Erectile Dysfunction
What Is Erectile Dysfunction?
Erectile dysfunction (ED), also known as impotence, is a condition where a person is having trouble staying hard. This inability to get or maintain an erection is occasionally normal, but persistent issues may indicate a medical condition that requires attention [1].
How Common Is It?
Erectile dysfunction is one of the most common male sexual health issues worldwide.
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A 2018 review estimated that ED affects about one-third of men [2].
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A 2019 global review reported a wide prevalence range for ED, ranging from 3% to 76% [2].
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In the UK, ED affects up to 1 in 5 men, or roughly 4.3 million individuals [3].
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A 2022 study suggests that as many as 41% of men may be living with ED in the UK [4].
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Globally, in 1995, it was estimated that 152 million men had ED. By 2025, that number is expected to rise to 322 million, more than doubling in just 30 years [3].
Types Of Erectile Dysfunction
There are four types or categories of erectile dysfunction.
Vascular erectile dysfunction
Vascular ED arises when the blood vessels sending blood to the tissue of the penis is affected. This is one of the most common types of ED [5]. A poor arterial flow can result from high cholesterol levels, diabetes, and smoking [6].
Neurogenic ED
This occurs due to nerve problems that prevent signals from traveling from the brain to the abdomen. This condition may arise from pelvic surgery, trauma, or radiation therapy. It can also arise from neurological conditions such as multiple sclerosis (MS), stroke, and spinal stenosis [5]. Nerve damage resulting in ED symptoms can also arise from surgery, diabetes, and Parkinson's disease [6].
Hormonal Erectile Dysfunction
It refers to an ED that occurs due to a deficiency of testosterone. Testosterone levels also play a key role in libido. In some cases, it may also arise from thyroid issues.
Psychogenic Erectile dysfunction
This type of ED involves psychological conditions such as thoughts, behaviour, and feelings [5]. In fact, factors such as stress, anxiety, and depression can also interfere with a man's ability to achieve and maintain an erection [6].
Erectile Dysfunction Age
Age is one of the most well-established risk factors for erectile dysfunction.
The Massachusetts Male Aging Study, followed over 1,000 men aged 40 to 70, found a clear decline in sexual function with age, including reduced sexual activity and fewer monthly erections [7]. Supporting this, data from the 2001 to 2002 U.S. National Health and Nutrition Examination Survey showed that ED affects around 5% of men aged 20 to 39, while the number rises to over 70% in men aged 70 and above [8].
The 2003 Health Professionals Follow-Up Study, which surveyed over 31,000 U.S. male health professionals, found that-
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Less than 2% of men experienced ED before age 40.
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About 25% reported ED beginning between the ages of 50 and 59.
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Nearly 40% reported onset between 60 and 69.
The study also revealed a sharp decline in self-rated sexual function with age. While nearly 75% of men aged between 53 and 59 rated their sexual ability as good or very good, 64% of those aged 80 to 90 described it as poor or very poor [9].
What Causes Erectile Dysfunction?
There are numerous factors that can cause ED, including conditions that can affect your -
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Circulatory System- Since erection relies on blood flow, suffering from such conditions may cause ED.
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Nervous System- This can affect your electric impulses that helps your body move including the penis.
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Endocrine System- Suffering from any endocrine system issues may affect your hormonal levels, such as Testosterone. This can thus result in ED.
Other conditions or health issues that result in ED include-
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High blood pressure (hypertension).
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Diabetes.
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Epilepsy.
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Chronic kidney disease.
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High cholesterol.
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Atherosclerosis.
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Peyronie’s disease.
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Stroke.
Further injuries to the penis or the area surrounding it can also cause ED. This may include-
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Penile fracture.
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Radiation therapy.
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Pelvic surgery, including bladder cancer.
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Injuries to the pelvis bone.
The intake of certain medications can also cause erectile dysfunction. The most likely drugs to cause erectile dysfunction are-
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Antidepressants.
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Sedatives.
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Anti-anxiety medications.
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Parkinson’s disease drugs.
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Diuretics.
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Muscle relaxers.
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Chemotherapy drugs.
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Muscle relaxers.
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Antiarrhythmics.
The use of substances such as alcohol, cocaine, opioids, nicotine, barbiturates, methadone, marijuana, and amphetamines can cause erectile issues such as ED. These substances can affect and suppress the central nervous system, which can damage the blood vessels, resulting in ED.
Apart from physical factors, emotional and psychological factors can also cause erectile dysfunction in men. Some psychological causes of weak erection include-
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Low self-esteem.
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Depression.
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Stress.
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Anxiety.
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Fear of sexual intercourse [5].
Erectile Dysfunction Symptoms
The key signs of erectile dysfunction are listed below-
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Inability to get an erection when excited.
