good physical conditioning, which is vital to good sexual health.
    • Try to eat a diet that consists of a variety of fruits and vegetables, and limit the amount of bad-for-you foods you consume, such as ultra-processed dishes. Some food products have been shown to have a positive impact on sexual wellbeing, including:
      • Watermelon
      • Pistachios
      • Coffee
      • Red pepper
  • Exercise Daily
    • Getting regular exercise can elevate an individual's mental and physical well-being, contributing to improved sexual health. It has been shown to help with the treatment of ED, as well as initially prevent it from developing.
    • It does this in a number of ways. For instance, exercise helps to increase circulation, increasing the amount of blood that can flow to the penis. It can also strengthen the muscles used to maintain erections, and also reduce the risk of developing health conditions that lead to ED, including heart disease and diabetes.
    • Regular exercise also helps to keep your weight in check and can relieve symptoms of anxiety and depression, as well as improve self-esteem and confidence.
    • Working with a physio to strengthen pelvic floor muscles, especially if premature ejaculation is also a factor.
  • Try to Reduce Stress and Anxiety
    • Erectile dysfunction can be caused by psychological factors such as anxiety and stress. As such, working to keep both of those under control may offer some help towards managing ED.
    • In this day and age, there are countless ways to combat stress and anxiety, many of which are free of charge and can be done from the comfort of your own way. Some of the most popular and effective ways to reduce stress and anxiety include doing yoga, keeping a daily gratitude journal, practicing meditation, and doing things that you enjoy.

4. Penis or Vacuum Pumps and Implants 

  • Vacuum pumps provide people with an at-home solution to their erectile dysfunction. Most men are able to have sex after using a pump, regardless of the root cause of their ED.
  • Penile implants may be recommended in some circumstances. Penile implants are usually only recommended if non-implant solutions are not possible, since this method impacts the erectile tissue, making it impossible to get an erection on one's own following the procedure.

Erectile Dysfunction FAQs:

What Causes Erectile Dysfunction?

A number of factors can cause erectile dysfunction, including obesity, a number of health conditions, certain medications, and stress and anxiety.

What Treatments Are Available for Erectile Dysfunction?

A range of erectile dysfunction medications, including VIAGRA Connect, psychological treatment and lifestyle changes can all help.

Do ED Medications Work?

ED medications have been shown to be highly effective in helping to improve erectile dysfunction, especially in people with mild to moderate symptoms.

Can Erectile Dysfunction Be Cured?

It depends on the underlying cause. There are many ways to approach treatment for ED, including some important lifestyle modifications. Your treatment plan depends on many factors, which is why it’s essential to see your doctor if you’re experiencing ED. In many cases, ED is reversible or treatable.

In the meantime, ED medication can help maintain a sex life.


Erectile dysfunction (impotence) - HSE.ie

Erectile dysfunction - Illnesses & conditions | NHS inform

Erectile Dysfunction (ED) | Impotence | Causes, Treatment & Medication | Patient