Erectile Dysfunction: The Definitive Guide

By Reviewed by Definitive Guides, Sexual Health Published on January 6, 2020 Updated on July 25, 2020
erectile-dysfunction-the-definitive-guide

As primitive as it may seem, more often than not, a man is still judged by his performance in the bedroom. Studies show that couples who reported a healthy sex life end up happier.[1]Loewenstein, G., Krishnamurti, T., Kopsic, J., & McDonald, D. (2015, August). Does increased sexual frequency enhance happiness? Journal of Economic Behavior & Organization, 116, 206-218. doi: 10.1016/j.jebo.2015.04.021

Being able to please your lover has less to do with size. Satisfaction always lies down with performance.

If you find trouble getting an erection or lasting as long as you should, then you might be in a little trouble. There is a probability that you are experiencing symptoms associated with erectile dysfunction.

This condition affects more men than many tend to realize and the symptoms often are gradual. That said, it’s essential to recognize the signs early on and take action before the problem becomes more serious.

What is Erectile Dysfunction?

Erectile dysfunction is the inability to maintain a lasting erection during sexual activity. Being unable to get your gear up every once in a while is okay, especially during stressful scenarios.

But, if you find it a constant struggle to keep an erection during intercourse, then that’s not a good sign. There’s a huge chance that you are among the 30 million men who suffer from erectile dysfunction.[2]National Institute of Diabetes and Digestive and Kidney Disease Site. (2017). Erectile Dysfunction (ED). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction

Erectile dysfunction is more common as men age.

In fact, a 2006 survey[3]National Institute of Diabetes and Digestive and Kidney Disease Site. (2017). Erectile Dysfunction (ED). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction pointed out that the following population is at higher risk of suffering from ED:

  • Age: 50s: 4% of men
  • Age: 60s: 17% of men
  • Age: 70s: 47% of men

Despite the older age bracket being at risk, erectile dysfunction may affect anyone.

Possible Causes of Erectile Dysfunction

Erectile dysfunction differs from one case to another. There are several factors and health concerns that may affect the condition.

Erectile dysfunction may occur due to both physiological and psychological factors. Certain medications, health conditions, and stress are among the most common culprits.

Medication and How It Affects Erectile Function

supplements for ed
It’s quite ironic how pills help you in one way, and yet it ends up hurting you in another. Men who suffer from certain medical conditions may find trouble with their erections.

One example is those who take prescription meds for hair loss, such as Finasteride. Finasteride may relieve hair loss, but it comes with some side effects.

The medication itself works by blocking the circulation of Dihydrotestosterone (DHT). And while DHT is good for muscle building and testosterone, it contributes to hair loss.

In the long run, this medication that works as a DHT blocker may trigger erectile dysfunction. [4]Chandrashekar, B. S., Nandhini, T., Vasanth, V., Sriram, R., & Navale, S. (2015, January). Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Indian Dermatology Online Journal, 6(1), 17. doi: 10.4103/2229-5178.148925

So before taking any pills, it is best to check about the side effects with your doctor first. And if possible, try to find natural remedies before opting for heavier medications.

High Blood Pressure may Result in Poor Erection

This one should be no surprise. What happens when you become aroused? Penile muscles relax and blood fills three large vessels in the shaft. This is Erection 101.

High blood pressure is a sure way to choke off the life support of your sexual performance. Hypertension may damage blood vessels that are essential to a full erection. [5]Heikkilä, A., Kaipia, A., Venermo, M., Kautiainen, H., & Korhonen, P. (2017, November). Relationship of blood pressure and erectile dysfunction in men without previously diagnosed hypertension. The Journal of Sexual Medicine, 14(11), 1336-1341. doi: 10.1016/j.jsxm.2017.09.007.

The good thing about hypertension is that it is evitable. You can keep high blood pressure at bay by maintaining a healthy and active lifestyle.

Atherosclerosis is an Ailment That May Trigger Erectile Dysfunction

We know the importance of blood pressure on erectile function. But another thing to consider is atherosclerosis.

Atherosclerosis is a condition where blood vessels become clogged. This condition is also referred to as atherosclerotic cardiovascular diseases.

Atherosclerosis is dangerous. It is among the most common causes of death throughout the world. This ailment is an inflammatory condition that affects the blood vessels.

For one, atherosclerosis may cause the blood vessels to swell. In the long run, this swelling may lead to clogging and reduction of blood flow.

As for erectile function, we all know that a good erection depends on good blood flow. Having atherosclerosis may interfere with penile blood supply. This may result in erectile dysfunction.[6]Liu, T., Meng, X. Y., Li, T., Fu, Z. L., Zhao, S. G., & Yao, H. C. (2016, January 15). Atherosclerosis is critical in the pathogenesis of erectile dysfunction. International Journal of Cardiology, 203, 367-368. doi: 10.1016/j.ijcard.2015.10.187

Stress and Depression may Trouble Sexual Health

Ed and stressEvery guy who has an active sex life has been there. We’ve all jumped into the sheets with a mind that was elsewhere.

Whether it’s work or the thought of getting caught, how the mind works may or may not become the enemy during sex. In fact, men with high anxiety often find themselves coming up short in the bedroom.

It’s well-known that psychological factors play a major role in sexual performance. Research showed that even petty things may affect your erection.  For example, your partner befriending your buddies may impose risks of erectile dysfunction. [7]Kray, L. J., Howland, L., Russell, A. G., & Jackman, L. M. (2017, January). The effects of implicit gender role theories on gender system justification: Fixed beliefs strengthen masculinity to preserve the status quo. Journal of Personality and Social Psychology, 112(1), 98-115. doi:10.1037/pspp0000124

Sounds unbelievable? Researchers believe that this might be due to different social perceptions of masculinity. [8]Kray, L. J., Howland, L., Russell, A. G., & Jackman, L. M. (2017, January). The effects of implicit gender role theories on gender system justification: Fixed beliefs strengthen masculinity to preserve the status quo. Journal of Personality and Social Psychology, 112(1), 98-115. doi:10.1037/pspp0000124

