Introduction
Some people have difficulty with their penis hardening or remaining firm on occasion. However, erectile dysfunction (ED) is frequently only a cause for concern when satisfactory sexual performance is consistently impossible.
Since the discovery that the drug sildenafil, or Viagra, affected penile erections, there has been a greater understanding that ED is a treatable condition. People who have a problem with their sexual performance, on the other hand, may be hesitant to talk to their doctor because it is an embarrassing issue.
ED is now well understood, and various treatments are available.
Causes
In the United States, up to 20 million people may be affected by ED. The condition affects more than half of people over the age of 50, and its prevalence rises with age. Problems with a person’s blood flow, nervous system, and hormone levels can all impair erectile function. A person may also develop ED as a result of psychological factors, such as sexual performance anxiety.
According to a 2019 study, gay men report ED at a higher rate than heterosexual men. However, the precise reasons for this are unknown, and researchers recommend further research in the field.
Physical reasons
The majority of ED cases are secondary. This means that erectile function was previously normal but has now become problematic. Physical causes are usually the root of a new and persistent problem. A person may have primary ED in rare cases. This is a condition in which a person has never had an erection. Primary ED can be caused by either a psychological or physical condition.
If a person has persistent erection problems, they should see a doctor because an underlying medical condition could be causing the problem. A proper diagnosis can aid in the treatment of any underlying medical issues as well as the resolution of sexual difficulties.
Among the most common physical causes of ED are:
• Heart disease and blood vessel constriction
• diabetes
• elevated blood pressure
• high cholesterol levels
• The metabolic syndrome and obesity
• Parkinson’s disease (PD)
• MS (multiple sclerosis)
• Thyroid conditions and testosterone deficiency are examples of hormonal disorders.
• Penis structural or anatomical disorders, such as Peyronie disease
• Tobacco use disorder, alcohol use disorder, and substance abuse, including cocaine use
• prostate cancer treatments
• complications from surgery
• injuries to the pelvic region or the spinal cord
• Treatment with pelvic radiation
• Atherosclerosis is a common cause of poor blood flow. Atherosclerosis causes the arteries in the penis to narrow or clog, preventing the necessary blood flow to produce an erection.
ED can also be caused by a variety of prescription medications. Before discontinuing or changing prescription medications, a person should consult their doctor. Among the medications that may cause ED are:
• high blood pressure medication
• Digoxin and other heart medications
• treatments for anxiety
• Monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants are examples of antidepressants.
• Opioid analgesics
• some cancer medications, including
• chemotherapeutic drugs
• anticholinergic’s
• hormone therapy
Physical causes account for 90% of ED visits, with psychological causes being far less common.
Psychological factors
Both treatable mental health disorders and commonplace emotional states that most people have experienced at some point in their lives can play a role in the development of ED. However, these are significantly less typical than physical explanations.
In terms of the mind, there are:
• anxiety about getting close to someone
• depression
• widespread unease
Specific sexual performance anxiety is a common psychological factor in people with ED, and it can prevent them from getting a full erection. A review found that males experience sexual performance anxiety at rates between 9 and 25%.
It’s also worth noting that medical and psychological factors may interact. One physical cause is that being overweight can cause alterations in blood flow, which can make it difficult to keep an erection going. Nonetheless, the person’s low self-esteem could be a psychosocial cause of erectile dysfunction.
Can ED be brought on by bicycling?
Concerns persist about how cycling may affect men’s health.
Long-distance cyclists may be at increased risk for erectile dysfunction (ED), infertility, and prostate cancer, according to some studies.
While researchers in 2014 did not find a connection between cycling and erectile dysfunction, they did find that more cycling time was associated with a higher risk of prostate cancer. On the other hand, a study published in 2020 found no link between cycling and erectile dysfunction or prostate cancer. Further investigation into the possible link between cycling and prostate cancer is needed.
ED and prostate cancer
Prostate cancer in its early stages is not associated with erectile dysfunction, but advanced prostate cancer can. Radiation therapy and prostatectomy, both used to treat prostate cancer, are associated with erectile dysfunction.
Unfortunately, some treatments for prostate cancer can cause erectile dysfunction. Hormone replacement therapy, for instance, has been linked to decreased libido and, by extension, erectile dysfunction. Studies have found that the medication finasteride may lead to erectile dysfunction in men.
Treatment
The good news is that there are numerous treatments available for ED, and most people will find one that works for them.
Drug therapies
PDE-5 (phosphodiesterase-5) inhibitors are a class of drugs that can help people with ED.
