What is Erectile Dysfunction?
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse.
It’s not uncommon and many men experience it during times of stress, hello Covid-19, and so from time to time it isn’t necessarily a cause for concern! Frequent ED, however, can cause stress, affect your self-confidence and often contribute to relationship problems.
More men believe themselves to have ED, when they are actually anxious about their sexual performance. Under enormous social pressure to be smooth sexual performers, they are mistakenly self-diagnosing with ED after a few failed attempts to have sex. If you look at the rise of easily accessible pornography, people have an expectation that men are going to be great performers. This causes performance anxiety.
It can however also be a sign of health problems that need treatment or a sign of emotional or relationship difficulties that may need to be addressed by a professional.
So let’s get back to basics and understand how it all works.
What Causes an Erection ?
An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.
When a man is sexually excited, muscles in the penis relax. This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. As the chambers fill with blood, the penis grows rigid.
Male sexual arousal is a complex process that shouldn’t be underestimated! It involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
An erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.
What Causes Dysfunction?
“Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction”
Erectile dysfunction can be caused by several different factors and they can include both emotional and physical (or a combination) of factors. Common causes include:
stress
anxiety
depression
relationship problems
cardiovascular disease
certain prescription medications, such as those used to treat high blood pressure or depression (antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions)
diabetes
hypertension, or high blood pressure
high cholesterol
being overweight; especially if you're obese, by damaging the blood vessels, decreasing testosterone and causing a state of generalized inflammation in the body
low testosterone levels or other hormone imbalances
kidney disease
increased age
sleep disorders
drug use
consuming too much alcohol
using tobacco products; which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS)
damage to the pelvic area through injury or surgery
Peyronie’s disease, which causes scar tissue to develop in the penis
Erectile dysfunction can be a result of any one of these factors or by several.
Psychological causes of Erectile Dysfunction.
As we said, male arousal and erectile function is a complex process and the brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
Depression, anxiety or other mental health conditions
Stress
Relationship problems due to stress, poor communication or other concerns
How is it diagnosed?
A physical exam and medical history are usually all that's needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.
Tests for underlying conditions might include:
Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
Psychological exam. To screen for depression and other possible psychological causes of erectile dysfunction.
Blood tests. To check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
Urine tests (urinalysis). To look for signs of diabetes and other underlying health conditions.
Ultrasound. This test is usually performed by a specialist urologist in the clinic. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis. This creates a video image to let your doctor see if you have blood flow problems.
What can I do?
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:
“See your doctor for regular checkups and medical screening tests. Don’t be afraid to reach out to your doctor for support.”
Take steps to reduce stress.
Get help for anxiety, depression or other mental health concerns.
Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
Stop smoking, limit or avoid alcohol, and don't use illegal drugs.
Exercise regularly.
See your doctor for regular checkups and medical screening tests. Don’t be afraid to reach out to your doctor for support.
Talk!
As we said earlier, a number of psychological factors can cause ED, including:
stress
anxiety
post-traumatic stress disorder (PTSD)
depression
If you’re experiencing psychological ED, you may benefit from talk therapy. During therapy you will discuss in confidence about:
your feelings around sex
any major stress or anxiety factors you may be experiencing
subconscious conflicts that could be affecting your sexual well-being
If ED is affecting your relationship, consider speaking with a relationship counsellor as well. Relationship counselling can help you and you partner reconnect emotionally, which may also help your ED.
Common Questions Answered:
Does masturbation cause Erectile Dysfunction?
No.
Does Viagra help?
Yes. Medication can be prescribed by your doctor to help you manage the symptoms of ED. You may need to try several medications before you find one that works for you. Some of the oral medications stimulate blood flow to your penis to help to treat ED.
Avanafil (Stendra)
Sildenafil (Viagra)
Tadalafil (Cialis)
It’s important to know that some medications used for other conditions may cause ED. It’s therefore very important to talk to your doctor about all your medications and whether they could be causing your symptoms. There may be others that you can take instead but never stop taking medications without first talking to your doctor.
Our advice, if concerned seek the support and guidance from your GP.