Did you know it’s possible that erectile dysfunction—ED for short—could affect as many as around 8 million men in the UK alonen? That’s quite a big number, so we think it’s time to remove the shame from the conversation around erectile dysfunction. Sadly, there are many men who see it as it’s a personal failure, but truth is ED is a medical condition, understanding it and why it happens can bring you one step closer to treating it—and most of the time, it can be treated.
Although the symptoms of ED seem straightforward to recognise, when it comes to the causes, diagnosis and treatment, it’ll vary from man to man. So, read on to learn all about what erectile dysfunction is, what causes erectile dysfunction, and what you can do to treat it.
Diagnosing the Causes of Erectile Dysfunction
Erectile Dysfunction Treatment
Preventing Erectile Dysfunction
Frequently Asked Questions About Erectile Dysfunction
What Is Erectile Dysfunction?
Erectile dysfunction is when you cannot get an erection or maintain an erection for long enough to have sexo.
When you get aroused, your nerves release chemicals that encourage blood flow to the penis. Inside the penis are two erection chambers known as the corpus cavernosum, which are made of a spongy muscle that relaxes during an erection and traps the blood. When the blood pressure builds up in these chambers, it firms up the penis to cause an erection. Following an orgasm, another set of nerve signals sends a message to the penis to relax the muscular tissues, contract, and release blood back into the circulation, causing the erection to go awayp.
No matter the cause of erectile dysfunction, when you have ED, this arousal mechanism is interrupted.
How Common Is It?
In the UK alone, erectile dysfunction could affect as many as around 8 million menn. Not only are there millions of men worldwide with erectile dysfunction, but one studyq estimated that this number will go up. The study estimated that in 1995, there were over 152 million men across the globe with erectile dysfunction and projected this number to increase to 322 million in 2025. Although the topic is considered taboo to talk about, it’s more common than you might think. While there is a correlation between erectile dysfunction and age, there have been several studies that have found that young men also showed an exceptionally high prevalence of erectile dysfunctionr.
Erectile Dysfunction Causes
Several causes can lead to erectile dysfunction. Your body’s vascular, nervous, and endocrine systems can all contribute to ED. Although there is a link between age and erectile dysfunction, it can affect men of any ages. Let’s look into what causes erectile dysfunction.
Physical Causes
Erectile dysfunction can arise due to physical diseases and medical conditions, such ass:
- Type 2 diabetes
- High blood pressure
- Diseases affecting the heart and blood vessels, among others, atherosclerosis
- Chronic kidney disease
- Multiple sclerosis
- Peyronie’s disease
- Injury occurred during prostate cancer treatment, such as radiation therapy or prostate surgery
- Injuries to the penis, spinal cord, prostate, bladder, or pelvis
- Bladder cancer surgery.
Psychological or Emotional Causes
If the above list has you concerned about erectile dysfunction, then don’t panic. It’s also possible that ED arises due to psychological or emotional issues. For young men (those aged under 40), these issues tend to be the main cause of EDr.
The psychological and emotional causes of ED includes:
- Fear of sexual failure
- Anxiety
- Depression
- Stress—can be general stress in life or stress about sexual performance
- Low self-esteem
- Guilt about sexual performance or certain sexual activities.
Health-Related Factors and Behaviours
There are also some health-related factors and behaviours that can contribute to erectile dysfunction, such as:s
- Smoking
- Drinking too much alcohol
- Using illegal drugs
- Being overweight
- Not being physically active.
Erectile Dysfunction Symptoms
The symptoms of erectile dysfunction includes:
- You can’t get an erection.
- You can’t maintain an erection for long enough for sex.
Although the above are symptoms of erectile dysfunction, having erectile dysfunction can also be a symptom of another health condition or a factor related to your health.
Diagnosing the Causes of Erectile Dysfunction
If you have symptoms of ED, then you may want to see your GP or go to a sexual health clinic to get a diagnosis for the cause and seek appropriate treatment.
Your doctor or nurse mayo,t:
- Ask you about your relationships and lifestyle to see if you have any other problems.
- Ask you about your medical and sexual history.
- Run a few basic health checks, like checking your blood pressure and pulse in the wrist or ankles for poor circulation.
- Examine your genitals to see if there are any obvious physical causes, for example, whether the penis lacks sensitivity.
- May refer you for a prostate examination if you have symptoms like peeing more than often.
