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Erectile dysfunction - impotence

Erectile dysfunction formerly known as impotence refers to the condition where a person has difficulty achieving or maintaining a sufficient erection in the penis during sexual activity. It is a common sexual dysfunction that can affect men of different ages and can have different causes, including physical, psychological or a combination of both.

Causes of Erectile Dysfunction

Erectile dysfunction can have several causes, often a complex mix of physical and psychological factors. Here are some common causes of erectile dysfunction:

Physiological Causes:

  • Vascular Issues: Reduced blood supply to the penis due to narrowing of blood vessels can lead to difficulties in achieving or maintaining an erection.

  • Hormonal Imbalances: Low levels of testosterone or other hormonal imbalances can affect sexual function.

  • Neurological Disorders: Conditions like multiple sclerosis (MS) or Parkinson's disease can affect the nervous system and, consequently, erections.

Psychological Causes:

  • Anxiety and Depression: Mental health issues can impact libido and sexual performance.

  • Stress: High levels of stress, especially prolonged stress, can negatively affect sexual function.

  • Performance Anxiety: Fear of underperforming in bed can lead to erectile dysfunction.

Lifestyle Factors:

  • Smoking: Tobacco smoking can damage blood vessels and, consequently, affect blood flow to the penis.

  • Alcohol and Drugs: Excessive alcohol consumption or the use of certain drugs can impact erections.

  • Lack of Physical Activity: Lack of exercise can contribute to overweight and other health problems that may lead to erectile dysfunction.

Underlying Medical Conditions:

  • Diabetes: High blood sugar can damage blood vessels and nerves, affecting sexual function.

  • Cardiovascular Diseases: Atherosclerosis and other heart problems can impact blood flow to the penis.

  • High Blood Pressure: Untreated high blood pressure can increase the risk of erectile dysfunction.

  • Side Effects of Medications: Certain medications like antidepressants, antihypertensives, and some prostate medications can have a negative impact on erections.

Symptoms of Erectile Dysfunction

Symptoms of erectile dysfunction typically involve difficulties in achieving or maintaining a sufficiently hard erection for satisfactory sexual activity. Here are some common symptoms:

  • Difficulty Achieving Erection: The primary symptom is often trouble achieving an erection firm enough for penetration.

  • Difficulty Maintaining Erection: If the erection cannot be sustained throughout intercourse, it may be a sign of erectile dysfunction.

  • Reduced Sexual Desire: Men with erectile dysfunction may experience decreased libido or interest in sex.

  • Anxiety and Stress: The experience of erectile dysfunction can increase anxiety and stress, further worsening the problem.

  • Premature Ejaculation: Some men with erectile dysfunction may also experience difficulties in controlling ejaculation.

  • Reduced Self-Esteem and Confidence: Erectile dysfunction can negatively impact self-image and self-confidence.

  • Relational Issues: Erectile dysfunction can create tensions and conflicts in the relationship, particularly if communication about the problem is lacking.

It is important to note that occasional erection issues are normal and do not necessarily indicate erectile dysfunction. To diagnose the condition, symptoms must be recurrent and persist over an extended period.


Treatment for erectile dysfunction varies depending on the underlying causes and individual health conditions. Here are some common treatment options:

Oral Medications:

  • PDE5 Inhibitors: Medications like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are common and effective. They increase blood flow to the penis by relaxing the muscles surrounding the blood vessels.

Penile Injections:

  • Alprostadil: A medication injected directly into the penis can increase blood flow and induce an erection. It is often used when oral medications are not suitable or do not have the desired effect.

Urethral Suppositories:

  • Alprostadil Suppositories: A small suppository is placed in the urethra, where it dissolves and increases blood flow to the penis.

Vacuum Erection Devices:

  • Vacuum Pumps: A device that creates a vacuum around the penis, drawing blood into it, followed by placing a ring at the base to maintain the erection.

Surgical Interventions:

  • Penile Implants: Surgically implanted devices that allow the man to control when and how long he has an erection.

Psychosexual Therapy:

  • Couples Therapy: Therapy can help manage psychological factors contributing to erectile dysfunction, such as anxiety, depression, or relationship issues.

Lifestyle Changes:

  • Diet and Exercise: A healthy lifestyle with a balanced diet and regular exercise can improve overall health, including sexual health.

  • Limiting Alcohol and Quitting Smoking: Reducing alcohol consumption and quitting smoking can also contribute to improving erectile function.

Managing Underlying Health Conditions:

  • Treating Underlying Causes: If erectile dysfunction is linked to underlying medical conditions such as diabetes or cardiovascular disease, these conditions should be treated to improve sexual function.

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