Erectile Dysfunction (ED): A Brief Guide
What ED Means
- Erectile Dysfunction (ED) refers to difficulty in getting or keeping an erection firm enough for sexual intercourse.
- It’s fairly common, and its likelihood increases with age and in the presence of certain health conditions.
How Erections Normally Work
- Nerves release signals (nitric oxide) when you’re aroused.
- These signals relax smooth muscle and open blood flow to the penis.
- The inflow of blood fills erectile tissue, and veins compress to trap it — maintaining rigidity.
- After sexual activity or when stimulation stops, blood exits and the penis returns to a flaccid state.
In ED, one or more of these steps is impaired (nerve signaling, blood flow, muscle relaxation, venous trapping).
Common Causes & Risk Factors
|
Type |
Examples / Contributors |
|
Vascular / Blood Flow Issues |
Atherosclerosis, high blood pressure, high cholesterol, diabetes |
|
Neurological |
Nerve damage, pelvic surgery, spinal injury, multiple sclerosis |
|
Hormonal / Endocrine |
Low testosterone, thyroid conditions |
|
Medications / Substances |
Some blood pressure meds, antidepressants, smoking, alcohol, recreational drugs |
|
Psychological |
Stress, anxiety, depression, performance pressure |
|
Anatomical / Structural Issues |
Peyronie’s disease (scar tissue), penile curvature, venous leak |
Signs & Symptoms You May Notice
- Difficulty getting an erection
- Difficulty sustaining the erection during sexual activity
- Loss of spontaneous erections (e.g. morning erections)
- Decreased sexual desire
- Emotional distress, reduced confidence, or relationship strain
Diagnosing ED
A healthcare provider will often:
- Review your medical history, symptoms, and medications
- Ask about sexual and psychological factors
- Perform a physical exam (genitals, pulses, nerves)
- Order lab tests — e.g. blood sugar, cholesterol, testosterone
- Possibly do additional testing (ultrasound, nocturnal erection tests, etc.) to assess blood flow or nerve function
What You Can Do to Help Yourself
- Address any underlying conditions: control diabetes, hypertension, high cholesterol
- Maintain a healthy weight, exercise regularly, stop smoking
- Limit alcohol, avoid illicit drugs
- Manage stress, anxiety, or mood issues
- Get adequate sleep— poor sleep can worsen hormonal and vascular health
- Talk openly with your partner or a counselor
- Ask your doctor whether medication side effects might be contributing
Treatment Options
|
Option |
What It Does |
Considerations |
|
Oral medications (PDE5 inhibitors, e.g. sildenafil, tadalafil) |
Improve blood flow by enhancing nitric oxide signaling |
Works best when the nerves and vessels are still reasonably intact |
|
Injected medications / intraurethral therapies |
Directly stimulate erection via local agents |
More invasive; may cause discomfort or priapism |
|
Vacuum erection devices |
Mechanical method to engorge penis |
Can be effective though less spontaneous |
|
Penile implants / prostheses |
Surgically inserted devices that allow controllable erection |
Higher cost / more invasive, but very effective in many cases |
|
Shockwave therapy, stem cell / regenerative therapies |
Emerging alternatives aiming to restore vascular function |
Still considered experimental in many cases |
|
Psychosexual therapy / counseling |
Address anxiety, relationship or performance issues that contribute |
Often used alongside physical treatments |
When to Seek Medical Help
If you notice:
- Sudden onset of ED
- ED with other symptoms like chest pain, shortness of breath, or dizziness (could signal heart disease)
- Painful erections or scarring / deformity of the penis
- Signs of low testosterone (low libido, fatigue, muscle loss)
- Medication side effects
- Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.
Key Takeaways
- ED is a symptom, not a disease — it often signals blood vessel, nerve, or hormonal issues
- Many effective treatments exist; your doctor can help you find the best fit
- Lifestyle, mindset, and partner communication can play significant roles
- Early evaluation is better — waiting may allow underlying issues to worsen
This handout is for educational purposes only and is not a substitute for professional medical advice. Always follow your healthcare provider’s instructions.
Sources:
- https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed)
- https://www.uptodate.com/contents/sex-problems-in-males-the-basics?search=erectile%20dysfunction&topicRef=6840&source=related_link
- https://www.uptodate.com/contents/epidemiology-and-etiologies-of-male-sexual-dysfunction?search=erectile%20dysfunction&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1