Moving forward, depression is still the biggest psychological factor that affects male health. About 61% of people with severe depression may encounter problems in bed. This percentage is from a study conducted by The Cleveland Clinic Foundation. [9]Cleveland Clinics. (2015). Depression and Erectile Dysfunction. Retrieved from https://my.clevelandclinic.org/health/articles/11832-depression-and-erectile-dysfunction

And it gets even worse – antidepressants may cause sexual problems, too. Selective serotonin reuptake inhibitors (SSRIs) may trigger erectile dysfunction and the like. [10]Olivier, J. D., Franco, D. C. E., Waldinger, M. D., & Olivier, B. (2017, June 14). Sexual Dysfunction, Depression and Antidepressants: A Translational Approach. In Sexual Dysfunction. InTech. doi: 10.5772/intechopen.69105

SSRIs may affect not only the erection but the sex drive as well. It may even cause delayed or premature ejaculation.[11]Olivier, J. D., Franco, D. C. E., Waldinger, M. D., & Olivier, B. (2017, June 14). Sexual Dysfunction, Depression and Antidepressants: A Translational Approach. In Sexual Dysfunction. InTech. doi: 10.5772/intechopen.69105

Metabolic Syndrome may Also Affect Male Performance

Metabolic syndrome is a multiple-cluster of conditions that occur altogether. It increases the risk of heart ailments, stroke, and diabetes, among others.

When you suffer from metabolic syndrome, you are at a higher risk of the following:

  • Obesity
  • Diabetes
  • Hypertension
  • Type two diabetes
  • High cholesterol levels

Men diagnosed with metabolic syndrome may be thrice more likely to experience ED. This is according to a study published in The Journal of Diabetes Research and Clinical Practice.[12]Derosa, G., Romano, D., Tinelli, C., D’Angelo, A., & Maffioli, P. (2015, May). Prevalence and associations of erectile dysfunction in a sample of Italian males with type 2 diabetes. Diabetes Research and Clinical Practice, 108(2), 329-335. doi: 10.1016/j.diabres.2015.01.037

Moreover, research demonstrated the link between male health and metabolic syndrome. The study pointed out that metabolic syndrome may lower testosterone levels. This may then lead to erectile dysfunction.[13]Kaya, E., Sikka, S. C., & Gur, S. (2015, April). A comprehensive review of metabolic syndrome affecting erectile dysfunction. The Journal of Sexual Medicine, 12(4), 856-875. doi: 10.1111/jsm.12828

Metabolic syndrome is often the result of poor lifestyle choices. A healthy diet and more physical activities may help this condition. In the long run, this may benefit male health in more ways than one.

Risk Factors That may Trigger Erectile Dysfunction

Erectile dysfunction is often caused by several factors. And it is an advantage to be aware of these possible causes.

Poor sexual performance and erections are often caused by certain lifestyle choices. Low sex drive and stamina also stem out from these faulty choices.[14]Maiorino, M. I., Bellastella, G., & Esposito, K. (2014, September 9). Lifestyle modifications and erectile dysfunction: what can be expected? Asian Journal of Andrology, 17(1), 5-10. doi: 10.4103/1008-682X.137687

Not Getting Enough Sleep may Have Adverse Effects on Male Health

sleep troubles
Sleep plays a crucial role in the body’s well-being. And unfortunately, a large percentage of the population doesn’t get enough sleep.

Constant sleep deprivation may affect the body in more ways that we can often think of. These include male health and vitality.

One study pointed out that sleep-deprived males tend to experience poor erections. Insomnia is also a condition to blame.[15]Reed-Maldonado, A. B., & Lue, T. F. (2016, April). A syndrome of erectile dysfunction in young men? Translational Andrology and Urology, 5(2), 228-34. doi: 10.21037/tau.2016.03.02

Another study looked at how sleep affects the regulation of hormones in the body. In the said study, the patients slept under different durations in the course of the trial.[16]Leproult, R., & Van Cauter, E. (2011, June 1). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173-4. doi: 10.1001/jama.2011.710

As a result, the study noted that sudden sleep deprivation affected testosterone levels. [17]Leproult, R., & Van Cauter, E. (2011, June 1). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173-4. doi: 10.1001/jama.2011.710

A significant decrease in testosterone may affect sexual health and performance.

Sleep deprivation may also cause other complications to one’s erectile function. Poor sleep relates to drastic effects on the nervous, immune, and cardiovascular systems. [18]Arnal, P. J., Drogou, C., Sauvet, F., Regnauld, J., Dispersyn, G., Faraut, B.,…& Chennaoui, M. (2015, December 9). Effect of sleep extension on the subsequent testosterone, cortisol and prolactin responses to total sleep deprivation and recovery. Journal of Neuroendocrinology, 28(2). doi: 10.1111/jne.12346 Combined, these three play a big role in sexual health.

Sleep-deprived men may also be at a higher risk of developing depression and anxiety. They may also develop hypertension in the long run and a decline in their glucose tolerance. As a whole, it may affect sexual health and functionality.

Cigarette Smoking

Stop smoking
Another important factor to consider in terms of erectile dysfunction risk factors is cigarette smoking. Smoking is dangerous and, even though most commonly associated with a significant increase in the risk of developing lung cancer, there are many other complications that smoking can also cause. One study [19]Kovac, J. R., Labbate, C., Ramasamy, R., Tang, D., & Lipshultz, L. I. (2014, December 29). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087-1092. doi: 10.1111/and.12393 explains that cigarette smoking contributes to a significant increase in the prevalence of atherosclerosis and coronary artery disease, as well as leads to the development of erectile dysfunction.

The primary way in which cigarette smoking leads to erectile dysfunction is because of the impact that it has on blood supply in the human body. Blood vessels usually become restricted and, with the development of conditions like atherosclerosis, the blood supply is significantly impaired. This leads to poor blood flow to the penis; thus causing poor erectile function.

Obesity

While we have mentioned this before, it is important to signify the significant impact that obesity may play in a man’s risk of developing erectile dysfunction. Obesity is a dangerous condition, often thought of as a disease in the modern world. The prevalence of obesity has increased at an alarming rate of the past few decades and still continues to increase. Obesity causes people to die prematurely – because it leads to heart disease, diabetes, insulin resistance, liver, and kidney disease, gallstones, and it can cause a person to develop osteoporosis.

