A Guide to Erectile Dysfunction: Causes, Symptoms & Treatments

A Guide to Erectile Dysfunction

Erectile dysfunction (ED) is the inability of a man to achieve or maintain an erection sufficient to insert the penis into the vagina and have satisfactory sexual intercourse. Common sexual dysfunctions such as decreased sex drive, premature ejaculation, and infertility are not considered erectile dysfunction. This disorder significantly affects the life of most men suffering from it.


Erectile dysfunction symptoms

Erectile disorders are often the result of other pathologies, i.e. these are the first symptoms of a serious illness that begins, so you should immediately contact the doctor. The doctor will find out the causes of the disorder and tell you which specialist to contact in order to solve the problem once and for all.

Alarming signs indicating the initial stages of ED in adult men are:

  • periodic or regular lack of an erection in the midst of sexual intercourse;
  • premature ejaculation;
  • lack of orgasm;
  • lack of ejaculation;
  • lack of erection, despite obvious arousal;
  • a sharp decrease in libido;
  • inability to have sexual intercourse with a partner;
  • regular preference of masturbation to physiological sex.

Erectile dysfunction tests

The first doctor to be visited by a man with such complaints is the andrologist. The specialist will conduct an examination, collect anamnesis, and, if necessary, send you for consultations with other doctors (urologist, sexologist, venereologist) and a set of diagnostic tests. To identify the causes of erectile dysfunction, you will be sent for:

  • psychotherapeutic testing;
  • screening for sexually transmitted infections;
  • general clinical examination of blood and urine;
  • assessment of the prostate secretion;
  • ultrasound examinations;
  • dopplerography;
  • cavernosography;
  • magnetic resonance and computed tomography of the pelvic organs, central parts of the nervous system.

The list of studies may differ in different clinical situations.

What causes erectile dysfunction?

A man’s sexual health depends on many conditions:

  • proper functioning of the endocrine system;
  • psychological health;
  • satisfactory state of micro- and macrocirculation;
  • anatomical features of the genital organ structure;
  • neurological health.

The impact of negative factors inevitably affects a man’s sex life. Causes of erectile dysfunction include drug addiction, alcohol dependence, psychopathology, diabetes mellitus and gonadal insufficiency. Anatomical abnormalities are also a common cause – Peyronie’s disease, fibrous deposits and sclerotic changes in the corpora cavernosa of the penis. In some cases, spinal pathologies, polyneuropathy and cerebrovascular accidents lead to sexual disorders.

However, modern medical practice shows that the main cause of erectile dysfunction is an unsatisfactory condition of the vessels supplying the penis. The provocateurs of this process are atherosclerotic lesions, hypertension and diabetic microangiopathy. Therefore, a patient with ED must have a comprehensive examination to identify the root cause.

Although erectile dysfunction and age are linked (the disorder becomes more common with age), it should not be considered a normal sign of aging. Older men are more likely to develop ED, as they are more likely to develop diseases that affect the blood vessels. Many old couples practice having sexual intercourse without achieving an erection or having intercourse; such couples sometimes choose not to seek special treatment. However, ED treatment may be appropriate for older men as well.

Besides, ED can be caused by some medications:

  • blockers of beta-adrenergic receptors: atenolol, bisoprolol, metoprolol, etc.;
  • angiotensin-converting enzyme inhibitors: ramipril, trandolapril, etc.;
  • angiotensin II receptor antagonists: losartan, valsartan, etc.;
  • sleeping pills – zolpidem;
  • anti-inflammatory drugs – valdecoxib;
  • statins: atorvastatin;
  • antihistamines – loratadine.

But beta-adrenergic receptor blockers cause impotence most often.

Scared? Do not worry. The frequency of its occurrence is very low – about 1-2%.

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Besides, you need to know what blood pressure medication does not cause erectile dysfunction:

  • alpha-blockers like doxazosin, prazosin, and terazosin;
  • calcium channel blockers like amlodipine, diltiazem, verapamil, and nifedipine;
  • ACE inhibitors like lisinopril, benazepril, enalapril, ramipril, quinapril, and ramipril;
  • ARBs like losartan, irbesartan, and valsartan.

And if you start noticing alarming symptoms, then be sure to inform your doctor right away in order to adjust the treatment.

Erectile dysfunction treatment options

ED treatment

The success of therapy mainly depends on the correct determination of the etiology of the disorder. If it’s a psychogenic problem, sexual health and activity can be restored with the help of consultations with a specialist. Unfortunately, the same cannot be said about severe organic disorders associated with surgical treatment or even removal of the prostate gland. However, in any case, qualified medical care is needed, which will stop the progression of the disease and prevent irreversible consequences.