The majority of these pills are taken 30 to 60 minutes before sex, with the most well-known being the blue pill sildenafil citrate (Viagra). Other options include:
• vardenafil (Levitra)
• tadalafil (taken on demand, or as a once-daily pill called Cialis)
• avanafil (Stendra)
PDE-5 inhibitors are only available with a doctor’s prescription. Before prescribing them, a doctor will check for heart conditions and inquire about any other medications the patient is taking.
PDE-5 inhibitors have the following side effects:
• flushing
• abnormalities in vision
• loss of hearing
• indigestion
• headache
Prostaglandin E1, a less commonly used trusted Source drug option, is applied locally by either injecting it into the penis or inserting it down the opening of the urethra.
Online drugstores
It is possible to purchase ED treatments over the internet. However, one should exercise caution when doing so.
The Food and Drug Administration (FDA) of the United States has a consumer safety guide for online pharmacies. Before placing an order, a person should ensure that their online pharmacy is licensed in the United States, employs a licensed pharmacist, requires a prescription, and provides direct contact with customer service representatives.
The list of Verified Internet Pharmacy Practice Sites can be used to determine whether a pharmacy is licensed. The FDA also provides tips for spotting the dangers of an unsafe website, such as keeping an eye out for the following.
• The website does not have a phone number.
• Prices are significantly lower than those of legal online pharmacies.
• Prescription drugs cannot be purchased without a prescription, which is illegal.
• Personal information is not safeguarded.
These shady websites may deliver drugs of unknown quality and origin. They may even send the incorrect medication or a dangerous product.
Vacuum cleaners
Vacuum erection devices are a mechanical method of producing an erection for men who do not want to use drugs or find that they do not work.
A person stiffens their penis by using a vacuum pump that is sealed around it and draws up blood. An accompanying band then prevents this blood from leaving the penis.
Because vacuum devices lack spontaneity, many people with ED prefer alternative treatments. Other treatments, such as oral medications, can, however, reduce spontaneity. Poor seals, for example, may make vacuum devices susceptible to mechanical flaws that reduce their efficacy.
Surgical procedures
Patients have several surgical treatment options available from reputable sources, including penile implants. A doctor inserts a malleable or inflatable device into the penis during this procedure. If drug-based treatments have failed, this surgery may help a patient achieve and maintain erections.
A patient may require vascular surgery to treat ED in extremely rare cases.
Surgery is typically recommended only after all other treatment options have been exhausted.
Do dietary supplements and complementary therapies work?
There are no doctor-recommended guidelines or established sources of evidence that support the use of dietary supplements such as herbal pills.
Aside from the lack of evidence in favor of non-prescription alternatives for ED, alternative supplements and treatments may be harmful, and in some cases, fatal, according to trusted sources.
Symptoms
People may not always be able to achieve an erection. This is not considered a medical problem if it occurs regularly. If a person is consistently unable to obtain an erection, they may have ED. There is no set period in which a person must experience ED to be diagnosed. Some professionals recommend 6 months.
ED, on the other hand, does not only refer to an inability to achieve an erect penis. The inability to ejaculate or maintain an erection for long enough to complete intercourse is also a symptom. Emotional symptoms such as embarrassment, shame, anxiety, and a decreased interest in sexual intercourse are common.
Exercises
Some exercises can be done to help reduce the effects of ED. Exercise to strengthen the pelvic floor muscles may be a beneficial treatment for people with ED, according to research.
Learn more about pelvic floor exercises by clicking here.
Aerobic exercise, such as jogging or taking a brisk walk, can also help the blood circulate better and improve ED in men with circulation issues.
Tests
Because there are so many possible causes of ED, a doctor will usually ask a lot of questions and order blood tests. These tests can detect heart problems, diabetes, and low testosterone levels, among other things. The doctor will also perform a physical examination, including a genital examination.
A doctor will conduct additional research after establishing a medical history. The “postage stamp test,” for example, can help determine whether the cause is physical or psychological.
Men typically have three to five erections per night. This test looks for erections at night by seeing if postage stamps placed around the penis before sleep have snapped off overnight. The Poten test and the Snap-Gauge test are two other nocturnal erection tests.
These methods provide limited information but can aid in the selection of additional tests by a doctor.
Conclusion
Erectile dysfunction (ED) occurs when a man is unable to maintain a full erection regularly. The condition is common, affecting approximately 20 million Americans.
A person may develop ED due to physical factors such as high cholesterol levels or psychological factors such as sexual performance anxiety. A doctor may advise a variety of ED treatments, including prescription medication and, in rare cases, surgical intervention.