The impact that obesity has on the body can have a considerable impact on a man’s abilities in the bedroom. Not only can the condition cause erection quality to diminish, but it can also lead to a significant decline in other qualities related to the man’s sexual performance – he won’t have the stamina or energy to satisfy his sexual partner, and he may not have the libido to want to participate in sexual activities in the first place. [20]Katib, A. (2014, September 9). Mechanisms linking obesity to male infertility. Central European Journal of Urology, 68(1), 79. doi: 10.4103/1008-682X.137687

What are the Complications of Erectile Dysfunction?

While erectile dysfunction affects a man’s ability to have a normal erection, there are some other factors that this condition can also have an implication on – thus, men should not only be concerned about the actual impact that the condition has on their erectile function, but also take other potential complications into account.

One of the major things that men will notice when they experience erectile dysfunction symptoms is that their sex life will not be satisfactory. They will not be able to experience significant pleasure and they will not be able to thoroughly please a sexual partner in the bedroom. In turn, this may also cause them to start experiencing problems in their relationship. There may be cases where the man’s sexual partner starts to think that they might be the problem and that they are not attractive to the man who is experiencing these issues anymore.

It has also been found that erectile dysfunction is a major contributor to anxiety and stress, and often causes men to experience low self-esteem as well. [21]Wilcox, S. L., Redmond, S., & Davis, T. L. (2015, June). Genital image, sexual anxiety, and erectile dysfunction among young male military personnel. The Journal of Sexual Medicine, 12(6), 1389-1397. doi: 10.1111/jsm.12880 Some men may start to feel embarrassed about the problems that they are facing in the bedroom. This may, in turn, also lead to performance anxiety, which can cause further problems in terms of their ability to have an erection during sexual intercourse and when stimulated sexually.

There is also the fact that erectile dysfunction would make it more difficult for a man to make a woman pregnant, which can become a serious issue in a couple who wants to start their own family. There are some causes of erectile dysfunction that may also contribute to infertility in men. [22]Lotti, F., & Maggi, M. (2018, May). Sexual dysfunction and male infertility. Nature Reviews Urology. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29532805

Another fact that should be taken into consideration here is the fact that scientists at Harvard Medical School found that erectile dysfunction is often a sign that a man might be developing heart disease. [23]Harvard Medical School. (2018, December). Finding hidden risk for heart disease. Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/mens-health/finding-hidden-risk-for-heart-disease While heart disease is not an actual complication of erectile dysfunction, it is a possible connection that men should keep into account when they start to experience weak erections when they are sexually stimulated.

How is Erectile Dysfunction Diagnosed?


Men who start to experience erectile dysfunction are often concerned and not sure whether they can be officially diagnosed with the condition. It is important to understand that treatment options are available and that a physician can diagnose the condition and conduct certain tests in order to ensure the treatment provided to a man is effective and helps him recover his functionality in the bedroom.

One of the major issues when it comes to diagnosing the condition is that it has been linked to quite a large number of potential causes and risk factors, as previously explained. For this reason, when a man approaches a physician and talks about his difficulties in the bedroom, the process of finding the best solution to the man’s erectile problems can take some time.

The physician will usually start by asking the man about the specific symptoms that he is experiencing. It is important for the physician to know if the man is also experiencing symptoms such as poor sex drive, poor sexual stamina, and fatigue during sexual intercourse. The physician may also ask the man if his sensations during sexual intercourse have been adversely affected as well, since there are some conditions, such as diabetes, that can affect nerves in the body, leading to reduced sensitivity in the penis during stimulation.

A comprehensive physical examination should always be conducted before proceeding so that the physician can determine the man’s general well-being at the moment. The physician will most likely request a full medical history of the male patient, which will provide the physician with an overview of any existing medical health problems the man has which could be interfering with his erectile function.

In order to obtain further information and a more accurate overview of the man’s current health, the physician will likely request a series of laboratory tests. These tests may include a complete blood count test, a urine test, as well as a fasting blood glucose test. Serum creatine, lipid profile, and prolactin levels may also be tested, along with a testosterone test early in the morning. A testosterone test is usually preferred to be done as early as possible in the morning. At this time of the day, a man’s testosterone levels are at their highest. This particularly true for men under the age of 45.[24]Long, N., Nguyen, L., & Stevermer, J. (2015, July). PURLS: It’s time to reconsider early-morning testosterone tests. The Journal of Family Practice, 64(7), 418-9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501456/

There are more advanced testing methods that are used in the modern-day world, which can provide physicians with accurate data in terms of how healthy a man’s sexual organs are, as well as other particular factors that can further assist with implementing an effective treatment plan.

An increased recognition in the fact that erectile dysfunction is often caused by psychological factors has led to physicians referring a patient to a psychiatrist or therapist for a mental evaluation. This can assist in determining if they may be experiencing erectile dysfunction symptoms due to an emotional or mental health issue, instead of a physical problem such as poor blood supply. [25]Maiorino, M. I., Bellastella, G., & Esposito, K. (2014, September 9). Lifestyle modifications and erectile dysfunction: what can be expected? Asian Journal of Andrology, 17(1), 5-10. doi: 10.4103/1008-682X.137687

There are a couple of neurological tests that physicians may order when they find it difficult to identify a particular cause behind a patient’s erectile dysfunction. These tests primarily aim to assist in determining if nerve damage has occurred in the pelvic region, which may contribute to the development of erectile dysfunction.

Neurological tests may include a color doppler ultrasound, as well as:

  • A combined intracavernous injection and stimulation test, often also referred to as a CIS test.
  • A pharmacologic cavernosometry and cavernosography

Each of these tests is used for specific purposes and can provide a physician with valuable information.[26]University of California San Francisco. (n.d.). Erectile Dysfunction
Diagnosis. UCSF Health. Retrieved from https://www.ucsfhealth.org/conditions/erectile_dysfunction/diagnosis.html
If damage to nerves in the penis or pelvic area of the patient’s body is detected through neurologic testing, the patient may be referred to a neurologist to undergo further treatment.