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Losing an erection before or during intercourse.
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A noticeable decline in interest in sexual activity.
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The need to have a lot of stimulation to get an erection [5].
Erectile Dysfunction Specialists
People with erectile dysfunction can consult-
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Urologist- They specialize in the urinary tract and male reproductive system.
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Endocrinologists- These specialists focus on hormone-related issues like low testosterone or diabetes.
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Cardiologists- Since ED is often related to poor blood flow and cardiovascular disease, a cardiologist may help improve the condition.
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Psychologist or Psychiatrist- Such doctors help with ED caused by stress, anxiety, or depression.
How Is Erectile Dysfunction Diagnosed?
ED can be diagnosed by-
Physical Exam
A doctor may examine the penis, testicles, and nerves to check for physical abnormalities or signs of nerve damage.
Blood Tests
These tests can detect conditions like diabetes, heart disease, and low testosterone, all of which may contribute to ED.
Urine Tests
Often used alongside blood tests, these can help identify diabetes and other underlying health problems.
Ultrasound
An ultrasound assesses blood flow to the penis. A small device (transducer) is placed over the blood vessels, sometimes after an injection to stimulate an erection. It helps detect circulation problems that could be causing ED.
Mental Health Evaluation
Since psychological factors like stress, anxiety, and depression can impact sexual performance, a brief mental health screening may be conducted to assess emotional well-being.
Erectile Dysfunction Treatments
Some of the effective treatments for weak erections include-
Lifestyle Changes
Health care professionals often recommend changes in daily habits to support erectile function. These include:
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Limiting or avoiding alcohol.
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Maintaining a healthy weight.
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Following a nutritious diet.
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Quitting smoking.
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Exercising regularly.
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Avoiding recreational drug use [10].
Counseling
Psychological factors can cause or worsen ED. In such cases, counseling may be beneficial. A mental health professional can help:
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Manage sexual performance anxiety.
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Address relationship or emotional concerns.
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Improve self-confidence [10].
Medications
Sometimes, medications taken for other health conditions may contribute to ED. Your doctor may:
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Adjust the dosage.
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Prescribe an alternative medication.
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Help manage side effects that affect sexual function [10].
Testosterone Therapy
If tests show low testosterone levels, a doctor may recommend testosterone replacement therapy (TRT), especially when used in combination with PDE5 inhibitors. This can be administered by-
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Oral tablets.
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Patches.
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Gels applied to the skin.
Vacuum Erectile Devices (VEDs)
A vacuum erection device is a non-invasive mechanical option that helps draw blood into the penis. It includes-
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A plastic tube that fits over the penis.
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A pump to create a vacuum and draw blood into the penis.
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An elastic ring to maintain the erection during intercourse [10].
Understanding Erectile Dysfunction Medication
Phosphodiesterase Type 5 (PDE5) Inhibitors are the most common prescription drugs for ED. They work by improving blood flow to the penis and include:
Sildenafil
Sildenafil is the active ingredient in Viagra. It typically works within 30 minutes and lasts for 4 to 6 hours. Affordable alternatives include-
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Cenforce
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Malegra
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Aurogra
These alternatives offer the same effectiveness as Viagra but are more cost-friendly options.
Tadalafil
Tadalafil is another popular ED medication. It is available under the brand name Ciali and has a longer duration of action, up to 36 hours. The cost of Cialis may be expensive, but it is available under numerous affordable options, such as Vidalista and Tadalista.
Vardenafil
Vardenafil, the active ingredient in the brand-name drug Levitra, is another effective option for treating erectile dysfunction. It works within 30 minutes and lasts for about 4 to 5 hours. For people seeking more affordable options without compromising on quality, alternatives like Vilitra and Vitara are available. These medications deliver the same therapeutic benefits as Levitra, offering reliable performance at a lower cost.
Avanafil
Avanafil, sold under the brand name Stendra, is a newer-generation ED medication known for its rapid onset, often working within 15 to 30 minutes.
Erectile Dysfunction Self-Care
Certain lifestyle changes can make a significant difference in improving ED in men. Some of the effective ways to improve ED are listed below.
Start Walking Daily
Simple physical activity, like walking, can be very beneficial. A Harvard study found that just 30 minutes of walking per day was linked to a 41% lower risk of developing ED. Other research shows that moderate exercise can help restore sexual function in overweight men suffering from ED [11].
Eat a Balanced Diet
The Massachusetts Male Aging Study found that men who followed a Mediterranean-style diet, rich in fruits, vegetables, whole grains, and fish, while low in red meat and refined carbs, had a lower risk of ED.
Monitor Your Vascular Health
High blood pressure, high cholesterol, high blood sugar, and excess triglycerides can damage blood vessels. These vascular issues are major contributors to ED. Regular checkups and lifestyle adjustments can help protect your heart, brain, and sexual health.
