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Erectile Dysfunction: Symptoms, Causes, Diagnosis, and Treatment

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Erectile Dysfunction (ED) is a common form of sexual dysfunction among men or people Assigned Males at Birth (AMAB). 

ED, or impotence, is the inability to get or maintain an erection for sexual activity.

ED can harm both sexual activity and quality of life.

The likelihood of developing ED increases with age. The NIDDK states that around 30 million individuals in the United States suffer from ED. 

This article covers the causes, symptoms, and treatment of Erectile Dysfunction in depth.

Erectile Dysfunction symptoms

Erectile Dysfunction affects penile erections. Some common symptoms of ED include:

  • Trouble achieving an erection 
  • Being able to achieve erections but having trouble maintaining it
  • Being able to achieve erections alone but not during sex

Some other related symptoms and conditions that may occur as a side effect of ED include:

Aside from affecting your sex life, ED can also affect your self-esteem. It can cause stress, Depression, and distress in your relationship. 

You should consult a doctor if you notice any of the above Erectile Dysfunction symptoms. 

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  • Erectile Dysfunction causes

    Multiple factors can contribute to Erectile Dysfunction. The causes of ED can be physical, like Diabetes, Obesity, and Hypertension, or psychological, like stress and Anxiety.

    To understand the causes of Erectile Dysfunction, let us first discuss how erections work.

    How do erections work

    An erection starts with sensory and mental stimulation in the brain. Your penis receives messages from your brain through the nerves.

    The nerve messengers cause the muscles in the penile tissues to relax. 

    This increases blood flow through the penile arteries, filling two chambers within the penis.

    As blood fills the chambers, the penis becomes rigid. The penile veins constrict to keep blood in the penis and maintain the erection.

    An erection gets over when the muscles in the blood vessels contract and stop the blood flow.

    Erectile Dysfunction can occur due to an issue in the erection process. It can happen if there is a lack of blood flow to the penis. 

    Read the article to find out how long does an erection last normally.

    Physical causes of ED

    Diabetes - Physical causes of EDSource: pixelshot
    Checking diabetes level

    Erectile Dysfunction can develop due to several physical factors. As healthy blood flow is essential for an erection, an issue in the blood vessels can lead to ED. 

    Some factors that can affect the blood vessels and lead to ED are:

    • Diabetes
    • Hypertension
    • Atherosclerosis
    • Smoking
    • Pelvic trauma 

    Erections occur when the nerve messengers stimulate the penile tissues. An issue in the nervous system can interrupt the erection process.

    Some factors that can impair the nervous system and cause ED include:

    • Spinal cord injury
    • Prostate or bladder surgery
    • Multiple sclerosis
    • Epilepsy

    ED can also occur due to hormonal imbalance. Some conditions associated with hormonal changes can contribute to ED:

    Psychological causes of ED

    Anxiety - cause of EDSource: Antonio_Diaz _from_Getty_Images
    Anxiety (cause of ED)

    Erectile Dysfunction doesn’t always have a physical cause. It can also occur due to psychological reasons.

    • Anxiety, which could be general or sex-specific
    • Fear of being inadequate at sexual performance
    • Sex-related stress or chronic stress due to other factors
    • Feeling guilty over engaging in sexual activity
    • Major depressive disorder and other mood disorders
    Epilepsy: A nerve disorder that causes multiple seizures.
    Atherosclerosis:The narrowing and hardening of arteries due to gradual plaque buildup.
    Multiple sclerosis: A disease that impairs the central nervous system.

    Situational causes

    There isn’t always an underlying cause for ED. In certain circumstances, a man can experience unexpected difficulties getting erections. 

    This might occur as a result of psychological reasons such as stress and performance anxiety. However, it can also occur as a result of other circumstances.

    Some factors that can contribute to temporary cases of Erectile Dysfunction include:

    Are you seeking clarity on the duration of temporary ED in men? Read this article: How Long Does Temporary Erectile Dysfunction Last In Men.

    Types of ED

    Erectile Dysfunction is usually categorized into two types: Organic and Psychogenic. While the symptoms of both types are similar, they differ in cause, severity, and treatment. 

    As discussed above, ED can develop due to several underlying causes. Depending on the cause, you may have one of the following types of ED:

    Organic ED

    This type of ED occurs due to physical factors like vascular disease, hormonal imbalances, neurological disorders, and penile trauma. Organic ED consists of three subtypes:

    • Arteriogenic ED occurs due to insufficient blood supply in the arteries
    • Neurogenic ED occurs due to an impairment in the nerves that stimulate erections
    • Endocrinologic ED happens due to a hormonal imbalance that affects erections

    Organic ED may be long-term and severe. It can also be a warning sign for potential health risks. 

    Psychogenic ED

    Psychogenic ED, or Psychological ED, is the inability to achieve and maintain erections due to psychological factors. These factors include Anxiety, Depression, stress, and relationship problems. 

    Psychogenic ED may be long-term or temporary, severe or mild. As mental and psychological problems are unreliable, so is this type of ED. 

    Diagnosis of Erectile Dysfunction

    The diagnosis of ED involves many stages, including a physical examination and a health history review. 

    Your doctor may prescribe certain Erectile Dysfunction tests to determine the underlying causes.

    Physical examination: Involves thoroughly examining your testicles and penis to check your nerves for sensation. 
    Blood tests: Your doctor may conduct a blood test to examine for heart disease and other physical causes of ED.
    Urine tests: Urine tests help check for signs of Diabetes and other underlying conditions.
    Ultrasound: The test helps detect signs of problems with blood flow. It is often combined with an injection into the penis to increase blood flow and cause an erection.
    Psychological exam: Your doctor may ask you questions to rule out the psychological causes of ED.

