ED arises from combined vascular, neurologic, hormonal, medication-related, psychological, and lifestyle factors. Evaluation includes history, exam, and targeted labs; treatments range from oral PDE5 inhibitors and vacuum devices to injections, hormone therapy when indicated, and penile implants. Counseling and risk-factor management are important.
What is erectile dysfunction?
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It affects men of all ages but becomes more common with aging. Estimates of prevalence vary by study; many reports suggest rates around 40% by age 40 and up to 70% by age 70 .
How erections work - and why they can fail
An erection depends on coordinated vascular, neurologic, hormonal, and psychological processes. Blood flow into the penile corpora cavernosa must increase and be retained. Nerve signals from the spinal cord and brain trigger that process. Testosterone and other hormones influence libido and erectile function.
ED usually reflects either organic (physical) causes, psychological causes, or a combination:
- Vascular: atherosclerosis, hypertension, or smoking impair blood flow.
- Neurologic: spinal cord injury, multiple sclerosis, pelvic surgery, or nerve damage.
- Endocrine: low testosterone or uncontrolled diabetes.
- Medications: some antihypertensives, antidepressants, and others can reduce erectile function.
- Psychological: stress, anxiety, depression, or relationship problems.
- Lifestyle: obesity, heavy alcohol use, and sedentariness increase risk.
Diagnosis: what clinicians look for
Evaluation starts with a focused medical and sexual history and a physical exam. Providers routinely ask about onset, severity, nighttime erections, medications, and cardiovascular risk factors. Basic tests can include fasting glucose, lipid profile, and morning total testosterone when indicated. Specialized testing (nocturnal penile tumescence, duplex ultrasound, or nerve testing) is reserved for unclear or refractory cases.
Evidence-based treatment options
Treatment targets the underlying cause and what works best for the individual:
- Oral PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) are first-line for many men with vascular or mixed ED.
- Vacuum erection devices create a mechanical erection and are effective for many men.
- Intracavernosal injections or intraurethral prostaglandin (alprostadil) work when oral therapy fails.
- Testosterone therapy is appropriate only for men with confirmed low testosterone and symptoms.
- Penile implants (inflatable or malleable) are a durable option when less-invasive treatments fail.
- Sex therapy and cognitive behavioral approaches help when psychological or relationship factors contribute.
When to seek care
See a qualified clinician (primary care or urology) if ED is persistent, causes distress, or coincides with symptoms of heart disease or diabetes. Addressing ED can reveal and allow treatment of broader health problems, such as cardiovascular risk factors.
- Confirm prevalence figures cited ("about 40% by age 40 and up to 70% by age 70") against current population studies and sources such as the Massachusetts Male Aging Study and recent meta-analyses.
FAQs about Erectile Dysfunction
What causes erectile dysfunction?
How is ED diagnosed?
What are the most common treatments?
Are ED medications safe?
When should I see a doctor about ED?
News about Erectile Dysfunction
Black market medications warning as millions of pills seized - BBC [Visit Site | Read More]
Beyond Viagra: What erectile dysfunction reveals about men’s health - Daily Nation [Visit Site | Read More]
Boots launches the UK’s first rapidly dissolving oral film to help treat erectile dysfunction - boots-uk.com [Visit Site | Read More]
Country-Singing Canary Spreads Message About Erectile Dysfunction for Numan - Little Black Book | LBBOnline [Visit Site | Read More]
Radical treatment offers hope for erectile dysfunction - The Hereford Times [Visit Site | Read More]
Enhancing penile function: the impact of a regenerative multimodal protocol on erectile dysfunction - Frontiers [Visit Site | Read More]
Record number of men having pioneering 'bionic willy' surgery on the NHS to beat erectile problems - The Sun [Visit Site | Read More]