When Should You Be Concerned About Your Erectile Function?

A large number of men may experience poor erectile function at times, which can make them worry about whether they should consult a doctor to seek advice on whether they might be suffering from erectile dysfunction. Fortunately, as mentioned before, a poor erection from time-to-time is generally considered normal – and is often not a cause for concern or alarm.

There are, however, cases where consulting with a doctor can be helpful and may help a man experience improvements in their erectile function. It is usually recommended that a man consult with their physician if the erectile problems they are experiencing cause them to experience anxiety, as well as when their erectile dysfunction reaches a level that leads to problems with the man’s sexual relationship with their partner.

A physician will be able to provide the man with the information he needs to understand what is going on and will be able to conduct a series of tests that will help him know why he is experiencing difficulties with his erections. This way, the cause of the man’s erectile difficulties can be targeted through a customized treatment plan, which may help to restore normal erectile function.

Myths and Misconceptions About Erectile Dysfunction

For millennia, doctors, shamans, and herbalists have been looking for the secret to male enhancement. Men have ingested everything from Spanish fly to concoctions of ground roots in order to find some way to enhance their sexual experience. The term “male enhancement” actually covers quite a bit of ground. It can focus on increasing a man’s size, increasing libido, or supplying blood flow for erections.

Naturally, many myths have cropped up around this problem, mainly due to the universal drive toward better sex, but also due to the somewhat desperate nature of sufferers. Charlatans, well-meaning physicians, and hopeful men still have some misconceptions about what male enhancement is and what modern medicine can and can’t do. With the advent of Viagra, the issue of male enhancement has been thrust into the spotlight, and it has led to a large number of myths that can discourage men with erectile issues.

Myth #1: Pills Solve All Erectile Problems in Men

pills for ed
If you believe the commercials, modern male enhancement medications can help you cool down an overheated car, wrangle a sailboat back on course, and allow you to enjoy a carefree life.

Surely, helping you achieve an erection is no problem for these pills, so taking them will make your life spectacular. In fact, these medications have a very limited window of conditions they treat.

Erectile dysfunction has a physical element to it: blood flow to the penis is restricted. This is easily solved with medications by directing increased blood flow to cause an erection. However, not all erectile dysfunction stems from a lack of blood flow. Some impotence is caused by a lack of libido, and Viagra does nothing for that. In many cases, the problem is psychological – relationship issues, depression, or performance anxiety – and drugs are unlikely to help a man’s sex life if he suffers from these issues. Although helpful, medications and supplements are not a magic bullet.

Myth #2: Medications, Supplements, or Techniques can Increase Penis Size

Men have a love/hate relationship with their penis size. They want to know where they measure up compared to other men, and if they feel that they won’t win any blue ribbons for size, they want to find a way to increase their length and circumference. History is full of hilarious, sometimes dangerous ways for men to increase the length of their penis, and sadly, none of them worked for the earnest fellows who dared to try them.

Viagra never makes claims to increase penis size, and many supplements do not tout this feature either. However, countless websites are available for men to sample, demonstrating exercise techniques, creams, and supplements that purport to add inches of length to the penis.

Unfortunately, the only way to increase penis size is through costly and painful surgery, and many men draw the line at allowing a surgeon anywhere near their sexual organs.

Myth #3: Only Old Men Need Help with Erectile Dysfunction

ed in older men
The idea that a man needs help with erections at all is so culturally taboo that conditions are applied to it to make it more palatable. If you’re 70 and can’t get an erection, that’s one thing.

That’s allowable, though still embarrassing. However, it isn’t truly the case. Yes, older men do respond well to medications and supplements, but they are certainly not the only men in need of assistance. They do not even make up the bulk of men who search for a male enhancement solution.

Despite taboos, erectile dysfunction is a common problem in men of all ages. Some clinical conditions can lead to this problem, such as diabetes, high blood pressure, atherosclerosis, and major depression, to name just a few. Since men of all ages are subject to these common conditions, any man is at risk for erectile dysfunction. A 40-year-old man who cannot get an erection is not an oddity, deserving of shame. He is likely a man with comorbid (coexisting) conditions that are preventing him from enjoying a healthy sex life.

Myth #4: Erectile Dysfunction is All In a Man’s Head

Men get blamed for many things when they are having erectile issues. Others may call their sexuality into question, wonder if they are attracted to their partner, or secretly dislike sex because they are prudes. As discussed, so many physical problems can cause erectile dysfunction that it usually has nothing to do with a man’s inner psychology, though it certainly can affect it. Diabetes, antidepressants, and chronic pain conditions are just a few of the non-psychological reasons for dysfunction.

This myth has a kernel of truth to it, though. Many times, mental issues can affect a man’s libido and the ability to achieve an erection. Performance anxiety and concerns about their body plague men as much as women. Psychological conditions, such as depression and post-traumatic stress disorder, can leave a man disinterested in any sort of physical activity, not just sex. In these cases, meeting with a qualified therapist who can work on sexual and life issues is the best course. When the problem stems from stress, worry, or relationship problems, no amount of medication or supplements will achieve the goal of sexual health.

Myth #5: Erectile Dysfunction Never Gets Better.

ed never gets better
The good news is that erectile dysfunction does get better, and so many solutions are available now that were unheard of 20 years ago. It is true that a man’s sex drive and perhaps performance decreases with age, but sexuality remains a large part of our healthy makeup for much longer than most people think.

Men and women having sex in their 50s, 60s, and 70s is possible, so if an erectile or libido issue is uncovered early in life, you still have time to take action.

Erectile dysfunction medications and supplements cannot perform miracles, but they can give you an edge in defeating your condition. Although they tend to be less helpful for psychological issues, they are definitely well suited for sexual problems brought on by age, disease, or medication. Simply because you have erectile dysfunction now does not mean that you can’t get help and overcome it. Speak to your doctor openly and honestly about your sex life, and you may find that the solution is easier than you think.

5 Things You Probably Didn’t Know About Erectile Dysfunction

#1: It isn’t just you.

