What causes erectile dysfunction and how is it treated?
When our bodies don’t work the way we want them to, it can be hard to talk about. Erectile dysfunction (ED) is no exception. But the frustration, embarrassment and stress that it can cause aren’t things that you have to put up with – because ED is highly treatable.
Keep reading for a complete definition of ED, explanations of different causes and contributing factors, and an overview of ED treatment options.
Understanding the symptoms of erectile dysfunction
ED isn’t limited to the complete inability to get an erection. While that is one form of dysfunction, symptoms of ED can also include:
- Inconsistent ability to get an erection when you want to have sex.
- Erections not lasting long enough for satisfying sex.
Causes of erectile dysfunction
There’s a variety of physical and mental factors that can cause or contribute to ED, generally by doing one of the following:
- Affecting blood flow to the penis
- Affecting signals between the brain and the penis
- Damaging nerves in the penis
Health conditions that can cause ED
Because of the different ways that ED can be caused, there are a number of health conditions that are associated with it.
For example, blood flow can be impacted by issues like blood vessel and heart conditions, high cholesterol and atherosclerosis. And nerve issues can result from conditions like diabetes, Parkinson’s disease, multiple sclerosis and some treatments for pelvic cancers.
Other health conditions that can contribute to ED include:
- Peyronie’s disease
- Low testosterone
- Injury to the penis, other pelvic organs or spinal cord
Medicines that can cause ED
Erectile dysfunction can be a side effect of certain medicines. The most common examples are blood pressure medicines, specifically diuretics (such as chlorothiazide and furosemide) and beta-blockers (such as metoprolol and atenolol), which can decrease blood flow to the penis.
Antidepressants are also commonly associated with ED, as they can make it harder both to get erections and to reach orgasm. They’re also associated with decreased sex drive in general. All antidepressants have a chance of causing ED, but selective serotonin reuptake inhibitors (SSRIs) like Lexapro, Prozac and Zoloft are the most likely.
Other medicines that can 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 levels and ED.
Psychological causes of ED
Sex requires the cooperation of your body and mind. So negative emotions like stress, fear or guilt can make it hard to get and maintain an erection, even without any other underlying health issues. The same goes for mental health conditions like anxiety and depression.
Worry about sexual performance is a common example of a negative feeling that can contribute to ED. And if that worry comes from noticing symptoms of ED, it may create additional stress or anxiety. But it’s important to note that negative feelings don’t have to be related to sex to interfere with it. It can be harder to get and stay in the mood if you work a very stressful job, for example.
Lifestyle factors that can contribute to ED
Certain lifestyle factors are associated with ED for similar reasons to some health conditions. For instance, smoking cigarettes negatively affects blood circulation throughout the entire body. And being overweight or inactive means being at higher risk for issues like heart conditions and diabetes.
Finally, studies have shown that chronic use of alcohol or illicit drugs has negative effects on sexual function for both men and women.
Treatment for erectile dysfunction has two parts:
Treating underlying health factors
The first step a doctor will take in treating ED is to address any underlying factors that may be involved.
- Health conditions – Many of the health conditions that can contribute to ED, such as those related to blood flow and diabetes, can be improved by lifestyle changes like getting regular exercise and losing weight. But treatment depends on the condition. If you have low testosterone, for example, testosterone replacement therapy may be recommended.
- Medicines – If you take a medicine that can contribute to ED, your doctor may recommend changing the dose or switching it for a different medicine. Always talk to your doctor before doing either.
- Psychological factors – If an emotional issue or mental health condition seems to be playing a role in your ED, your doctor may recommend going to a counselor or taking other steps to support your mental health.
- Lifestyle factors – If appropriate, your doctor will encourage you to limit or stop smoking, drinking alcohol or using drugs. It’s important to be honest with your doctor about your substance use, as it helps fill in the picture of your overall health.
Making it easier to get or maintain erections
In some cases, getting underlying health factors under control is enough to treat ED. But if you continue to experience symptoms of ED, there are additional treatments that can help, such as:
- Oral medicines – Medicines like Viagra and Cialis increase blood flow to the penis and help it respond normally to sexual stimulation.
- Alprostadil – Alprostadil and other similar medications can cause automatic erections. Alprostadil is either injected into the base or side of the penis, or is taken as a penile suppository using a special application tool.
- Penis pumps – If medicines aren’t effective, your doctor may recommend a penis pump. Also known as vacuum erection devices, penis pumps pull blood into the penis manually. A tension ring can then be placed around the base of the penis to maintain an erection.
- Penile implants – Surgical implants can be an option for some people if medicines aren’t effective. These implants are rod-shaped devices that are placed on either side of the penis. They can either be inflatable, or firm but flexible.
Take back control
Erectile dysfunction has a lot of possible causes and is frequently the result of a combination of factors. But with the right combination of lifestyle changes, medicine and other treatments, you can remove it – and any related stress – from your daily life.
If you feel like you might 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 necessary.
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