Erectile dysfunction (ED) is a common sexual problem that affects millions of men worldwide. It is a condition in which a man has difficulty achieving or maintaining an erection during sexual activity.
ED can be a source of embarrassment and frustration for many men and can have a negative impact on their self-esteem and relationships. While ED is often associated with aging, it can affect men of all ages. In this article, we will explore what causes erectile dysfunction, including both physical and psychological factors.
If someone is experiencing symptoms of erectile dysfunction, it is important to talk to your GP first. ED can be a symptom of an underlying health condition, and in some cases, it can be a sign of a more serious medical problem such as cardiovascular disease, diabetes, or hormonal imbalances.
Understanding the underlying causes of ED is the first step towards finding an effective treatment and improving sexual function and overall quality of life.
Symptoms Of ED
Men with erectile dysfunction may find it challenging to get an erection, or they may have trouble keeping an erection long enough to complete sexual intercourse.
The symptoms may include:
#1. Reduced sexual desire or libido
#2. Difficulty achieving orgasm or delayed ejaculation
#3. Psychological symptoms such as depression, anxiety, or stress
#4. Problems with confidence or self-esteem, especially related to sexual performance
Low Libido
Low libido, also known as low sex drive, refers to a decrease in sexual desire or interest in sexual activity.
It can manifest in different ways, depending on the individual. Some men may experience a lack of interest in sexual activity altogether, while others may have difficulty achieving or maintaining an erection during sexual activity.
A study [1] published in the National Library of Medicine found that the prevalence of low sexual desire increased from 15% in men aged 40-49 to 34% in men aged 60-69.
This is not necessarily surprising, as a variety of physical and psychological changes can occur as men get older that may impact sexual function.
For example, changes in hormone levels, particularly a decrease in testosterone, can lead to a decrease in sexual desire. Additionally, chronic health conditions such as heart disease and diabetes, which are more common in older adults, can also contribute to low sexual desire.
And last, but not least, drinking excess amounts of alcohol and drugs misuse may also be linked to a loss of libido.
Delayed Ejaculation
Delayed ejaculation refers to a difficulty or delay in reaching orgasm or ejaculation during sexual activity, even though the person is aroused and willing to ejaculate.
It may take longer than usual, or in some cases, it may not happen at all. It is also sometimes referred to as “retarded ejaculation” or “impaired ejaculation.”
Physical causes of delayed ejaculation may include certain medications, such as antidepressants, antipsychotics, or blood pressure medications. Psychological and emotional factors can also play a role in delayed ejaculation.
These may include anxiety, depression, relationship problems, past sexual trauma or abuse, or negative attitudes towards sex.
Communication is key here: talking openly and honestly with a partner about delayed ejaculation can help to reduce anxiety and build intimacy. It can also be helpful to seek support from a healthcare provider or sexual therapist.
Depression, Anxiety & Stress
All 3 are the symptoms of erectile dysfunction (ED), as the experience of ED can cause emotional distress and psychological symptoms.
Depression can be a symptom of ED because it can lead to decreased sexual desire and interest, as well as decreased pleasure during sexual activity. Research has shown that men with depression are more likely to experience ED than those without depression.
Anxiety can also be a symptom of ED because the fear of not being able to perform sexually can cause anxiety and even panic attacks. Anxiety can also lead to muscle tension, which can impede blood flow to the penis and reduce the firmness of the erection. Studies have shown that anxiety is a significant risk factor for ED.
Stress can also be a symptom of ED because the frustration and disappointment caused by ED can lead to feelings of stress and even anger. Chronic stress can also lead to a reduction in testosterone levels, which can affect sexual desire and function.
It is important to note that depression, anxiety, and stress can also cause ED, as they can contribute to the development of the condition by affecting various physical and psychological processes involved in sexual arousal and performance.
Low Self-Esteem
Low self-esteem can have a significant impact on sexual relationships. Men with ED may avoid sexual encounters or withdraw from intimacy in order to avoid the possibility of failure. This can create tension and conflict in the relationship, as their partner may interpret their behavior as rejection or disinterest.
Conversely, partners may also struggle to support their loved one with ED. They may feel rejected or unattractive themselves, and may blame themselves for their partner’s inability to achieve an erection. This can lead to feelings of frustration, anger, and disappointment, which can further exacerbate the problem.
It is important for partners to communicate openly and honestly about their feelings and concerns regarding ED. This can help to reduce tension and improve understanding and empathy between partners.