Now, admittedly, this isn’t much of a shock to those of you who have been reading our blog for an extended period of time, but for many men who are beginning to experience the signs and symptoms of ED, the entire experience can be very isolating. If we ignore the feelings of inadequacy and self-doubt for a second and look at the raw data, it is estimated that as many as 30 million men in the United States suffer from some degree of ED. THIRTY. MILLION. That’s far too many other guys in the same boat as you to qualify as being alone. What’s more? As many as half of men over the age of 75 reports experiencing some or all ED symptoms. [27]U.S Department of Health and Human Services. (2009). Erectile Dysfunction [PDF File]. Retrieved from http://go.sdsu.edu/student_affairs/healthpromotion/files/03743-Erectile_Dysfunction_%28NIH%29_06-2009.pdf

#2: It might be all in your genes.

Yes, genes, as in genetics; not jeans as in your pants. A series of genetic researchers the world over are not only examining the relationship between genetics and erectile dysfunction, but also if gene therapy might yield a successful treatment, or possibly even a cure. While all of this is still in its very early days, it is nonetheless an incredibly interesting idea. [28]Brooks, D., Sandberg, J., Christ, G., & Terlecki, R. (2016). 017 Development of Gene Therapy for Erectile Dysfunction: Delivery to Corpus Cavernosa using Viral Vectors. The Journal of Sexual Medicine, 13(5), S8-S9. doi: 10.1016/j.jsxm.2016.02.019

#3: ED as a symptom, not the disease?

brush your teeth
Contrary to popular belief, erectile dysfunction is typically not, on its own, a disease itself. Often, it signifies a larger health issue or concern. As such, even if it is uncomfortable, it is something that wholly deserves medical attention. If you begin to experience these symptoms yourself, your best bet is to go see your doctor and confirm that nothing more serious is going on before engaging in any kind of treatment or supplementation for the ED itself. Doing so will take a large burden off of your shoulders, and also ensure that whatever treatment path you choose will not in any way backfire and pose a more serious risk to your health than it would have otherwise.

#4: Brush your teeth, avoid ED?

I know what you’re thinking: what on earth could one possibly have to do with the other? If it’s any consolation, most people would think the same thing at first. Apparently, though, there is a pretty intriguing link between oral hygiene and erectile dysfunction. Studies have shown that, in general, men with gum disease or other oral health conditions are more likely to experience ED in their lives than those with stellar oral hygiene.[29]Saini, R. (2016, June). Periodontal Disease Linked to Erectile Dysfunction. Journal of Oral Biology, 3(1), 1. Retrieved from http://periogen.com/assets/joby-2377-987x-03-0024.pdf While this sounds absurd, the proposed link between the two is the commonality of inflammation in such oral health diseases, which may create a diversion of blood flow to places other than where it should be going. Again, this research is still relatively new, but this is just further proof that your dentist is always right.

#5: It actually isn’t part of the aging process.

This sort of plays back into point number 3, but is worth devoting a bit more time to. The most common myth associated with erectile dysfunction is that it is a natural part of getting older. Statistically, though, this isn’t really true. We said nearly half of men over 75 experience symptoms of ED, but the keyword there is “symptoms”. Individually, the symptoms can be the result of any number of factors, such as blood pressure irregularities, but those men typically do not qualify as having the actual condition itself. As we said earlier, it is often a sign of some larger health concern rather than existing in a bubble as a disease of its own. This is especially true in older men who, by their very nature, are more prone to getting sick as the body’s natural defenses begin to weaken. As such, age really doesn’t have all that much to do with it, and certainly not as much as people may believe.

Discussing the Use of Sexual Enhancements with Your Partner

Chances are that the last thing you want to talk to your partner about is your interest in taking supplements as a sexual enhancement option. [30]Fisher, W. A., Meryn, S., Sand, M., Brandenburg, U., Buvat, J., Mendive, J.,…& The Strike Up a Conversation Study Team. (2005, February 18). Communication about erectile dysfunction among men with ED, partners of men with ED, and physicians: The Strike Up a Conversation Study (Part I). The Journal of Men’s Health & Gender, 2(1), 64-78. doi: 10.1016/j.jmhg.2005.01.018 You’re definitely not alone in this, and more importantly, there isn’t anything wrong with it either.

Sexual Enhancements with Honesty

sad coupleThe best thing you can be is up-front with your partner about your fears, concerns, or insecurities. Surprisingly it’s common on how often we trick ourselves into thinking that we need help with our bedroom game. We worry we aren’t pleasing our partners. Sometimes, all it takes is to hear them say “It’s great for me”. This will make us realize it’s all in our heads. So tell them that you worry they aren’t enjoying it. That you’re considering taking something to make the experience better for them. Hopefully, they will be supportive of your decision to improve things.

If not…well, that’s a topic for another blog entirely.

What if it’s My Hardware?

If the first scenario doesn’t apply to you, then it may be that something isn’t working as it should. Now if that’s the case, it’s always best to speak with a specialist before you start testing supplements of any kind, as it may be a more serious medical issue than simply old age wearing everything down. Also if there’s no serious medical concern, but your doctor agrees that things aren’t functioning at optimal levels, then at least you know , and hopefully your partner will agree that some help will not be a bad idea.

What if it’s Good, but I Want it to be Better?

If this is you, then the first thing you want to do is make sure that taking supplements won’t backfire on you and cause more harm than good. It isn’t likely, but too much testosterone can be just as detrimental as not enough, so it’s definitely worth keeping in mind.

As for talking to your partner, the one thing you want to be sure of is that at no point do you ever insinuate that the sex isn’t good enough. This type of thing is a bit beyond the realm of this blog, but you always want to frame this sort of discussion as a matter of wanting the experience for your partner to be even better. Causing your partner to feel inadequate is a terrible move.

You need to maintain that the desire for supplements is a result of feeling like you could do more to make the experience better. Whether that be through longer erections, increasing stamina, or dealing with issues of premature ejaculation.

I Want to Take Them Because I Always Climax Too Fast

Discuss sexual enhancement with your partner
Are you concerned that you might be suffering from a case of premature ejaculation? The first step is always to speak with a physician since this can potentially signal deeper medical issues than you’d initially expect.

