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Erectile Dysfunction: What It Is and How to Treat It

While occasional difficulty achieving or maintaining an erection is not a cause for concern, ongoing issues with erectile dysfunction are another story. As many as 10% of men experience long-term erectile dysfunction, which can arise from a wide variety of causes.

Erectile dysfunction can be stressful to both your relationships and your own self-confidence. It can also be a symptom of an underlying health condition that requires treatment, including issues with your cardiovascular system. If you’re experiencing ongoing erectile dysfunction, you should see a doctor. The solution may be simple, especially because many different treatments are available.

What Is Erectile Dysfunction?

Erectile dysfunction is defined as the inability to sustain an erection for the purposes of sexual intercourse. Chronic erectile dysfunction symptoms include ongoing difficulty achieving an erection, maintaining an erection and ejaculating, in addition to reduced sexual desire.

Erectile dysfunction is stressful for most men who experience it. The condition can lead to low self-esteem, as well as an unfulfilling sex life and relationship issues, including the inability to get a partner pregnant. With as many as 30 million dealing with erectile dysfunction, it’s the most common sexual problem that men experience.

It’s time to see a doctor when you experience sexual problems including erectile dysfunction and premature or delayed ejaculation. In addition, men with heart disease or diabetes should also make a doctor’s appointment, as these serious medical conditions can be linked to erectile dysfunction.

Causes of Erectile Dysfunction

Erectile dysfunction can stem from a myriad of causes, including physical issues and emotional or psychological causes. It occurs when blood flow to the penis is restricted in some way or when the nerves in the region have been damage. In some cases, erectile dysfunction can be a warning sign of a serious disease. Discovering the cause of your erectile dysfunction is important for both your physical and emotional health.

Because male sexual arousal involves both physical and psychological causes, any disruption in these areas can result in erectile dysfunction. Often erectile dysfunction is a result of a combination of issues. For example, a minor physical ailment might result in a weak erection, which in turn might trigger anxiety about the ability to sustain an erection, which then makes the erectile dysfunction even worse.

Physical Causes of Erectile Dysfunction

Erectile dysfunction occurs when blood flow to the penis is reduced to the point where an erection can’t be achieved. This can occur as a result of heart disease and hardened arteries. The high blood sugar that results from diabetes can also reduce blood flow to the penis — and diabetes can also cause damage to the nerves and small blood vessels in the penis.

In addition, some medical treatments can result in erectile dysfunction. Some medications include erectile dysfunction as a side effect, and tobacco use is also implicated in the condition. Men undergoing radiation or surgical treatment for prostate, bladder, or colorectal cancers may find themselves experiencing erectile dysfunction.

Other causes of erectile dysfunction include:

  • Atherosclerosis (clogged blood vessels)
  • High cholesterol
  • Metabolic syndrome (a condition in which high blood pressure, high cholesterol, high insulin levels and belly fat co-occur)
  • Multiple sclerosis
  • Substance abuse, including alcohol abuse
  • Low testosterone levels
  • Hypertension (high blood pressure)
  • Peyronie’s disease (in which scar tissue develops inside the penis)
  • Obesity
  • Injuries or surgeries affecting the spinal cord or pelvis
  • Parkingson’s disease
  • Sleep disorders

In addition, erectile dysfunction becomes more common with age. However, not all men experience erectile dysfunction as they grow older — which is why it’s always important to pinpoint the underlying causes of the condition.

Psychological and Emotional Causes of Erectile Dysfunction

Erectile dysfunction isn’t always linked to physical causes. All sorts of emotional issues can interfere with sexual response and trigger erectile dysfunction. These include:

  • Relationship problems (with their concomitant communications issues and stress)
  • Stress from conditions at home or work
  • Anxiety, including anxiety about sexual performance
  • Depression
  • Stress stemming from deep-seated cultural or social conflicts

Treatment for Erectile Dysfunction

When you seek treatment for erectile dysfunction, your doctor will search for the causes of the condition. They’ll ask you questions about your medical history and conduct a physical exam to look for underlying physical causes involving your cardiovascular system. They’ll also ask you questions about your lifestyle — and it’s important to be absolutely honest about any use of tobacco, drugs or alcohol.

You should also plan to speak openly with your doctor about any stress in your life, as well as any depression or anxiety that you’re facing. You should also be honest about the symptoms of erectile dysfunction you’re dealing with, including issues involving your erections, ejaculation, orgasms and sexual desire. While this discussion might feel awkward, the more honest you can be, the more your doctor will be able to help you.

In general, most men don’t need a lot of medical tests to prepare for erectile dysfunction treatment. In some cases, your doctor may order blood tests to check for blood sugar or testosterone levels or an ultrasound to check blood flow in the penis.

The treatment your doctor recommends will depend on the causes of your erectile dysfunction. Lifestyle changes and psychological counseling may be sufficient to correct the problem, and a variety of medications are also available.