What Causes Erectile Dysfunction
(Footage Courtesy Of Mayo Clinic)
Erectile dysfunction (ED) is a complex condition that can be caused by a variety of physical, psychological, and lifestyle factors. In many cases, ED is caused by a combination of factors rather than a single cause.
Physical causes of ED include cardiovascular disease, diabetes, hormonal imbalances, neurological disorders, Peyronie’s disease, obesity, tobacco and alcohol abuse, and the side effects of certain medications. Stress, anxiety, depression, and relationship issues are also responsible for impotence.
Lifestyle factors such as smoking, alcohol and drug use, obesity, and lack of exercise can also increase the risk of developing this disorder.
High Blood Pressure & High Cholesterol
High blood pressure and high cholesterol are both potential causes of erectile dysfunction (ED).
Hypertension can damage the blood vessels that supply blood to the penis, making it difficult to achieve or maintain an erection.
Cholesterol levels of 7+, on the other hand, can cause a buildup of plaque in the blood vessels, which can also interfere with blood flow to the penis.
There is a growing body of research that supports the link between high blood pressure, high cholesterol, and ED. A study [2] published in the Journal of Sexual Medicine found that men with hypertension were more likely to experience ED than those without hypertension, and that the severity of the ED was linked to the severity of the hypertension.
Similarly, another research [3] found that men with high cholesterol were more likely to experience ED than those with normal cholesterol levels.
These findings suggest that managing high blood pressure and high cholesterol can be an important part of treating ED. Lifestyle changes such as improving diet, increasing exercise, and quitting smoking can help lower blood pressure and cholesterol levels. In some cases, medication may also be needed to control blood pressure and cholesterol.
Diabetes
During their lifetime, it is estimated that a considerable proportion of men with diabetes, ranging from 35% to 75%, will experience erectile dysfunction or impotence.
Men who have diabetes usually experience erectile dysfunction 10 to 15 years earlier than their counterparts without diabetes. Moreover, as men with diabetes age, the occurrence of erectile dysfunction becomes increasingly prevalent.
In fact, when men with diabetes surpass the age of 50, the likelihood of experiencing difficulty in attaining and maintaining an erection reaches approximately 50% to 60%. In those who exceed the age of 70, there is a staggering 95% likelihood of encountering some level of erectile dysfunction.
The development of erectile dysfunction in men with diabetes is multifactorial and includes dysfunctions in nerve, blood vessel, and muscle function.
For men to achieve an erection, they require a healthy vascular system, functional nerves, adequate male hormones, and a sexual stimulus.
Diabetes can cause damage to the nerves and blood vessels that regulate erection, leading to difficulty in achieving a firm erection even when male hormones are present, and sexual desire is intact. But can erectile dysfunction caused by diabetes be reversed?
Men who experience difficulty in attaining and/or sustaining an erection due to diabetes can opt for oral medications such as avanafil (Stendra), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), and vardenafil (Levitra, Staxyn).
Trying out male enhancement pills like Male Extra is also a good catch but please make sure you always consult your doctor before taking any new over-the-counter supplement.
Hormone Imbalances
If you’re wondering if hormone imbalances could cause erectile dysfunction (ED), then the answer is a solid YES!
In the review article “Testosterone therapy in erectile dysfunction and hypogonadism,” the authors suggest that low testosterone levels can contribute to ED by reducing libido and impairing penile blood flow.
They explain that testosterone plays a crucial role in regulating sexual desire and the production of nitric oxide, which is essential for penile blood flow and the relaxation of smooth muscle cells in the corpus cavernosum.
Neurological Disorders
Neurological erectile dysfunction (ED) occurs when there is a disruption or damage to the nerves involved in the sexual response pathway. This pathway involves the brain, spinal cord, and peripheral nerves that control blood flow to the penis and the ability to achieve and maintain an erection.
Neurological ED can result from a variety of conditions that affect the nervous system, including spinal cord injuries, multiple sclerosis, Parkinson’s disease, and stroke.
The nervous system appears to play a critical role in the sexual response pathway, and any disruption to this system can result in ED. For example, spinal cord injuries can disrupt the nerves that control blood flow to the penis, making it difficult to achieve an erection.
Multiple sclerosis can cause damage to the myelin sheath that protects nerves, resulting in nerve damage and ED. Parkinson’s disease can cause tremors and muscle rigidity that can also interfere with sexual function.
Treatment for neurological ED depends on the underlying cause and severity of the disorder. Medications, such as phosphodiesterase type 5 (PDE5) inhibitors, may be effective for some men with neurological ED.
