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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Sexology Erectile Dysfunction

Erectile Dysfunction

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An erection problem is the inability to get or maintain an erection that is firm enough for a man to have intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction. Erection problems are common in adult men and almost all men are affected by it sometime or the other. Any difficulty in having or keeping an erection more than 25% of the time, it is considered a problem.


What causes erectile dysfunction (ED)?

  • Damage to nerves, arteries, smooth muscles, and fibrous tissues often as a result of disease is the most common cause of ED

  • Diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease can cause ED. Almost 50 percent of men with diabetes may have erectile dysfunction.

  • Surgery (prostate and bladder surgery) or injury to the penis, spinal cord, prostate, bladder, and pelvis

  • Hormonal abnormalities

  • Medicines used for treating blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine an ulcer drug can lead to ED as a side effect 

  • Being overweight and lack of exercise are possible causes  


Psychological factors that can lead to erectile dysfunction

  • Stress related to work or family issues
  • Anxiety associated with sex because of a prior bad experience
  • Anger or frustration with partner
  • Inability to communicate openly with your partner

  • Feeling that your partner has negative feelings for you


Self-care tips 

  • Reduce smoking, alcohol, and drugs

  • Lose excess weight

  • Exercise and take a healthy diet

  • Talk it out with your partner. Communicate your anxiety related to your sexual performance or resolve any anger or conflict before you make love


When to approach a doctor? 

  • You continue to experience erection problem in spite of taking the self-care measures listed above
  • You think that a medicine that you are taking could be causing the problem

  • The problems begin after an injury or prostate surgery.

  • You have other symptoms such as low back pain or abdominal pain


 How is erectile dysfunction treated?

  • The treatment of erectile dysfunction depends on the underlying cause.

  • Some men benefit from making lifestyle changes such as quitting smoking, losing excess weight, and increasing physical activity

  • Stopping or changing a medicine may be enough if erectile dysfunction is occurring solely as a side effect of the medication

  • Psychological counseling is helpful if erectile dysfunction is associated with anxiety

  • Medicines for treating erection problems include pills, injections into the penis, and pellets inserted in the urethra

  • Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are used to treat mild to moderate cases. There is a false notion that they boost sexual performance even in men without erection problems. These medicines should not be used without consulting a doctor as they can have serious side effects. When taken along with some blood pressure medicines (nitroglycerine/ alpha-blockers), they can cause a dangerous fall in blood pressure, which in certain instances may be fatal.

  • If pills do not help, your doctor may suggest an injection or a testosterone patch. Many men who do not benefit from pills respond to injections or pellets inserted into the urethra.

  • In cases that do not respond to above mentioned therapies, vacuum devices or implants may be required. Implants can restore erection in many men with erectile dysfunction.