You may have to undergo further testing, especially if you are referred to a specialist like a urologist. Possible tests for erectile dysfunction may includet:
- Lab tests. Such as blood tests to check for possible causes of erectile dysfunction like diabetes, chronic kidney disease, hormonal problems, and atherosclerosis.
- Imaging tests. These tests are used to detect poor blood flow through the penis using ultrasound.
- Nocturnal erection test. For this test, you’d need to wear a plastic ring-like device which measures whether you have erections at night while you sleep.
- Injection test. A healthcare professional will give a penile injection with medication (or via the urethra), which will cause an erection to evaluate how erect your penis gets and how long you maintain an erection.
Erectile Dysfunction Treatments
Should your doctor diagnose you with erectile dysfunction, there are numerous treatments that can help your condition. Let’s have a look at the treatment options available from lifestyle changes to medication and more.a
Treating Any Underlying Causes
If you have ED, your doctor will want to rule out any possible causes. This is why in your first appointment, your doctor will investigate your medication, medical history, and give you a medical check-up. Your doctor is more likely to begin treatment byo:
- Switching you to a different medication if your current medication could cause erectile dysfunction.
- Treat issues like high blood pressure, high cholesterol, or hormone problems with appropriate medication.
- Offer some recommendations for lifestyle changes that could help.
- Refer you to a councillor or therapist if mental health issues could be the root of your erectile dysfunction.
Lifestyle Changes
In many cases, erectile dysfunction can be improved by making some changes to your lifestyle, such asu:
- Reaching a healthy weight
- Quitting smoking
- Reducing alcohol consumption
- Stopping any illegal drug consumption
- Taking up regular exercise
- Reducing stress.
Treating Any Psychological Causes
If you are younger (under 40) and have no known health issues, it’s possible your ED may have a psychological root cause. Conditions like depression or anxiety can lead to erectile dysfunction, and psychological treatment can helpu. However, it’s still important to get it checked out by a doctor first, just to be sure there is no physical cause that needs treating.
The most common types of psychological treatments for ED include:u
- Sensate focus. This is a type of sex therapy involves a mutual agreement with your partner to not having sex for a period of time, but exploring each other’s bodies, except for the genitals and breasts, without the expectation of sex. Over time, you can build up intimacy, eventually leading to penetrative sex.
- Psychosexual counselling. This type of therapy allows you and your partner to discuss any issues, like anxiety around erectile dysfunction, with a psychosexual counsellor. Your therapist may also provide you with practical advice, like how to make use of other treatments to help your sex life.
-
Cognitive behavioural therapy (CBT). CBT may help if you identify unhelpful or unrealistic thoughts that contribute to anxiety or depression in general or even towards specific issues that may cause erectile dysfunction, like your self-esteem, sexuality, or personal relationships.
ED Medications
Your doctor may prescribe or recommend medication to help with erectile dysfunction. In fact, oral PDE-5 inhibitors (short for type-5 phosphodiesterase inhibitors) are usually the first in line for the treatment of erectile dysfunction, regardless of the cause. PDE-5 medications help increase blood flow to the penis and the main types of medication used to treat erectile dysfunction includeo:
- Tadalafil
- Sildenafil
- Vardenafil
- Avanafil
However, only sildenafil and tadalafil are available over the counter in UK pharmacies. Tadalafil which is the active ingredient in Cialis Together®, which has been trusted by 84 million men worldwide for over 20 years. Cialis Together® can also be purchased online if you prefer to buy it privately. All you need to do is fill out a few questions to ensure that it’s suitable for you.
Vacuum Devices
If you cannot take medication for ED, then vacuum devices may be an option.b This is a plastic tube that is placed onto the penis along with a detachable elastic ring. The pump creates a vacuum which helps pull blood into the penis, and the ring is moved to the base of the penis to help maintain the erection by preventing the blood from flowing back to the body.c Although it’s best you talk to your doctor about this option, and vacuum pumps are not always available on the NHS.d
Alternative Treatments
Some men like to turn to alternative and complementary therapy. These can includeu,v:
- Acupuncture
- Vitamin or mineral supplements
- Pelvic floor exercises.
However, talk to your doctor if you are considering any of these, especially if you are trying any supplements, as they can interfere with any medications you are taking or have any other side effects.e
Surgical Treatments
As a last resort, some men may need surgery. Surgery is performed by a urologist and there are two types of surgeryv:
- An implanted device in the penis to cause an erection
- Artery reconstruction to increase the blood flow to the penis.
