A Primer on Erectile Dysfunction

by Arthur Evans

There can be two different but connected meanings for the term erectile dysfunction (ED). In a general sense, erectile dysfunction means the incapability to attain or keep an erection apt for sexual intercourse. The inability to achieve a suitable erection can have multiple causes; however, healthcare providers formally call it ED if another underlying disorder does not trigger it.


  • Erectile dysfunction (ED), formerly called impotence, is a widespread problem that affects millions of men.
  • A physical examination is often not a necessity to diagnose ED.
  • When other medical conditions cause ED, an in-person test may be required.
  • There are numerous tests to realize the source of erectile dysfunction, and it can be adequately treated.

Erections are complicated things, and they involve several systems in your body, including your brain, nerves, and blood vessels. There can be two different ways in which erections arise. They can be prompted mentally as a reaction to things an individual with a penis smells, hears, sees, or imagines. Or they can crop up mechanically after a physical stimulus.

Whichever way it happens, the body subsequently undergoes a sequence of reactions. Without considering all of them, as they are rather complex, the outcome is that additional blood gushes into the penis, although the overflow is condensed. As the penis becomes hard, an erection is made.

Anything that obstructs this system of stimulation and erection can instigate ED. The causes can be physical or psychological, varying from hypertension to performance apprehension and beyond.

The most important risk factor for ED is age because, in general, testosterone diminishes, and risks for other disorders influencing ED increase as we grow old. Data indicate that more than half of men between 40 and 70 have gone through ED. Numerous lifestyle options, including smoking, obesity, using alcohol or illicit drugs, can also augment this risk.  

It is essential to determine the cause of ED because it might indicate a more significant health issue. An ailment can cause the patient to be unaware of having, such as diabetes, cardiovascular disease, and several others.

ED can be caused by other medical conditions that comprise high blood pressure, low testosterone, benign prostatic hyperplasia (BPH). In several cases, ED could be merely the side effect of some medications. In the United States, some of the most frequently prescribed medications include ED as a possible side effect.

The root cause of ED can be physical or psychological. Studies suggest that ED and depression can be part of the cause for each other. Men who suffer from depression are likely to get ED by 39% times more than those who do not, and men having ED are nearly three times more prone to get depression.

Testing for erectile dysfunction

A Primer on Erectile Dysfunction

As it could be a symptom of a more severe medical condition, you should consult a physician if you are undergoing any sexual dysfunction. Multiple tests are available to help your physician diagnose ED and find out the root cause, if there is any. It can be performed with no in-person visit in numerous cases, for example, online through telemedicine.

Firstly, they would like to know your entire medical history to understand if there is any apparent reason, like a drug you are taking. The following are some of the familiar kinds of prescription drugs that are reported to trigger ED:

  • Psychiatric medications like antidepressants
  • Antihistamines
  • Parkinson’s disease medications
  • Hormonal medicines
  • Painkillers, particularly opiates
  • High blood pressure medications
  • Diuretics 
  • Chemotherapy

Your physician will be looking to talk about your sexual history and sexual interest. You should be truthful with them regarding recreational drug usage and habits like smoking, which can affect ED. You will possibly deal with a trouble-free questionnaire known as the International Index of Erectile Function (IIEF).

The version of five questions (IIEF-5) requires you to rank some erection-related subjects. These comprise the frequency of your ability to get erections, the trouble of keeping them, and how frequently the erections were firm enough for penetration. A lengthy version of fifteen-questions (IIEF-15) goes pressing, demanding facts like libido, frequency of ejaculation, and the relationship you have with your sexual partner.

At this instant, in multiple cases, they can make a diagnosis of ED and prescribe appropriate treatment. This could be a medication accompanied by lifestyle changes if needed. In case the medicines are not working, or if your physician thinks that your ED arises from another condition, they may want to carry out additional tests to make out the cause.

Treatment options

A Primer on Erectile Dysfunction

Fortunately, ED is very much curable. Usually, if there is no apparent underlying disorder, the first phase would include medications known as phosphodiesterase type 5 (PDE5) inhibitors. These comprise sildenafil with brand name Viagra, vardenafil with brand name Levitra, tadalafil with brand name Cialis, and avanafil with brand name Stendra. Doctors may also suggest lifestyle changes.

In case an underlying disorder is detected, you must treat that, and with a bit of luck, the ED will disappear. In some instances, doctors may prescribe PDE5 inhibitors as a makeshift measure, during which they look forward to taking effect of the treatment for the underlying disorder.

There are more choices for patients who do not react to PDE5 inhibitors or cannot receive them. One method incorporates self-administered injections put into the urethra. 

Individuals who realize injections to be painful may care about a vacuum constrictor device (VCD) as an alternative. These act by “forcing” an erection, applying a vacuum pump to draw blood into the penis before the outflow is cut off with an elastic ring located around the base. Besides, the best solution could be a surgically implanted prosthesis for persons for whom the above methods do not work.

Erectile dysfunction is a delicate topic for lots of people. You may be reserved in talking to your doctor about it. If you belong to a particular age group, they may initiate the topic with you. Keep in mind, it’s not pretty much what’s happening down there. 

Your capability to get and keep an erection relates to several other systems in your body. Hence, it could be a sign of a very severe problem. But fortunately, several straightforward tests can be performed to ascertain your ED and get you going a healthy way to have a better feeling. 

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