If you’ve been cleared, though, then taking supplements might be the right move.[31]West, E. & Krychman, M. (2015, October). Natural Aphrodisiacs–A Review of Selected Sexual Enhancers. Sexual Medicine Reviews, 3(4), 279-288. doi: 10.1002/smrj.62 The general consensus seems to be that women do not worry about the premature ejaculation itself. In fact, many take it as a compliment! For most women who do have an issue with it, it boils down to the experience. It may just not be lasting as long as they’d like.

Chances are if you’ve made it to the point that you’re considering taking supplements to help curb this issue. If that’s the case, then you’ve already thought of this. If so, this is another case of stressing that you want the experience to be as great as you can make it for the both of you.

The Big One

As the bolded print suggests, this is the biggest take-home of this entire post. Don’t feel ashamed about talking about sexual enhancements. Shame is a natural emotion for guys to feel when they believe they’re not satisfying their partner. It isn’t irrational, or even abnormal to feel that way. This emotion should motivate you rather than inhibit you. It speaks to a certain level of self-awareness and a desire to improve that some men simply lack. This will put you ahead of the rest for that reason.

Can Erectile Dysfunction be Prevented?

A relatively large number of scientific studies have shown that it is not only older men that should be concerned about erectile dysfunction, as young adult men also seem to experience these symptoms. [32]Reed-Maldonado, A. B., & Lue, T. F. (2016, April). A syndrome of erectile dysfunction in young men?. Translational Andrology and Urology, 5(2), 228-34. doi: 10.21037/tau.2016.03.02 For this reason, men are increasingly becoming concerned about developing erectile dysfunction symptoms, and want to know if they can effectively prevent the condition from affecting them.

The answer to this question is both yes and no. There are many things that men can do in order to significantly minimize their risk of experiencing erectile problems, but sometimes the cause is not directly associated with the individual’s lifestyle and environmental factors. Still, implementing some preventative measures may still help a man keep his erectile abilities for longer and stay sexually active, even at an older age.

One of the most important preventative measures lies within a man’s diet. What a person eats has a significant impact on their body, and when a man’s diet is causing problems with their cardiovascular system, it is also having an adverse impact on their erections. A diet that is filled with fatty foods, processed foods, and fried foods causes an increase in cholesterol build-up in the arteries and blood vessels and restricts blood flow in the body. This does not only cause the heart to become damaged, but also leads to poor erections. To prevent this from happening, men should rather opt for healthier food choices, and ensure they include a larger amount of vegetables and fruits in their daily diet.
Diet and Nutrition
When a man is more conscious about his diet and what he puts into his body, his chances of becoming overweight or obese also becomes lower. Healthy weight management strategies can be a useful preventative measurement, as this reduces the man’s risk of heart disease and diabetes – both conditions can have a negative effect on their ability to have normal erections. [33]Lucky, M., Minhas, S., & Kalsi, J. (2017). Management of erectile dysfunction in men with diabetes. Male Sexual Dysfunction: A Clinical Guide, 210-219. Retrieved from https://books.google.com/books?hl=en&lr=&id=iuoCDgAAQBAJ&oi=fnd&pg=PA210&dq=erectile+dysfunction+poor+diet&ots=ZxHhHkq86Y&sig=NBe6fZm6PqSo68TylRGqBTpteXw#v=onepage&q&f=false

Exercise should also be an important part of a man’s life if they wish to keep their erections strong for a long time. When a man participates in physical activities regularly, they are maintaining healthy blood flow, a healthy cardiovascular system, and contributing to a healthier weight. [34]Begot, I., Peixoto, T. C., Gonzaga, L. R., Bolzan, D. W., Papa, V., Carvalho, A. C.,…& Guizilini, S. (2015, March 1). A home-based walking program improves erectile dysfunction in men with an acute myocardial infarction. The American Journal of Cardiology, 115(5), 571-575. doi: 10.1016/j.amjcard.2014.12.007

As part of an erectile dysfunction prevention strategy plan, a man should also go for regular check-ups at his doctor. Frequently having their blood sugar, blood pressure levels, blood cholesterol levels, and serum testosterone levels checked can indicate problems with any of these bodily systems early on. When issues are identified, treatment protocols can be implemented, which helps to restore a better balance and leads to a lower risk of erectile dysfunction developing due to hypertension, high cholesterol levels, diabetes, or perhaps a testosterone deficiency.

A man who is concerned about developing erectile dysfunction should also educate himself on the possible risk factors that may cause him to develop such symptoms. When he identifies any of these risk factors in his own life, appropriate changes should be implemented in order to minimize his exposure to erectile dysfunction risks. [35]Maiorino, M. I., Bellastella, G., & Esposito, K. (2014, September 9). Lifestyle modifications and erectile dysfunction: what can be expected?. Asian Journal of Andrology, 17(1), 5. doi: 10.4103/1008-682X.137687

This may include smoking cessation, reducing their stress levels, undergoing treatment for depression, and avoiding sexual activities that may put their health in harm’s way. Men should also improve their sleeping schedules if they wish to prevent poor erections, as sleep has been shown to have a crucial part in ensuring men can continue to have healthy and rigid erections, while sleep deficiency has been scientifically proven to contribute to weaker erections and even worse signs of erectile dysfunction.

Erectile Dysfunction Treatment Options

The fact that there are millions of men diagnosed with this condition and struggling to please their sexual partner on a day-to-day basis, does not mean it is impossible to achieve a full and long-lasting erection again once the symptoms of erectile dysfunction set in. Even though recognition of this disastrous condition has increased over the last few years, especially with new treatments being developed and announced frequently, there are still a lot of men who feel alone when they are faced with a weak erection that won’t last long enough for them to be able to please their partner.

Science has advanced to the point where a lot of men who had previously experienced erectile dysfunction symptoms are now able to please their sexual partners without facing these issues anymore.

Treatment for erectile dysfunction tends to vary from patient-to-patient, as the cause behind the condition is not always the same. Some men may experience emotional trauma or mental health issues, which causes them to experience weak erections. Other men may have physical health issues that are causing their body to experience nerve damage, or sometimes a restriction in blood flow toward the pelvis area.