Maintain a Healthy Weight
Excess weight, especially around the waist, increases the risk of erectile dysfunction. Men with a 42-inch waist are 50% more likely to experience ED than those with a 32-inch waist. Losing weight not only improves vascular function but also supports hormonal balance, which is crucial for strong erections.
Strengthen Pelvic Floor
Strengthening the pelvic floor muscles can enhance erection firmness and help retain blood in the penis during arousal. In a British clinical trial, men who performed Kegels twice daily for three months, along with lifestyle changes like quitting smoking and reducing alcohol, saw better results than those who only received lifestyle advice [11].
Manage Stress
Stress from work, relationships, or major life changes can lower your sex drive and contribute to erectile dysfunction. In turn, ED can increase anxiety, creating a cycle that impacts your performance and confidence. By reducing stress through relaxation techniques, therapy, or lifestyle changes, you can improve both your mental well-being and sexual function [12].
ED Treatments Available At Healthnaturo
At Healthnaturo, we offer a wide range of effective and affordable erectile dysfunction medications, available in various strengths to suit different needs and preferences. Our collection includes trusted generics of popular ED treatments, including options with Sildenafil, Tadalafil, and Vardenafil.
Sildenafil Options
Sildenafil is the active ingredient in Viagra and is known for its fast-acting results. Available Sildenafil treatment options at Healthnaturo include:
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Malegra 200 mg
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Aurogra 100 mg
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Cenforce 100 mg
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Cenforce 150 mg
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Cenforce 200 mg
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Cenforce Professional.
Tadalafil Options
Tadalafil, the long-lasting active compound in Cialis, is ideal for extended effectiveness. Available options for Tadalafil ED medications include:
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Vidalista Professional
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Vidalista 20 mg
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Vidalista 40 mg
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Vidalista 60 mg
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Tadalista Super Active.
Vardenafil Options
Vardenafil, the active compound in Levitra, offers reliable performance with fewer side effects for some men. Available options of Vardenafil tablets for managing ED at Healthnaturo pharmacy include-
Vilitra 20 mg.
Vilitra 40 mg.
Vitara V 60 mg.
References
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Erectile Dysfunction, Mayoclinic.
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Is Erectile Dysfunction (ED) Common?, Healthline.
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Erectile dysfunction: 50+ facts and statistics, lloydspharmacy.
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Prevalence, Comorbidities, and Risk Factors of Erectile Dysfunction: Results from a Prospective Real-World Study in the United Kingdom, NCBI.
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Erectile Dysfunction, clevelandclinic.
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The 4 different types of erectile dysfunction, numan.
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Changes in Sexual Function in Middle-Aged and Older Men: Longitudinal Data from the Massachusetts Male Aging Study, agsjournals.onlinelibrary.
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Prevalence and Risk Factors for Erectile Dysfunction in the US, amjmed.
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Sexual Function in Men Older Than 50 Years of Age: Results from the Health Professionals Follow-up Study, acpjournals.
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Treatment for Erectile Dysfunction, niddk.nih.gov.
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5 natural ways to overcome erectile dysfunction, Harvard.
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Ways to Avoid Erectile Dysfunction, WebMD.
FAQ's
ED can begin as early as your 20s, but it becomes more common with age, especially after 40.
If you regularly have trouble getting or maintaining an erection during sexual activity, you may have ED.
ED can result from physical conditions (like diabetes or heart disease), psychological factors (like anxiety), or medication and lifestyle habits.
In many cases, yes, especially when the underlying cause is treatable or reversible.
Common causes include stress, anxiety, low testosterone, lifestyle factors, and early signs of health conditions like diabetes or high blood pressure.
In younger men, ED is often linked to performance anxiety, stress, depression, or lifestyle habits like smoking or substance use.
If you have morning erections or can get an erection in some situations but not others, it may be psychological; physical causes tend to affect all scenarios.
Regular exercise, reducing stress, quitting smoking, and a healthy diet can significantly improve ED symptoms naturally.
No, ED medications treat the symptoms temporarily but do not address the underlying cause.
There’s no one-size-fits-all, but lower doses of PDE5 inhibitors like sildenafil or tadalafil are well-tolerated by many men; consult a doctor for guidance.
Newer options include shockwave therapy, stem cell therapy, and faster-acting PDE5 inhibitors like avanafil.
Occasional erection issues are normal; ED is a persistent difficulty in achieving or maintaining an erection, often requiring medical attention.
For most men, oral medications like sildenafil or tadalafil combined with healthy lifestyle changes provide the best and most accessible ED treatment.
In erectile dysfunction, a man is unable to achieve or maintain an erection firm enough for sexual activity due to reduced blood flow or nerve/hormonal issues.