Published Aug 29, 2023

Everything you need to know about erectile dysfunction (ED)

Jake Bissaro
Written by
Jake Bissaro
Dr. Sudip Bose
Medically reviewed by
Dr. Sudip Bose
Happy couple enjoying life together in the city in winter
Published Aug 29, 2023

Erectile dysfunction (ED) can negatively affect your sex life, relationship, and how you see yourself. This common condition is often treatable with the proper medication. So if you’re suffering from ED, you’re not alone.

Here, we look at the science behind and possible causes of ED. Plus, how you can get erectile dysfunction treatment online with a little (discreet) help from Dr. B.

What is erectile dysfunction in medical terms?

Erectile dysfunction—also called impotence—is a common form of sexual dysfunction for people who have penises. It’s characterized by the inability to achieve or maintain an erection firm enough for sexual intercourse. Lost sensitivity from erectile dysfunction can happen, too.

Occasional trouble getting an erection is typical. But if the problem progresses or occurs regularly, it could be ED.

What causes erectile dysfunction?

Sexual arousal is a complicated process where hormones, muscles, emotions and brain activity must work together to complete a complex series of actions.

Here’s how erections pop up.

  • First, mental stimulation in the brain triggers nerves in the penis to relax.
  • This allows blood to flow in and fill the openings in the spongy tissue. 
  • Increased blood pressure in the corpora cavernosa chambers expands the penis, creating an erection. 
  • The erection is sustained with help from the tunica albuginea membrane, which traps the blood in the corpora cavernosa.

ED can occur suddenly or gradually. And any physiological or psychological conditions that hinders one of the above can become a cause of ED.

ED is more common as men age. One study from the 1990s found that the prevalence of men with ED increases from 5% to 15% between 40-70. But the condition isn’t considered a natural part of the aging process—and ED’s most common causes aren’t directly related to age.

What are some medical causes of ED?

Some medical conditions can damage blood vessels, narrow arteries and affect blood sugar. Any of these can have a negative impact and cause erectile dysfunction.

Illnesses that can contribute to ED include:

  • Type 2 diabetes
  • High blood pressure (hypertension)
  • Heart disease
  • Multiple sclerosis (MS)
  • Chronic kidney disease
  • Prostate cancer treatments like radiation therapy, prostate surgery or hormone therapy
  • Lifestyle choices like smoking and heavy alcohol consumption
  • Use of substances like heroin, cocaine, barbiturates or amphetamines

A consultation with a medical provider can help you identify what may be causing your ED. If the root cause isn’t clear, they may refer you to a specialist to help further diagnose your condition.

What are some psychological causes of ED?

Sometimes, a downshift in your mental health can cause ED. This includes any extra stress, depression or anxiety. The causes of erectile dysfunction in your 20s are often psychological. But these can affect anyone at any age.

Treatment methods—like therapy, couples counseling, deep breathing exercises or medication—may address ED’s psychological factors.

Can Covid-19 cause erectile dysfunction?

Research is limited. But there’s some evidence that Covid-19 infections may increase the risk of erectile dysfunction. That’s because these Covid-related health conditions may affect the arousal process.

Covid-19-related ED conditions include:

  • Endothelial dysfunction: A condition that causes the blood vessels to narrow, increasing the risk of high blood pressure and cardiovascular disease.
  • Impaired pulmonary hemodynamics: Damage to the body’s ability to move blood through the lungs.
  • Hypogonadism: The inability to produce enough testosterone. (ED is a common side effect).

The best way to reduce Covid-related ED is to avoid a severe Covid-19 case. Follow the CDC's guidelines, including staying current on vaccines, getting tested and masking in public places. Here’s more about the link between ED and Covid-19.

Is erectile dysfunction common?

Erectile dysfunction is very common—and becomes more likely with age. One review estimated that the condition affects one-third of all people with penises. Another estimated the prevalence to be as high as 52%.

What does erectile dysfunction feel like?

People with erectile dysfunction cannot maintain an erection that lasts long enough for sex—and may not be able to achieve an erection at all. The penis often becomes flaccid before completing sexual activity with a partner or self-ejaculation.

Erectile dysfunction can lead to feelings of sadness, frustration, anger or diminished masculinity. In severe cases, it can trigger depression or anxiety disorders.

How do I know if I've got erectile dysfunction?

If you consistently have trouble maintaining or achieving an erection that is sufficient for sex, it may be erectile dysfunction. ED is a complex issue, and it’s usually best to get help when diagnosing the root cause. The first step is to speak with a licensed medical provider.

They may perform these tests:

  • Overnight erection test. A device is wrapped around the penis to monitor if an erection happens overnight. (Penises usually rise 3-5 times nightly.)
  • Blood test. A blood test can determine if ED is caused by a hormonal imbalance.
  • Ultrasound. A technician holds a transducer over the penis, which uses sound waves to check blood flow. 
  • Injection test. Sometimes performed with an ultrasound, a doctor injects an erection-inducing medicine into the base of the penis. 

Can I fix my erectile dysfunction?

Though it’s not always easy, addressing lifestyle factors that cause ED can usually improve the condition.

For hormonal imbalances, mental health issues and cholesterol, the proper support often improves ED. For cases unrelated to a specific lifestyle or medical issue, prescription ED treatments are very effective at improving or reversing ED.

The most common prescription ED medications include:

  • Tadalafil (Cialis)
  • Sildenafil (Viagra)
  • Avanafil (Stendra)
  • Vardenafil

These erectile dysfunction prescription medications belong to a class of drugs called phosphodiesterase 5 (PDE-5) inhibitors. They work by promoting blood flow in the penis. They’re available in pill form and are usually taken before sex. Each medication is different. So follow your medical provider’s prescription instructions carefully.

Many over-the-counter herbal remedies also claim to improve or cure ED. These products haven’t been subjected to the same rigorous safety standards as prescription medications. And they may interfere with other treatments or health conditions. So you should only try them under the guidance of a medical provider.

Herbal remedies for treating ED include:

  • Rhodiola Rosea, or “golden root”
  • Ginseng
  • Horny goat weed
  • Arginine

It’s best to be wary of any product claiming to be an herbal Viagra. These are rarely as effective as approved medications. And they may even contain harmful ingredients.

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Online treatment for erectile dysfunction

Intimacy doesn't require an erection. Many couples still have satisfying sex lives even if ED isn’t successfully treated.

But accessing an online ED doctor has never been more convenient. Start a discreet $15 consultation for erectile dysfunction pills online. We’ll connect you with a licensed provider who will review your health history and treatment options. If they recommend a medication like Cialis or Viagra online, they’ll send the prescription to the pharmacy of your choice.

Here’s more on the process of how + where to get ED medication. If ready to get your love life back on track, get started today.

Sources:

Centers for Disease Control and Prevention. (2022). How to protect yourself and others.

Feldman, H. A., et al. (1994). Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study34871-1). The Journal of Urology.

Gerbild, H., et al. (2018). Physical activity to improve erectile function: A systematic review of intervention studies. Sexual Medicine.

Sansone, A., et al. (2021). Addressing male sexual and reproductive health in the wake of Covid-19 outbreak. Journal of Endocrinological Investigation.

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