See All Blog Posts

Erectile Dysfunction - Causes, Diagnosis and Treatment



Erectile dysfunction, simply put, is being unable to get or sustain an erection firm enough for sex. The term Erectile Dysfunction or ED, refers to situations where it is extremely difficult to get an erection, or where a man gets one, but cannot sustain it long enough for the sexual act.

This problem may affect your self-esteem, motivation and energy levels. When left untreated, ED could actually cost you your relationship and even your job. This is why it is important to speak up, even if the thought is mortifying. Erectile dysfunction may be caused by another, more disturbing condition, like a heart problem or spinal cord issues.

Erectile dysfunction can be an embarrassing and worrisome condition. But, if it is any consolation, more than half of America’s male population shares your concerns. ED is remarkably common; one in 10 men have suffered or will suffer from the condition in their lifetime.

Furthermore, erectile dysfunction and premature ejaculation go hand in hand.

Fortunately, it is not the end of your sexual adventures. ED is treatable, preventable and reversible. In this article, we’ll walk you through the causes, symptoms and treatment of ED, as well as how to prevent it.

What Causes ED?

Many people think ED or impotence is a normal consequence of aging, but it is not. In fact, people begin to expect election problems at 60.

Even though the chances of having the condition increases as men grow older, it is not a normal consequence. According to recent studies, 40% of men over 40 have ED, and 70% of men above 70 suffer from this problem. Nonetheless, it is not an age-induced occurrence and can be reversed.

Stress, psychological issues, relationship problems or health concerns may be the cause of ED. In order to understand ED, let’s break down how a normal erection works.

How Does a Normal Erection Work?

When you are sexually stimulated, your brain redirects blood flow to the penis. The penis has chambers called erection chambers, which contain spongy tissue designed to hold large volumes of blood. When these spongy tissues are filled with blood, they become saturated and swell, making the penis erect. This is also what causes some men to experience “growing” of the penis when erect. The high pressure of the blood the penis receives is what makes an erection hard and firm.

Erectile dysfunction may happen because of a sensory issue like inability to be sufficiently aroused. Anything that prevents blood flow to the penis will also lead to ED.

Physical causes of ED

Health conditions that commonly cause erectile dysfunction include vascular disease, nerve diseases and diabetes. Vascular diseases like atherosclerosis and hypertension affect circulation. They reduce the blood getting to the penis. Thus, erections become weak and short-lived. Nerve problems like injury to the spinal cord or multiple sclerosis may also make it hard for the muscles of the penis to receive signals from the brain. This may be called lost sensitivity erectile dysfunction. Diabetes too plays an important role in nerve degeneration. Scholarly articles establish a strong link between diabetes and ED.

Psychological causes of ED

Issues like performance anxiety, psychological trauma, stress, depression and anxiety can negatively affect your sexual performance. In psychological ED, identifying and treating the underlying issue will significantly improve sexual outcomes.

Lifestyle factors

Your sexual health may be an archetype of your general health. If you are obese, rarely work out, eat unhealthy food, drink and smoke excessively, you are more likely to develop ED. Having an active lifestyle and paying good attention to your diet can help you enjoy sex better.

Medications that can cause ED

Some prescription drugs are known to make getting an erection hard. If you are on any of these medications, speak to your doctor before discontinuing them. Antihypertensives e.g., Lisinopril, Atenolol, Verapamil etc. Antiarrhythmic drugs e.g., Digoxin Antidepressants and anxiety medications Hormone therapy Opioid painkillers Cancer chemotherapy drugs, amongst others.

Types of ED

Erectile dysfunction may be primary or secondary. In primary ED, the patient has had no erections since puberty. This type of ED is rare and is usually due to anatomic abnormalities or psychological distress. In secondary ED, the patient has had sustained erections before, but is suddenly not getting erections, even in arousing scenarios.

Do I Have Erectile Dysfunction?

One or two failed erections is perfectly normal. People with ED fail to get or sustain an erection more than 50% of the time. If you check the following boxes, it’s time to see your doctor.

  • Frequent difficulty obtaining or sustaining an erection
  • Reduced sexual desire or libido
  • Premature ejaculation
  • Delayed ejaculation
  • No ejaculation at all

Diagnosis of ED

Medical history and physical examination The first step in confirming whether you have ED is a medical history exam. Here, the doctor basically asks you questions that may seem offensive and intrusive, but are very important in shaping your diagnosis. He may ask if you normally have an erection in the morning, have ever ejaculated or what kind of sexual positions you prefer. Also, your doctor may take a look at your penis. At this stage, the aim is to detect any obvious anatomical abnormalities like a bent, fractured or swollen penis.

Blood tests to check for underlying health issues Blood tests can determine if you have a low blood count, a liver problem or if you’re short on testosterone. Some blood tests you may have to do are thyroid function tests for hormones, total blood cell count and liver function tests. Urine tests to check for underlying health issues A sample of your urine can easily tell your doctor if you have a hormone issue, diabetes, or kidney problems, amongst others. Ultrasound or other imaging tests to evaluate blood flow Even if your penis looks normal from the outside, your doctor may recommend an ultrasound. From the scan, they will be able to spot any obstructions or tears that perhaps make sustaining an erection difficult.