Due to the complexity of treating the condition, it is important for a man to undergo a full diagnosis with a licensed and experienced physician. This will ensure that the root cause of their symptoms can be effectively identified, which will greatly increase their chances of having a firm and proper erection again.

Prescription Drugs for Erectile Dysfunction

Male patients diagnosed with erectile dysfunction are often provided with prescription drugs that assist with improving their erections. There are different types of drugs that have been approved for this purpose, with Viagra being one of the first – and the one that is widely known throughout the world. These drugs work in different ways, but all of them serve the purpose of stimulating a man sexually in order to produce better erections. Some of the prescription drugs that are available to treat erectile dysfunction may also help to increase a man’s libido.

In some cases, a physician may prescribe these drugs to a male patient while other tests are being conducted. This would provide the patient with a solution to help them get back their vigor in the bedroom while the physician is working on identifying the root cause behind the man’s problems.

The most popular types of prescription erectile dysfunction drugs that are commonly provided to patients who present symptoms of this condition include:
pills for ed
Cialis

  • Recommended dosage: 2.5 mg
  • Side effects: Upset stomach, headache, back pain, muscle pain, stuffy nose, flushing, or dizziness.

Levitra

  • Recommended dosage: 10 mg
  • Side effects: Headache, flushing, stuffy/runny nose, dizziness, vision changes, sensitivity to light, and blurred vision.

Viagra

  • Recommended dosage: 50 mg
  • Side effects: Warmth or redness in the face, neck, or chest, stuffy nose, headaches, stomach pain, nausea, diarrhea, loss of hearing, ringing in the ears and dizziness.

When prescription drugs are utilized, it is important to closely monitor how they affect the patient. Some of these drugs are known to cause a series of unpleasant side-effects, and there have been reports of life-threatening adverse events occurring after a patient has taken drugs like Viagra. For this reason, some physicians may prefer to conduct some tests to determine if a prescription drug is the most appropriate way to treat the patient’s erectile dysfunction.

Should side-effects develop, the patient should stop using the drug and consult with his doctor. The doctor may conduct some tests to determine why the patient may be experiencing the side-effects, or provide the patient with another type of prescription drug to see if their body reacts better to the alternative option.

Can Testosterone Replacement Therapy Improve Erectile Function?

A popular question among men is whether or not they can opt for testosterone replacement therapy when they show signs of erectile dysfunction. This is a very complicated question and an unclear topic, as studies have provided mixed results on the topic, and doctors also believe in different answers. [36]Elkhoury, F. F., Rambhatla, A., Mills, J. N., & Rajfer, J. (2017, December). Cardiovascular health, erectile dysfunction, and testosterone replacement: controversies and correlations. Urology, 110, 1-8. doi: 10.1016/j.urology.2017.07.030

In order to understand whether or not this type of treatment would be helpful, it is important to know what the role of testosterone is in regards to erectile function and sexual health. Testosterone is the main sex and steroid hormone in the male body. The hormone is responsible for a large number of functions, from muscle growth toward hair growth. When it comes to sexual well-being, testosterone is known to play a very important role in a man’s sex drive or libido. The hormone, however, does not seem to have any direct effects on how hard a man’s erection gets or whether he is able to have an erection at all.

This is the main reason why many experts believe that testosterone therapy may not be the ideal solution for men who experience a weak erection. At the same time, however, there may be times where this particular treatment could potentially have a positive effect on a man’s erectile function.

A scientific publication in the Reviews in Urology Journal [37]Rajfer, J. (2000). Relationship between testosterone and erectile dysfunction. Reviews in Urology, 2(2), 122-8. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476110/ explains that studies found men with lower levels of androgens and testosterone hormones tend to experience reduced efficiency in terms of their erections. They continue to explain that erections become less frequent in these men, and the rigidity and amplitude of their erections also tend to decline.

First, it should be noted that in men who already have serum testosterone levels that are found to be within the “normal” range, the use of testosterone replacement therapy would not do much good. In fact, this may cause the man to start experiencing adverse effects.

Now, in men with serum testosterone levels that are considered to be on the low side, this treatment MIGHT be helpful, but not for every single individual who falls into this category.

Since testosterone plays a role in physical strength, muscle strength, and even sex drive, a man with low testosterone who is finding that this issue is causing him to feel weak, experience fatigue, and finding himself constantly out of energy, might want to try treatment with synthetic testosterone. This would usually only be helpful if the low testosterone also causes the man to experience a weak sex drive, as introducing more testosterone into the man’s body may help to stimulate his libido.

While the use of testosterone therapy could be potentially helpful for some men who experience weak erections, giving that their natural serum testosterone levels are low, there are some possible adverse effects that this treatment may cause the man to experience. Recognizing the risk and weighing the pros and cons is important for any man who is considering undergoing testosterone replacement therapy.

The side-effects that have been associated with the use of synthetically-produced testosterone hormones in the male body include the development of acne, as well as oily skin. Fluid retention may occur, and the prostate tissue may be stimulated, which can induce urinary tract symptoms, such as an increase in urination frequency or a reduced urine stream. The risk of prostate abnormalities is also increased in men who undergo testosterone replacement therapy. There is also an increased risk of developing blood clots, and some men who turn to this treatment option may find that their breast tissue becomes enlarged. [38]Grech, A., Breck, J., & Heidelbaugh, J. (2014, August 27). Adverse effects of testosterone replacement therapy: an update on the evidence and controversy. Therapeutic Advances in Drug Safety, 5(5), 190-200. doi: 10.1177/2042098614548680

Natural Ways that Erectile Function can be Improved

If you would rather try to conquer this problem on your own before venturing into the doctor’s office, then we say, “Congrats.” Let’s take a look at some of the safest and easiest ways to naturally help with erectile dysfunction.

Diet and Exercise

exercises for men
Eating a healthy diet and incorporating exercise into your daily routine are the top two ways to naturally combat erectile dysfunction. What’s more, adopting this new lifestyle will be extremely beneficial overall. You’ll notice a marked improvement in all areas of your doctor’s standard rap sheet review.