In more severe cases, penile implants or other surgical interventions may be necessary to achieve an erection. Working with a healthcare provider or specialist, such as a urologist or neurologist, is essential for proper diagnosis and treatment of neurological ED.
Peyronie’s Disease
Peyronie’s disease is a disorder in which the penis develops a curve or bend during an erection. The bend is caused by a build-up of fibrous scar tissue within the penis. This scar tissue can be painful and cause difficulty with sexual intercourse.
The exact cause of Peyronie’s disease is not known, but it is thought to be related to an injury or trauma to the penis. Other risk factors may include genetic factors, aging, and certain medical conditions such as diabetes and high blood pressure.
The symptoms of Peyronie’s disease can vary, but typically include pain during an erection, curvature or bending of the penis, and difficulty achieving or maintaining an erection. Some men may also experience depression or anxiety related to their sexual function.
Treatment options for Peyronie’s disease may include medication, such as collagenase injections or oral therapies, or surgery to remove or reposition the scar tissue. In some cases, a penis extender or traction device may be used to straighten the penis.
Side Effects Of Medications
There are many medications that can contribute to erectile dysfunction (ED) as a side effect. These medications may affect the nerves, blood flow, or hormones involved in achieving an erection. Some examples include:
#1. Antidepressants: Some antidepressants can cause sexual side effects such as ED, decreased libido, or delayed ejaculation.
#2. Blood pressure medications: Certain blood pressure medications (e.g. thiazide diuretics, loop diuretics, and beta-blockers) can affect blood flow to the penis, making it difficult to achieve or maintain an erection.
#3. Hormone medications: Certain hormone medications used for prostate cancer treatment can decrease testosterone levels and cause ED.
#4. Antihistamines: Some antihistamines can cause ED as a side effect.
#5. Opioid pain medications: Opioid pain medications can affect the production of testosterone and contribute to ED.
#6. Chemotherapy drugs: Some chemotherapy drugs can cause nerve damage or hormonal changes that may lead to ED.
#7. Anti-anxiety medications: Some anti-anxiety medications can cause sexual side effects such as ED.
It is important to never stop taking medication without consulting with your healthcare provider first, as it could have serious consequences for your overall health.
Obesity
Can losing weight help with erectile dysfunction?
Yes, losing weight can help with erectile dysfunction (ED) in some cases.
Obesity and being overweight can increase the risk of developing ED because it can lead to the development of conditions that affect blood flow and nerve function, such as diabetes and high blood pressure. In addition, excess weight can cause hormonal imbalances that may contribute to ED.
Losing weight through a healthy diet and regular exercises can improve overall cardiovascular health as well increase insulin sensitivity and hormone levels, which can further improve sexual function.
Several studies [4, 5, 6] have shown that losing weight can improve erectile function in overweight and obese men with ED. In one study, men who lost an average of 33 pounds over two years saw significant improvements in their ED symptoms.
Tobacco And Alcohol Abuse
While there is limited research on the long-term effects of nicotine use on erectile function, it is possible that chronic nicotine use can contribute to the development of permanent ED.
Nicotine is a vasoconstrictor, which means it can narrow blood vessels and reduce blood flow to the penis. Reduced blood flow to the penis can make it difficult to achieve or maintain an erection. Nicotine can also damage nerves and affect nerve function, which can further contribute to impotence.
Long-Term Effects
The link between alcohol consumption and erectile dysfunction (ED) is well established. Alcohol can have both short-term and long-term effects on sexual function, including ED. Here’s some of them:
Decreased testosterone levels: Alcohol consumption can decrease testosterone levels, which is an important hormone for sexual function. Lower testosterone levels can lead to decreased libido and difficulty achieving and maintaining an erection.
Nervous system and blood vessel damage: Chronic alcohol consumption can damage the nervous system and blood vessels, which are crucial for the physiological processes involved in sexual function. Reduced nerve function can lead to decreased sensitivity in the genital area, while damaged blood vessels can decrease blood flow to the penis, making it difficult to achieve or maintain an erection.
Psychological factors: Alcohol consumption can increase anxiety and depression, which can also contribute to ED. Additionally, alcohol use can impair judgment and decision-making, which can lead to engaging in risky sexual behavior and potentially contributing to impotence.
Medication interactions: Alcohol can interact with certain medications used to treat ED, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), making them less effective.
How To Fix Erectile Dysfunction
So we’ve come to the point where fixing erectile dysfunction is possible for most men, thanks to the various treatment options available.