Shock wave therapy (SWT)

Shockwave therapy consists of noninvasive low-intensity sound waves that pass through erectile tissue, restoring normal blood supply. In the treatment of erectile dysfunction, a tangible positive result is observed after 1-3 sessions.

Such therapy is aimed directly at the cause of the pathology, therefore, it does not just eliminate the symptoms. Completing the full course provides a long-lasting and lasting effect even without pharmacological support. In some cases, shock wave therapy can prevent surgery. The method is painless and does not cause negative consequences.

Watch a video explaining how shockwave therapy works for ED:

Magnetic laser therapy (MLT)

Double exposure to the magnetic field and laser radiation allows to increase the penetration depth of the pulses. MLT increases the effectiveness of medications, eliminates pain in the urethra and the external genital area, and significantly improves the quality of erection. The treatment is painless and comfortable. In case of surface irradiation, the patient is provided with special glasses for eye protection.

Ozone therapy

Ozone therapy is a harmless and simple technique that allows you to get a good result. The procedure consists in the intravenous administration of a physiological solution saturated with an oxygen-ozone mixture. Its concentration is determined by the doctor. One dropper is placed for 30 minutes. As a result of the course of ozone therapy (5-15 procedures):

  • disease-causing fungi, bacteria, viruses are destroyed;
  • the blood is saturated with oxygen;
  • vascular lumen expands;
  • inflammation is removed;
  • metabolic processes are accelerated;
  • immunity is strengthened.

Prostate massage

Therapeutic massage of the prostate gland is performed by a urologist to normalize blood flow to this organ. This eliminates the lack of oxygen and nutrients in the tissues. Additionally, this treatment option helps achieve a free out-flow of prostate secretion, removal of congestion, reduction of inflammation and an increase in the effect of medicinal preparations.

Erectile dysfunction drugs

Today, doctors practice a stepwise approach in the treatment of ED, which involves the sequential application of therapeutic methods. Drug therapy begins with phosphodiesterase type 5 inhibitors – PDE-5 inhibitors (alternatives to vacuum erectors and shock wave therapy). Then the treatment may be supplemented by intracavernous injections and falloprosthesis. A change in the stage of treatment is made when it is ineffective or unacceptable for the patient.

PDE-5 inhibitors dilate the blood vessels of the penis, making it possible to have an erection even in men with serious circulatory disorders. Currently, bestsellers among erectile dysfunction medications include:

  • Viagra (sildenafil);
  • Cialis (tadalafil);
  • Levitra (vardenafil);
  • Stendra (avanafil).

Testosterone preparations may be effective for organic erectile dysfunction (in the absence of contraindications for testosterone therapy). Forms of release are various: injection, transdermal patches, testosterone gel.

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The drug, its dose, administration regimen and course duration are selected individually. Many erectile dysfunction drugs are available over the counter. There are also their generic versions that have the same composition and efficiency but are much cheaper.

If oral drugs do not improve the patient’s condition, intracavernous injections of vasoactive drugs can be used. There are several drugs for administration directly into the corpus cavernosum of the penis. These are prostaglandin E1, phentolamine, papaverine. After selecting the required amount of the drug, the patient is transferred to the autoinjection. The recommended frequency is no more than three times a week.

Which erectile dysfunction drug is best?

Viagra, Cialis, Levitra are considered the best medications for ED. It’s impossible to select the number 1 medicine for this disorder as the best remedy is selected by a doctor in accordance with the patient’s age, the severity of symptoms, concomitant diseases, body features, etc.

  1. Viagra is the leader in the ranking of ED drugs. Almost all men who take this medicine experience maximum pleasure in the process of intercourse. The active ingredient of the drug is sildenafil, which starts working 30 minutes after intake. This substance normalizes the natural processes of the male body. To get a stable and hard erection, a man must be sexually aroused. After intercourse, an erection disappears naturally, and the penis returns to its normal state. According to the research results, Viagra lasts about 5 hours. Contraindications for use are diabetes mellitus, high blood pressure, heart disease. In any case, you should consult a doctor before taking the pills;
  2. Cialis is an ED drug with the longest action – up to 36 hours. The active ingredient of the drug is tadalafil. During this period, a man can have up to 15 erections. In developed countries, there is the following tactics for prescribing Cialis: small dosages of the substance (5-10 mg) are taken daily. Thanks to this approach, a man can have sex and receive maximum satisfaction from it at any time. In addition, the main component of the drug has a beneficial effect on blood circulation and the treatment of BPH. You need to take 1 tablet about 1 hour before sexual intercourse. During this time, the drug has time to dissolve and start working. When the tablet is taken on an empty stomach, the absorption period of the substance is significantly reduced. Sometimes these time intervals are influenced by the individual characteristics of the organism;
  3. Levitra is the safest drug for erectile dysfunction. The product eliminates ED without side effects. The active ingredient of the medicine is vardenafil. It starts working 30 minutes after intake and lasts for about 5 hours. Levitra should not be combined with similar medications. There are contraindications for use. Before treatment, you should consult your doctor.