Psychological evaluation

Here, your doctor checks for signs of dissatisfaction in other areas of your life. Perhaps your inability to sustain an erection is due to a general lack of happiness and motivation in your life. Sometimes, psychological problems occur alongside other causes of ED. They may also try to establish comorbidities, like anxiety and erectile dysfunction.

For example, multiple sexual failures in the past may make you develop a fear of intimacy. About 25% of men experience sexual performance anxiety.

ED Treatment Options

The best treatment for Erectile Dysfunction is most often medication. However, depending on the cause and type, one may benefit from natural remedies for ED.

Many people with psychological ED report improved outcomes with home remedies for ED, as well as ED therapy.

Treatment options include erectile dysfunction meds, devices, surgeries and new ED treatments like implantation.

What Drugs Can I Use For ED?

Oral PDE5 Inhibitors If you have poor penile blood flow, you will benefit from a PDE type-5 inhibitor. These agents make your erection firmer and longer-lasting by increasing blood flow to the penis. Some common brands are

  • Viagra (Sildenafil)
  • Cialis (Tadalafil)
  • Levitra (Vardenafil) PDE type-5 inhibitors are known to cause side effects like headaches, blurry vision, back pain, muscle aches, stuffy nose, amongst others. These side effects are due to the temporary redirection of blood flow away from those areas. Once your circulation returns back to normal, those side effects should disappear.

Consult your doctor before using PDE5 inhibitors, especially if you currently use other drugs.

Testosterone Therapy

Erectile dysfunction caused by inadequate stimulation can be treated with testosterone hormone therapy. Testosterone may be given as intramuscular injections, subcutaneous pellets or even topically, applied under the arms like a deodorant or rubbed on like a gel.

Alprostadil Penile Injections

If you do not respond to oral PDE5 inhibitors, penile injections are a way out. Alprostadil can be injected into the corpus cavernosum (ICI) or the urethra (UI). Alprostadil produces an erection that lasts for about 30 minutes, or until climax. However, this impotence treatment produces an erection that may last hours, developing into priapism, a painful, sustained erection.

You may require medical attention to reverse this ED problem.

Is Surgery An Option?

Yes. Penile surgeries are a great option, with a 95% success rate. In a penile implantation surgery, your doctor inserts an inflatable tube into your penis. The tube can be inflated or deflated at will.

The tube does not interfere with normal intercourse, neither does it make the penis feel unnatural. When you inflate the cylinder, it collects fluid from a reservoir. It becomes firm and enlarged , automatically distending the penis like a normal erection would.

How Can I Manage ED Without Medications?

Vacuum devices People who cannot tolerate drugs or implants can consider using a vacuum. All you need to do is attach the vacuum to the penis. It creates a negative pressure that draws blood to the organ. When sufficiently inflated, you slip a restriction band from the vacuum tube to the base of your penis. This band prevents immediate backflow. This is not a well-liked option since using a vacuum may be awkward in certain situations. Nonetheless, daily vacuum therapy is effective and has no known side effects. Counseling and therapy Cognitive behavioral therapy (CBT) is one of the best treatments for erectile dysfunction, especially psychological ED. It also shows great results when the reason for erectile dysfunction is trauma or injury.

Lifestyle changes

A daily exercise routine may be your ED cure. According to a paper released by Harvard, going on a 30-minute walk daily can get you better erections. An active lifestyle reduces your risk of erectile dysfunction by 41%, the study says.

Eating a balanced diet, working out daily, quitting smoking and drinking may be a permanent cure for erectile dysfunction.

Alternative therapies for ED

Acupuncture is one of the safe natural remedies for ED. Acupuncture helps in maintaining an erection by allowing your penile muscles to be adequately stimulated. This ancient Chinese practice increases penile stimulation by passing tiny needles through the skin at precise points. Coping With Erectile Dysfunction Successful ED therapy would be difficult without a supportive and understanding partner. Constant communication with your sexual partner works just as well as ED meds.

Also, having honest conversations with your health provider, even when it’s hard, will help you see better results from ED therapy.


The best way to keep ED at arms length is to eat healthy, stop smoking, engage in regular physical activity and watch your weight. While these sound pretty generic, they reduce your risk of diabetes and heart diseases, the major culprits in ED.


Erectile dysfunction is a common condition that causes men to have weak erections, or no elections at all. ED may be caused by physical or psychological issues. Thankfully, there are a host of guaranteed erectile dysfunction treatments like ED medication, implants, devices and alternative therapy.

Without medical help, ED can seriously affect your relationship, and degrade not just your sex life, but your general health too. Also, ED may be a pointer to a more serious health condition.

For safety reasons and best results, speak to your healthcare provider if you think you have ED.


The information provided in this article is for educational purposes only and should not replace professional medical advice. If you suspect you are experiencing any type of pain, please consult a healthcare professional for proper evaluation and treatment. Remember to always prioritize your health and well-being.