With advancements in medical science and technology, men who suffer from ED can now choose from a range of effective therapies that can help them overcome this disorder and improve their sexual health and well-being.
While ED can be a challenging condition to deal with, it is important to remember that there are also many natural remedies that can help you manage and even overcome it.
What Is The Best Natural Remedy Alternative For Erectile Dysfunction?
Diet
A balanced diet can help maintain sexual function and decrease the risk of ED by improving overall health and reducing the risk of conditions that can contribute to it, such as diabetes, high blood pressure, and heart disease.
Foods that are rich in nutrients such as zinc, vitamin E, and L-arginine, can also help improve blood flow and erection.
Other than that, to keep your sexual health up you may need to consume more leafy greens, whole grains, nuts, and fish. In addition, it is important to limit consumption of processed and high-fat foods, as these can contribute to the development of conditions that can increase the risk of ED.
Physical Activity
Physical activity may be particularly effective if obesity, inactivity, or cardiovascular disease, among other conditions, contribute to your ED. These conditions can interfere with blood flow and overall cardiovascular health, which are important for sexual function.
Exercise can help improve blood flow, reduce inflammation, and promote the release of hormones and chemicals that can improve your sexual health.
For example, a study published in the journal Sexual Medicine found that men with ED who participated in a 12-week exercise program, consisting of aerobic and resistance training for only 40 minutes a day, experienced significant improvements in erectile function and overall sexual satisfaction, as well as a reduction in body mass index and blood pressure.
Sleep
Several studies have shown that working nonstandard shifts, such as night shifts or rotating shifts, can disrupt the body’s natural circadian rhythm and negatively impact sleep quality. Poor sleep quality has been associated with a range of negative health outcomes, including hypogonadal symptoms and sexual dysfunction.
One study published in the Journal of Sexual Medicine found that male shift workers had a higher prevalence of erectile dysfunction compared to male day workers. Another study published in the International Journal of Endocrinology found that poor sleep quality was associated with lower testosterone levels in male shift workers.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is perhaps one of the most useful forms of therapy for addressing ED, particularly for men who experience anxiety or psychological factors that contribute to their impotence.
CBT aims to change negative patterns of thought and behavior that can interfere with sexual function and intimacy. In the case of ED, CBT can help men identify and challenge negative beliefs about their sexual performance, reduce anxiety related to sexual activity, and improve communication with their partner.
Several studies [7] have shown that CBT can be effective in treating ED. For example, a systematic review and meta-analysis of 16 randomized controlled trials found that CBT was associated with significant improvements in erectile function and sexual satisfaction compared to control groups. Another study published in the Journal of Sexual Medicine found that a CBT-based program was associated with improvements in erectile function, sexual desire, and overall sexual satisfaction in men with the disorder.
It’s important to note that CBT may NOT be effective for all men who suffer from ED and that other treatment options, such as medication or vacuum erection devices, may be necessary for some individuals.
However, CBT can be a valuable tool for addressing the psychological factors that contribute to ED and improving overall sexual functioning and satisfaction.
Shockwave Therapy
Shockwave therapy is a non-invasive treatment for erectile dysfunction (ED) that uses low-intensity sound waves to improve blood flow to the penis. The therapy works by improving blood flow to the penis, promoting the growth of new blood vessels, and increasing the release of growth factors that improve tissue health.
The device used in shockwave therapy is typically a handheld device that delivers the sound waves through a small probe or applicator. The probe is placed on the skin of the penis and moved around to deliver the sound waves to different areas. The device is designed to deliver precise and controlled energy to the penile tissue, ensuring that the sound waves are focused on the area of the penis that requires treatment.
Shockwave therapy typically involves several treatment sessions, with each session lasting between 15 and 30 minutes. The number of sessions required can vary depending on the severity of the ED and the individual’s response to treatment. Most men require between 6 and 12 sessions to achieve optimal results.
Stop Watching Porn
The availability of unlimited pornography is an enormous social phenomenon that has yet to be fully understood in terms of its long-term effects.
While some researchers suggest that pornography use can be associated with negative effects on relationships and sexual function, others argue that these effects are not well-established and that more research is needed to determine the true impact of pornography on individuals and society as a whole.
One concern about unlimited porn is that it may contribute to a normalization of sexual behaviors that were once considered taboo or deviant, potentially leading to more extreme or risky sexual behaviors. Additionally, there are concerns that excessive pornography use could lead to addiction, decreased sexual satisfaction, and decreased sensitivity to sexual stimuli.