Diet

First things first, you’ll need to figure out your caloric intake before making the appropriate choices. It’s far easier than it seems with this caloric calculator.

Exercise 

Beginning an exercise program doesn’t require an advanced knowledge of exercise science. It’s as simple as becoming more physically active during the day. If you’re just starting out, take little steps. Start by walking 30 minutes each day. Eventually, work your way up to higher intensity activities such as jogging or cycling. Get yourself into the weight room for the best results. Performing resistance training three times per week will provide you with a huge caloric burn and better body composition.

Kegel Exercises

Your chest and legs don’t have to be the only muscle that you target. Your pelvic floor muscles can also be the focus of your workouts if you want to improve your bedroom performance and fight off erectile dysfunction. Check out this article on how to perform Kegel exercises.

Supplements for Erectile Dysfunction

The supplement industry has unlocked the key to a number of powerful herbal remedies, all with a specific purpose. You can find a non-prescription supplement for just about every condition out there, including erectile dysfunction. Here are several ingredients that are safe, all-natural, and scientifically proven to boost sexual performance while warding off erectile dysfunction:

DHEA

According to an article published in The World Journal of Men’s Health, DHEA (Dehydroepiandrosterone) was very effective in treating erectile dysfunction. [39]El-Sakka, A. I. (2018, May 11). Dehydroepiandrosterone and Erectile Function: A Review. The World Journal of Men’s Health, 36. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29756417

Maca

Clinical trials have been very promising in a recent review of studies that were published in Sexual Dysfunction, where subjects were given Maca root to alleviate sexual dysfunction. [40]Crespo, A. O. O., Cedillo, A. X. O., Cedillo, P. O. O., & Sánchez López. M.E. (2016). Systematic Review On The Use Of Maca (Lepidium Meyenii) In Sexual Dysfunction [PDF File]. Pinncale Journal Publication, 3(4). Retrieved from https://pdfs.semanticscholar.org/f150/36db1fe717ba337a59625e44c6be5b12602a.pdf

Korean Red Ginseng

The ancient root, Korean red ginseng, has been touted as a cure-all for many ailments and research is finally adding erectile dysfunction to that list. A study published in The Korean Journal of Herbology demonstrated that Korean red ginseng was a safe and recommended alternative to invasive procedures. [41]Lee, Y. J., Kho, M. C., Tan, R., Lee, J. Y., Hwang, J. S., Cha, J. D.,…& Kang, D. G. (2015, November 30). Beneficial effect of combination with Korean Red Ginseng,  Gastrodia Rhizoma and Polygoni Multiflori on cholesterol and erectile dysfunction in hyperlipidemia rats. The Korea Journal of Herbology, 30(6), 69-75. doi: 10.6116/kjh.2015.30.6.69

Yohimbine

Placed in many thermogenic, or fat burning, supplements, Yohimbine was reported to have extra benefits for those taking the supplement: increased libido, sex drive, and bedroom performance. Studies, such as this one published in Cardiology, have confirmed that Yohimbine may be an effective treatment for erectile dysfunction. [42]Nayak, B. N., & Buttar, H. S. (2015). Herbal therapy for men with erectile dysfunction. Current Research: Cardiology, 2(1). Retrieved from https://www.pulsus.com/scholarly-articles/herbal-therapy-for-men-with-erectile-dysfunction.html

Tribulus Terrestris – Tribulus Terrestris has been a hot supplement in the bodybuilding world for its reported effects on boosting testosterone levels. As it turns out, it’s also useful for combating erectile dysfunction. A study published in the Journal of Sex & Marital Therapy demonstrated the effectiveness of the herbal remedy Tribulus Terrestris in treating moderate cases of erectile dysfunction. [43]Roaiah, M. F., El Khayat, Y. I., Gamal El Din, S. F., & Abd El Salam, M. A. (2015, April 7). Pilot study on the effect of botanical medicine (Tribulus terrestris) on serum testosterone level and erectile function in aging males with partial androgen deficiency (PADAM). Journal of Sex & Marital Therapy, 42(4), 297-301. doi: 10.1080/0092623X.2015.1033579

Tongkat ali – Tongkat ali is another well-known supplement to boost testosterone, favorite among men in Asia but growing in popularity all over the world. This supplement has been proven to be a safe and natural alternative to testosterone replacement therapy (TRT) and therefore enhance the erection quality of men with lower testosterone levels due to aging. [44]George, A. & Henkel, R. (2014, January 6). Phytoandrogenic properties of Eurycoma longifolia as a natural alternative to testosterone replacement therapy. Andrologia, 46(7):708-21. doi: 10.1111/and.12214

Conclusion

Erectile dysfunction is a problem that millions of men are faced with. The condition affects a man’s sexual performance by impairing their ability to have healthy, firm erections. While some men with erectile dysfunction are still able to achieve a rigid erection, the erection may not last for a significant period of time, resulting in their penis going limp while they are participating in sexual intercourse.

The impact of erectile dysfunction can be detrimental for a sexually active man and may cause complications with his sexual relationships, as well as contribute to the development of mental health problems, including depression and low self-esteem.

Men should become educated on the symptoms that may signal erectile dysfunction, but also be aware that from time-to-time, the erectile function may be impaired due to medication, or perhaps even a stressful day. At the same time, recognizing when it may be time to speak to a doctor is equally important, as this may yield early treatment for erectile dysfunction, which may result in a higher chance of regaining normal functionality in terms of sexual performance and erectile function.

References   [ + ]

Fran Sanchez, BSc MSc

About Fran Sanchez, BSc MSc

Fran Sanchez, the founder of Herbolab, graduated from Uppsala University (Sweden) with a master in molecular biology and Karolinska University (Sweden) with a degree in medical sciences and business. He then moved to Singapore to run e-commerce operations in a pharmaceutical company, until eventually, he could fulfill his dream of creating a brand dedicated to help men reach their peak performance. Drawing on his experience as a lifelong multi-sport athlete and cutting edge medical and scientific research, Fran launched herbolab tongkat ali as flagship supplement in April of 2014. Fran now spend most of his time weight lifting and creating content dedicated to improve people’s lives.

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