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Erectile Dysfunction: Medical Information on Causes, Diagnosis, Symptoms and Treatment

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Important Answers about Erectile Dysfunction

  • Erectile Dysfunction Overview
  • Attaining an Erection
  • Causes of Erectile Dysfunction
  • Diagnosing Erectile Dysfunction
  • Priapism
  • Erectile Dysfunction Symptoms and Treatments
  • Prevention

Erectile Dysfunction

Erectile Dysfunction Overview

Erectile dysfunction (ED) is a common impotence condition that occurs when men have repeated or consistent issues when attaining or sustaining an erection. If left untreated, erectile dysfunction can cause sexual intercourse to become difficult. Studies indicate that one out of every five men suffers from this condition at varying stages of life. Alternatively, failing to maintain an erection on a regular basis might be the result of some other physical, emotional or mental condition involving stress or another issue that leads to a reduced desire for sex.

Studies reveal that 52 percent of all men are experiencing or have experienced erectile dysfunction. While more than 70 percent of men 70 years and older experience the condition, it affects only 40 percent of men 40 years and younger. In addition, men suffering from diabetes and heart disease using specific medications have a higher potential risk of developing erectile dysfunction. Factors that may or may not indicate ED include:

  • Stress
  • Fatigue
  • Issues surrounding relationships
  • The consumption of alcohol
  • Performance anxiety

Typically, doctors will diagnose erectile dysfunction if it remains a condition for weeks or months. Alternatively, there are other sexual activity problems not related to erectile dysfunction that include a lack of interest in sexual intercourse, absent or delayed ejaculation or premature ejaculation.

Attaining an Erection

Men attain an erection by increasing the flow of blood into the penis. The increased blood flow is typically the result of direct contact with the penis or stimulation caused by sexual thoughts. During this stage, the muscles in the penis become relaxed due to sexual excitement or stimulation allowing an increased blood flow into the arteries of the penis. The flow of blood begins to fill the corpora cavernosa (two chambers within the penis), making the penis rigid and erect.

Causes of Erectile Dysfunction

There are often numerous factors that increase the potential risk of developing erectile dysfunction. This is because attaining and maintaining an erection is not just a physical reaction but requires the brain, muscles, hormones, blood vessels, and nerves. Any issue involving one or more of these components has the potential of blocking the penis’ normal functioning. The most common causes affecting the dysfunction of maintaining an erection include:

  • Diabetes
  • Cardiovascular disease
  • Aging
  • Multiple sclerosis
  • Depression and/or anxiety
  • High Blood Pressure (hypertension)
  • Injury
  • Damage caused by surgery, cancer, radiation, or pelvic/penile/perineal trauma
  • Spinal Cord or Nerve Damage
  • Obesity
  • Anxiety
  • Drug Use
  • Substance abuse
  • Enlarged prostate gland
  • Low Testosterone Levels
  • Parkinson’s disease
  • Tobacco use

Studies indicate that persistent alcohol use significantly increases the potential of inducing erectile dysfunction. The research indicated that nearly three out of four men suffering from alcohol dependence syndrome also experience sexual dysfunction.

Diagnosing Erectile Dysfunction

A complex physical examination can be conducted and with a complete medical history, the doctor can determine if there are any health issues that are directly associated with the failure to attain and maintain an erection. To ensure a diagnosis is accurate, it is recommended to see a specialist who will conduct a battery of tests and provide consultation. The examination can help determine if the male is suffering from priapism. In obtaining a medical history, the doctor will likely ask the patient:

  • How long has it been since your last erection?
  • How long do your erections typically last?
  • Have you used any legal or illegal drugs?
  • Have you had any injury to your genital area or spinal cord?

The physical examination used to determine the root cause(s) of the problem will likely involve checking for any sign of cancer in the belly or rectum. The patient might be referred to a urologist for further screen testing that includes:

  • Comprehensive Blood Tests
  • Arteriogram – An x-ray used to detect dye injected into the artery by the physician
  • Color Doppler Ultrasound – An imaging test that reveals the blood flow in the penis


Without proper blood flow, it is impossible for man to attain and maintain an erection. Normally, during sexual arousal, the penis and arteries in the pelvis will relax and expand allowing and increased the level of blood to flow into the penis’ spongy tissues. While this is occurring, veins and the valve will close, trap the blood to produce an erection. When sexual arousal ceases, the closed valves in the veins open and allow the blood to flow away from the area, returning the penis to a normal state.

However, an insufficient amount of blood flow can cause priapism, which is defined as a typically painful erection lasting four hours or more. Males of any age can experience priapism. The two forms of priapism involve:

  • Ischemic or Low-Flow Priapism – This form of priapism is the result of blood becoming trapped in the penis chambers during an erection. Diagnosing a definitive cause is difficult. However, the condition often affects males suffering from malaria, leukemia or sickle cell disease. Injuries to the spinal cord can also cause priapism. Without immediate treatment, the damage caused by the condition can result in excessive scarring and permanent ED (erectile dysfunction).
  • Non-Ischemic or High-Flow Priapism – This form of priapism is rare and typically less painful. It is often the result of injury to the penis or surrounding perineum area between the anus and scrotum when a ruptured artery causes a blood flow blockage to the penis. Additionally, scorpion stings and black widow spider bites are also known to cause priapism.

Many cases of priapism are the result of men using or misusing certain types of medication used to treat mental illness and depression. These drugs include Thorazine (chlorpromazine) and Desyrel (trazodone HCl). Additionally, injections or pills used to treat erectile dysfunction have also been known to cause priapism.

Erectile Dysfunction Symptoms and Treatments

Typically, the only symptom involved in erectile dysfunction includes a lack of attaining an erection that is sufficiently hard enough and lasts sufficiently long enough to complete sexual activity. There are numerous treatments effective to combat erectile dysfunction that include therapies and medications. Most of these include:

  • Psychotherapy can assist individuals suffering from depression that might be associated with erectile dysfunction
  • Oral PDE5 Inhibitors including Viagra, Cialis, Levitra, Staxyn, and Stendra
  • Intracavernosal Injections including Edex, Caverject, Bimex and Trimix
  • Intraurethral Prostaglandin E1 including MUSE
  • Surgical Procedures
  • Vacuum Devices
  • Adopting and maintaining a Healthy Lifestyle
  • Changes in Prescription ED Drug when appropriate


Making healthier lifestyle choices can prevent erectile dysfunction. Managing existing health problems can also help. Some of these steps include:

  • Routinely visit your primary health care provider for routine checkups and screening tests.
  • Exercise on a routine basis
  • Quit smoking
  • Avoid using illegal drugs
  • Avoid or limit the consumption of alcohol
  • Seek out medical attention for depression, anxiety or other mental health problems

Losing the ability to attain and maintain an erection could be caused by either a psychological or physical issue, or a combination of both. Never assume that the ED problem is long-term or permanent. Consider changing lifestyle choices that produce anxiety, stress or other health concerns. Seeking help from professionals increases the chances of curing the problem.


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