This chart compares the top 3 erectile dysfunction (ED) drugs currently on the market: Viagra, Levitra, Cialis:

ED drugs comparison chart

How to cure erectile dysfunction at home?

Many patients wonder how to cure erectile dysfunction naturally and permanently at home. In fact, one can improve potency not only with medication but also with natural remedies at home. Traditional methods are quite effective and can be used by all men in the early stages of ED. There are herbs and foods that have proven their effectiveness more than 3 thousand years ago and are successfully used by traditional healers.

Natural ED treatment methods that improve male potency can be divided into 4 groups.

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Herbs that increase male potency

  • Ginseng has been used to treat impotence since ancient times. The best treatment option is the root of this plant, which, unfortunately, is not available to everyone. Currently, the pharmacy ginseng tincture is used in the morning and during the day at the same dosage;
  • St. John’s wort. An infusion of St. John’s wort can increase blood circulation in the pelvic organs. To prepare the tincture, you will need 2 tablespoons of the herb and a glass of boiling water. The prepared infusion must be taken in 3 doses for 1 day;
  • Aloe. Aloe juice with honey, prepared in a 1: 5 ratio, can effectively improve potency. Treatment should be continued for 1-1.5 months, take 1 tablespoon of the mixture 3-4 times a day;
  • Green tea. An alcoholic infusion of green tea leaves (30 g) and sugar (150 g) is kept at a temperature of +5 +6 degrees in the refrigerator for one week. Take 1 tablespoon in the morning and at bedtime, with a sufficient amount of liquid.

Foods that boost male libido

Diet therapy always improves potency in men and remains effective at any age.

These products include:

  • meat;
  • fish (especially flounder and mackerel);
  • red caviar;
  • seafood (mussels, shrimps);
  • dairy products (cream, sour cream, cottage cheese);
  • mushrooms, chicken eggs;
  • vegetables (onions, turnips, carrots, tomatoes, lemons);
  • fruits (avocados, bananas, pineapples, figs, dates, strawberries);
  • nuts are perhaps the most effective dietary supplement that significantly enhances potency. These are walnuts, hazelnuts, peanuts, pistachios;
  • spices (black pepper, paprika, horseradish, ginger root, cardamom, chili).

Natural supplements that boost testosterone levels

Popular natural supplements for erectile dysfunction are:

  • dehydroepiandrosterone (DHEA);
  • L-arginine;
  • ginseng;
  • propionyl L-carnitine;
  • yohimbe;
  • ginkgo;
  • epimedia;
  • zinc.

Erectile dysfunction exercises

There are special exercises for men that will improve male potency and quality of sex. You can train in an office chair, behind the wheel, in an elevator, and even on a couch. For example, Kegel exercises help you achieve a stable erection, get rid of erectile dysfunction and premature ejaculation.

Such exercises are also prescribed for men who have been treated for prostate cancer to restore sexual function.

This video helps you choose the best exercises for ED if you’re a beginner:

With regular exercise, the result will become evident within 3–6 weeks: problems with urinary incontinence will decrease or disappear altogether, and the quality of sex will significantly improve.

A 2015 study found that aerobic exercise of any kind is also an effective way to prevent and combat erectile dysfunction. So walk, run and squat.

How to prevent ED?

ED prevention

It is impossible to guarantee that you will never face this trouble: unfortunately, no one is safe from multiple sclerosis or serious injuries. But it is quite possible to reduce the risks.

Doctors say that the most effective way to prevent erectile dysfunction is a healthy lifestyle:

  1. Move more. It strengthens the cardiovascular system;
  2. Follow healthy eating habits. Try to eat vegetables, fruits, cereals, meat, fermented milk products every day. And avoid foods that are high in saturated and trans fats, such as fast food or store baked goods;
  3. Monitor your weight. It is desirable that the body mass index (BMI) does not exceed 24.9;
  4. Give up bad habits. Try to quit smoking and limit alcohol consumption;
  5. Learn to control stress;
  6. Regularly undergo preventive examinations with a therapist and health care specialists. This will help you detect high cholesterol levels or prediabetes in the early stages;
  7. Get medical treatment if necessary. Diagnosed diseases require therapy. Do not postpone it: every day it becomes more difficult to defeat the disease.