Erectile dysfunction (impotence): Overview and facts

Dr Ochi Igboko

Men have a lot of fears about erectile dysfunction. Fight those fears with facts. Stop worrying and start learning about why men sometimes don’t get erections.

What Is Erectile Dysfunction (ED)?

Erectile dysfunction is when you’re unable to get and maintain an erection. If you have trouble with ED every once in a while, it’s probably nothing to worry about. But if it happens frequently or on a regular basis, it could be a sign of other health problems.

No matter how often you experience ED, it can affect your relationship and cause issues with self-esteem. But it’s also very common and, if you talk to your doctor, treatable.

Why Can’t I Get an Erection?

Decreased blood flow, typically because vessels that supply blood to the penis have narrowed, is often the cause of erectile dysfunction (ED) in older men. Emotional issues are more commonly at the root of it for younger men.

Drugs That Can Cause ED If you are having problems achieving or maintaining an erection, you may want to take a look at your medicine cabinet first. A number of prescription and over-the-counter drugs may cause erectile dysfunction.

ED and Your Lifestyle  Think you may have erectile dysfunction? You may be surprised to learn that a lot of the things we know aren’t good for your health can also affect your ability to get or keep an erection.

ED and Psychological Factors Psychological factors like stress, anxiety and depression are responsible for about 10%-20% of all cases of erectile dysfunction.

Other Conditions that Can Cause Impotence Many things can lead to ED. Stress, depression, anxiety, and alcohol use often trigger it. In other cases, physical factors like diabetes, kidney disease and blood vessel diseases are the culprit.

Diabetes and ED About 35% to 75% of men with diabetes will experience at least some degree of erectile dysfunction  during their lifetimes.

Blood Vessel Problems and ED Vascular diseases, which affect blood flow to the organs, may be the cause of ED in as many as 50% to 70% of men who have it.

Clogged Arteries and ED The link between atherosclerosis — the hardening of the body’s arteries — and erectile dysfunction is well known to doctors. If you have ED, understanding the connection might save your life.

High Blood Pressure and ED While many drugs used to treat high blood pressure have been linked to erectile dysfunction, some are much less likely to cause problems. Certain high blood pressure drugs may even improve erectile dysfunction for some men.

Prostate Cancer Treatments and ED Prostate cancer is not a cause of erectile dysfunction. However, treatments for the disease can cause it.

Lowering Your Risk for ED

If you’re at risk of developing erectile dysfunction, taking steps to prevent it – like stopping smoking, exercising and maintaining a healthy weight — will also help you lead a healthier life overall.

Is It My Age?

Age does appear to play a role in ED. The older you get, it may take you longer to get an erection, and it may not be as firm as it was when you were younger.

But getting older does not cause ED, it only increases your chances of getting it. In fact, ED can affect men of all ages.

A recent study showed 1 in 4 patients going to the doctor for the first time for ED was under age 40. And almost half of them had severe ED when compared to older patients. The younger patients smoked cigarettes and used illicit drugs more than the older men, as well.

How Is ED Diagnosed?

You’ll probably only need a physical and to talk to your doctor about your medical history. But if you have other health problems that could be the cause of your ED, you may want to see a specialist, usually a urologist, for a consultation that could include:

Blood tests

Mental health exam

Overnight erection test

Ultrasound of your penis to check blood flow


How Is ED Treated?

Every situation is different, so your doctor will focus on the specific condition that could be causing your ED. Your treatment could include:

Medications. There are several different ED medicines that can help produce an erection, such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). Testosterone replacement and medications injected directly into your penis to help with erection are also common.

Treating underlying causes. Your doctor might recommend you make certain lifestyle changes like quitting smoking and drinking, and adding exercise to your daily routine. He may also swap medications that could be contributing to your ED with ones that won’t have that side effect.

Talking to a counsellor for psychological, emotional, or relationship issues might also help.

Other options. Surgery and penis pumps are also treatment options you can discuss with your doctor if medication doesn’t work. Penile implantsand blood vessel surgery come with risks, so they’re usually considered as last options.

About author

Dr Ochi Igboko

Consultant Anesthesiologist & Critical Care Physician. Email:

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