According to a study [8] by Canadian researchers, sexual difficulties were reported by 53.5% of males between the ages of 16 and 21. Among those surveyed, 27% reported experiencing erectile dysfunction, 24% had difficulty achieving orgasm, and 10% reported low sexual desire. All of them watched porn.
A comprehensive study [9] conducted between 2001 and 2002, which examined thousands of European men between 40 and 80, found that approximately 13% experienced erectile dysfunction (ED). However, in 2011, when the same survey was conducted on men between the ages of 18 and 40, the rates of ED among this group ranged from 14% to 28%, representing a 600-1300% increase compared to a decade earlier. These findings demonstrate how prevalent sexual problems have become, with pornography being the most likely contributing factor.
Life Without Porn
Our sexual drive can be a significant motivator for achieving goals. However, excessive pornography use can deplete this energy and diminish our drive to pursue real-life sexual partners and achievements. This may happen because our primal urges are satisfied through pornography use, and our DNA may interpret this as having already achieved sexual success, leading to a reduced drive to pursue further goals.
Giving up pornography can have a transformative effect on your life. When you quit watching porn, your brain is no longer flooded with artificial dopamine hits, which allows you to see your situation more clearly and objectively. The dopamine spikes that occur when watching porn can reduce your motivation and make it less likely for you to engage in the difficult work required to achieve long-term success.
After quitting pornography, you will quickly become engrossed in working towards real goals. By stopping the overstimulation of your brain with pornography, you will experience a heightened sensitivity to dopamine. This, in turn, will increase your enthusiasm and goal-oriented behavior, creating a stronger desire to achieve something significant.
Final Verdict
In conclusion, I’d like to say that dealing with erectile dysfunction can be a challenging experience, but it’s important to remember that there are many remedies and treatments available to address this disorder.
Whether you choose to seek out professional medical interventions or explore natural alternatives, there is no shame in taking action to improve your sexual health and well-being. Remember that you are not alone in this, and there are countless other men who have faced similar challenges and have gone on to regain a fulfilling and satisfying sex life.
So, if you’re struggling with erectile dysfunction, don’t be afraid to seek out support and guidance from your healthcare provider or a trusted therapist. With their help and your own commitment to making positive changes, you can identify the underlying cause of your erectile dysfunction and find a solution that works for you.
Remember that this is a TREATABLE condition, and there is no reason to let it hold you back from living a happy and fulfilling life. Take action today and embrace the many opportunities available to regain control over your sexual health and well-being.
References
- K Shigehara, Y Kato, M Iijima, et al. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido. Sex Med 2021;9:100426.
- Wang, Y., Tian, Y., Yao, Z., et al. (2017). The association between hypertension and erectile dysfunction: A systematic review and meta-analysis. Journal of Sexual Medicine, 14(12), 1597-1607. doi: 10.1016/j.jsxm.2017.10.075.
- Corona, G., Rastrelli, G., Burri, A., et al. (2014). Metabolic syndrome and erectile dysfunction: A meta-analysis of observational studies. Journal of Sexual Medicine, 11(8), 1913-1928. doi: 10.1111/jsm.12604.
- Esposito, K., Giugliano, F., Di Palo, C., Giugliano, G., Marfella, R., D’Andrea, F., … & Giugliano, D. (2004). Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. Jama, 291(24), 2978-2984.
- Wing, R. R., Rosen, R. C., Fava, J. L., Bahnson, J., Brancati, F., Gendrano III, I. N., … & Kitabchi, A. E. (2010). Effects of weight loss intervention on erectile function in older men with type 2 diabetes in the Look AHEAD trial. Journal of Sexual Medicine, 7(1pt1), 156-165.
- Reis, L. O., Favaro, W. J., Barreiro, G. C., de Oliveira, L. C., & Chaim, E. A. (2011). Erectile dysfunction and hormonal imbalance in morbidly obese male is reversed after gastric bypass surgery: a prospective randomized controlled trial. International journal of andrology, 34(3), 225-232
- Bilal A, Abbasi NuH. Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study. J Sex Med 2020;8:396–407.
- O’Sullivan, Lucia, L. Brotto, E. Byers, J. Majerovich, J. Wuest. “Prevalence and Characteristics of Sexual Functioning Among Sexually Experienced Middle to Late Adolescents.” The Journal of Sexual Medicine 11, no. 3 (2014): 630–41.
- Park, B. Y., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., Klam, W. P., & Doan, A. P. (2016). Is internet pornography causing sexual dysfunctions? A review with clinical reports. Behavioral Sciences, 6(3), 17