Lifestyle Changes

In some cases, erectile dysfunction is a result of lifestyle choices. Changing those lifestyle factors by losing weight and exercising, reducing stress, or limiting tobacco, drug or alcohol use can make a big difference. In many cases, these lifestyle changes also affect physical conditions such as heart disease or diabetes that factor into erectile dysfunction as well.


Sometimes men get into an emotional loop where anxiety, depression or fear of intimacy causes erectile dysfunction, which in turn amps up the underlying emotional issues. If any mental health issues feed into your erectile dysfunction, ask your doctor for a referral to a counselor to address them.


You have quite a few options available if you’re seeking medical treatment for erectile dysfunction. Some oral medications relax the muscles of the penis and make them more responsive, while others are administered into the penis directly. Doctors are most likely to try non-invasive medications first.

PT 141

Also known as bremelanotide, PT 141 is a peptide that increases sexual desire in both men and women. PT 141 is a melanocortin receptor agonist that you self-inject into fatty tissue with a small needle (similar to the needles used to inject insulin). It boosts libido within an hour, and its effects can last for up to 72 hours. Because it’s derived from a synthetic hormone similar to the naturally-occurring hormone that produces melanin, PT 141 also provides sunless tanning or darkening of the skin. Typical doses are around 2mg, but your doctor will prescribe the appropriate amount for your situation.

PDE5 Inhibitors: Slidenafil (Viagra) and Tadalafil (Cialis)

You’ve probably seen ads for Viagra and Cialis, two well-known erectile dysfunction medications. These drugs improve blood flow to the penis, increasing the quality of erections for about 70% of the men who take them.

While men with diabetes and cancer can take these drugs, anyone who is taking nitrates for a heart condition should avoid them.

Sildenafil, known by its brand name Viagra, blocks an enzyme that tightens muscle tissue and restricts blood flow throughout the body. It increases blood circulation, which results in a firm erection. Sildenafil is taken orally. It works within about 20 minutes and lasts for up to five hours.

Tadalafil, sold under the brand name Cialis, was originally designed to help heart disease patients. Its ability to improve blood flow to the penis soon led to its becoming a popular treatment for erectile dysfunction. It takes about 30 minutes for Tadalafil to work, and its effects can last for several days.


Alprostadil is a medication sometimes prescribed when oral medications don’t treat erectile dysfunction successfully. While this drug has an 85% success rate, it must be injected into the side of the penis or inserted into the urethra (though this second mode of application isn’t as successful as the self-injections).

Your health care provider can train you in how to administer the injections. Alprostadil results in an erection that lasts for 20 to 30 minutes, sometimes sustaining after orgasm. In rare cases, erections last for more than four hours, in which case, medical attention is needed.

Other Medications and Medical Treatments for Erectile Dysfunction

Your doctor is likely to start your medical treatment for erectile dysfunction by seeing how you respond to non-invasive methods. If these don’t work, don’t despair — you still have several options to test out. Whether any of these methods are appropriate depends largely on the cause of your erectile dysfunction. In some cases, these could be the solution for your problem:

  • Testosterone replacement therapy. While most erectile dysfunction is not the result of testosterone deficiency, low testosterone levels can cause erectile dysfunction. Blood testing is required to confirm low testosterone before this therapy can begin.
  • Vacuum erection devices. Sometimes known as penis pumps, these devices create a vacuum around the penis to draw blood into the organ, creating an erection. While these devices are safe to use and may be appropriate for men who can’t take medication, they sometimes create a sense of numbness, and men may not experience ejaculation when using them.
  • Penile implants. This surgical treatment for erectile dysfunction involves placing a semi-rigid rod or an inflatable device inside the penis. It’s particularly useful for men who have experienced scarring inside the penis as a result of Peyronie’s disease.
  • Penile vascular surgery. Men who have experienced extreme pelvic trauma may get relief for the resulting erectile dysfunction through surgery that bypasses any artery damage to the penis. However, this surgery is typically only performed on younger men and is inappropriate for older men whose arteries have started to harden.

How to Get Help With Erectile Dysfunction

Men who have been experiencing erectile dysfunction on a more than occasional basis can feel hopeful, knowing that there are many possible solutions to the problem.At Boston Vitality Center, we’re prepared to provide plenty of options, including medication, to get you back on the path you want to be on. We handle all the testing and review your medical history thoroughly to keep your health foremost in mind. Then we guide you through a full exploration of what choices are right for you, and help you formulate an appropriate, safe treatment plan.

If you’re ready to speak to a doctor and to learn what’s at the root of your erectile dysfunction, schedule a consultation today at Boston Vitality Center. Learning the causes of your erectile dysfunction is just a first step that puts you on the path toward healthier relationships, greater self-esteem and a more fulfilling sex life.

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