Preventing Erectile Dysfunction
There are some preventative measures you can take to improve your overall health and lifestyle factors that can cause erectile dysfunction, such asw:
- Quit smoking. Smoking can cause heart and blood vessel damage.
- Follow a healthy eating plan. A healthy diet can help control your weight and blood pressure and prevent diabetes.
- Maintain a healthy weight. There is some connection between obesity and erectile dysfunction, as diabetes and high blood pressure are some of the main causes of ED, so keeping or getting your weight in a healthy range can help prevent these.
- Physical activity helps get your blood pumping around the body, including your penis, but talk to a doctor if you are new to exercise.
- Avoid illegal drugs. Some illegal drug can affect your ability to get or keep an erection.
When to Call a Doctor
If you have had erectile dysfunction for more than a few weeks or your problem keeps reoccurring, see your doctor to get it checked out, as it could be a symptom of an underlying condition.f
Frequently Asked Questions About Erectile Dysfunction
- What Is the Best Way to Fix Erectile Dysfunction?
There is no one way to cure erectile dysfunction as it can have several underlying causes, from those that are physical or medical to psychological ones, or even a combination of both.
- Is Erectile Dysfunction Curable?
Almost all cases of erectile dysfunction can be treated, so it’s not just something you have to live with. In fact, most treatments—particularly lifestyle changes and psychological treatment—can help you live a healthier and happier life in the long run.g
- What Are the Causes of Erectile Dysfunction in Your 20s and 30s?
Although ED tends to affect men over 40, more and more men under 40 report having issues with erectile dysfunction. The causes of erectile dysfunction in men can arise for different reasons, like psychological issues, such as depression or anxiety, or relationship issues, but may also be caused by physical symptoms like cardiovascular risk even in seemingly healthy young men.x
- Does ED Affect Sperm?
Having erectile dysfunction does not necessarily mean you have a low sperm count or are infertile, but it’s important to note that the same conditions can cause both male infertility and erectile dysfunction or have overlapping risk factors.h
Erectile dysfunction may be easy to diagnose, but its causes and treatments are more complex and individual. As we have seen, men of all ages can get ED for numerous reasons. As the pressures and stresses of modern life add up, more men are prone to getting ED, so we must keep the conversation open. Erectile dysfunction, in most cases, can be overcome, so there is no need to suffer in silence and shame. If you are having difficulties getting or maintaining an erection, talk to your healthcare professional to find out what is causing it so you can get the treatment you need and live a healthy and happy life.
MAT-XU-2401151 (v1.0) September 2024
Sources
a https://academic.oup.com/pmj/article/93/1105/679/6984456
b https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
c https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
d https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
e https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence#treating-erectile-dysfunction
f https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence
g https://www.yalemedicine.org/conditions/erectile-dysfunction
h https://www.medicalnewstoday.com/articles/does-erectile-dysfunction-affect-sperm-count
n Estimated from the Office for National Statistics (ONS) 2021 UK population data and Irrational quantitative survey 2021, where 3,445 (i.e. 34%) of 10,197 adult men qualified or identified as suffering from Erectile Dysfunction.
o National Health Service, August 26, 2020, (Accessed July 2023), https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
p Urology Care Foundation, June 2018, (Accessed July 2023), https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed)
q Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999 Jul;84(1):50-6. doi: 10.1046/j.1464-410x.1999.00142.x. PMID: 10444124.
r Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU Int. 2019 Oct;124(4):587-599. doi: 10.1111/bju.14813. Epub 2019 Jul 2. PMID: 31267639.
s National Institute of Diabetes and Digestive and Kidney Diseases, July 2017, (Accessed July 2023), https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
t National Institute of Diabetes and Digestive and Kidney Diseases, August 2022, (Accessed July 2023), https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis.
u NHS Inform, February 10, 2023, (Accessed July 2023), https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence
v National Institute of Diabetes and Digestive and Kidney Diseases, August 2022, (Accessed July 2023), https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
w National Institute of Diabetes and Digestive and Kidney Diseases, August 2022, (Accessed July 2023), https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/prevention
x Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. 2017 Feb;6(1):79-90. doi: 10.21037/tau.2016.09.06. PMID: 28217453; PMCID: PMC5313296.