    Do not self-diagnose ED. Erectile Dysfunction can occur due to several underlying causes. It can also be a warning sign for certain heart conditions. Visit a doctor if you experience symptoms of ED.

    Erectile Dysfunction treatment

    Erectile Dysfunction can be a frustrating condition that can interrupt your sex life. But there are several ways to manage it. 

    Your doctor will check your symptoms and potential causes to determine the appropriate Erectile Dysfunction treatment.

    They may prescribe ED medicines, suggest therapy, or recommend other treatment approaches for your needs. 


    The standard first-line treatment for Erectile Dysfunction is an oral Phosphodiesterase-5 (PDE5) inhibitor. 

    These medications work by inhibiting the enzyme PDE5 to increase blood flow to the penis. It increases the ability to get erections during sexual stimulation. 

    Currently, the FDA has approved a few medicines for treating ED. These include:

    These Erectile Dysfunction pills are only available with a prescription. Before prescribing, a doctor may check your medical history to rule out heart diseases and drug interactions. 

    All PDE5 inhibitors work similarly but differ in onset and duration of action. They are available in a range of doses. 

    Your healthcare provider may help determine which medication is best suited for your needs. 

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  • Psychological treatment

    Couple counseling sessionSource: Helgy
    Counseling session

    If your Erectile Dysfunction has a psychological cause, you may need to try different treatment approaches.

    You may need to try sex therapy, counseling, or cognitive-behavioral therapy (CBT). 

    Sex therapy: It is a type of counseling that helps people overcome sexual troubles. According to certain studies, sex therapy may help treat psychological ED.
    Counseling: If ED occurs due to Anxiety or Depression, seeking therapy or psychological counseling may help. 
    Cognitive-behavioral therapy (CBT): It involves learning ways to change behavior and mental patterns. Combining it with sex therapy may treat Erectile Dysfunction.

    Vacuum erection devices

    Vacuum erection devices are a mechanical approach to getting erections if the medication doesn’t work.

    It is a plastic tube that slips and seals around the penis. A pump at the opposite end of the tube creates a low-pressure vacuum around the erectile tissue, causing an erection. 

    An elastic ring preserves the blood in the penis for 30 minutes. A vacuum erection device can work for 75 percent of men with instructions.

    Read this article to know the best vacuum devices: What is the Best Vacuum Device For Erectile Dysfunction

    Surgical treatment

    Surgical treatment is typically a last resort for ED. It is only necessary when no other treatment is effective. ED surgical procedures fall into two categories:

    Penis implant. It is a device implanted by a urologist to help keep the penis erect.
    Surgery. A urologist performs surgery to reconstruct arteries to improve blood circulation to the penis.


    Quit smokingSource: stock_colors_from_Getty_Images
    Avoid smoking

    Certain lifestyle modifications may help reduce the risk, whether you have ED or are looking for ways to prevent it. 

    Changing your behavior to help improve vascular health and reduce inflammation can help prevent ED. 

    Some lifestyle adjustments that can help prevent Erectile Dysfunction include:

    • Adopt a healthful eating regimen
    • Get help to quit smoking 
    • Stop drinking
    • Manage weight to avoid Diabetes and Hypertension.
    • Maintain erectile health by doing ED exercises
    • Refrain from illegal substance use

    Erectile Dysfunction — the bottom line

    Having Erectile Dysfunction can be frustrating, and it may be challenging to talk about it. But ED is more common than you realize. 

    If you experience ED symptoms, consult a doctor for a diagnosis. Erection problems can arise due to various factors. A doctor will help determine the underlying cause of your ED. 

    Treating ED is possible, and so is having a rich, satisfying sex life. Taking quick action and consulting a doctor can help you overcome challenges in your sex life. 

    Frequently Asked Questions

    Is Erectile Dysfunction permanent?

    ED is only sometimes permanent. In some cases, it can be reversible. A five-year study in the Journal of Sexual Medicine revealed a remission rate of 29 percent.

    How can I improve my Erectile Dysfunction?

    There are several ways to improve Erectile Dysfunction symptoms. Adopting a healthy lifestyle, which includes physical activity and a nutritious diet, may help. 
    Avoid smoking and consuming alcohol, as these might amplify the effects of ED. In addition, medications or counseling may help address the problem.

    How to know if you have Erectile Dysfunction?

    You may visit a doctor to get a diagnosis for ED if you experience symptoms. People with ED experience trouble achieving or maintaining an erection during sex. 
    A medical professional will help determine if you have ED by conducting blood tests or physical examinations. 

    Is Erectile Dysfunction 100% curable?

    Erectile Dysfunction may or may not be 100% curable. The likelihood of reversing ED depends on the cause. 
    If it is possible to cure the underlying cause, it may be possible to cure ED. Even if your ED is not curable, it is possible to control symptoms.

    Can you get ED in your 20s?

    Erectile Dysfunction can sometimes affect young males in their 20s. Some estimates indicate that 8% of males in their 20s and 11% in their 30s suffer from ED. 

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    Photo of author Janet Fudge
    Janet Fudge is a highly skilled and experienced pharmacologist who serves as a contributing writer for With a strong academic background from a premier US University and a passion for helping others, Janet has become a trusted voice in the pharmaceutical world. After completing her Doctor of Pharmacy degree, Janet embarked on a successful career in the pharmaceutical industry, working with various clients, including hospitals, retail pharmacies, and drug manufacturers. Her in-depth knowledge of pharmacology and dedication to patient-centered care has led her to excel in her field. As a writer for, Janet uses her wealth of expertise to provide readers with accurate, reliable, and up-to-date information on various topics related to medicine and healthcare. Her engaging writing style and ability to break down complex topics into easily digestible content make her a valuable resource for healthcare professionals and the general public.
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