Erectile dysfunction, also known as impotence, affects over half of men over the age of 40. Lots of things can cause it and it’s more likely to happen when you get older. Erectile dysfunction can be upsetting — but there are ways of preventing and treating it.

What is erectile dysfunction?

Erectile dysfunction is when you find it difficult to get or keep an erection. 

Struggling to get an erection from time to time is normal. Things like anxiety, drinking alcohol, or tiredness might cause it.

But if you’re experiencing it often, you should speak to a GP. That’s because erectile dysfunction can also be a sign of other health problems — like heart disease and type 2 diabetes

What causes erectile dysfunction?

Erectile dysfunction can happen for many reasons. Physical causes include:

It can also be a side effect of some medicines, like:

  • antidepressants 
  • antihypertensives — used to treat high blood pressure
  • antihistamines — used to treat allergies
  • recreational drugs — like cocaine, marijuana, and heroin

It if only happens sometimes, an emotional problem (like anxiety or stress) might be causing it.

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Is there a test for erectile dysfunction?

If you’re experiencing erectile dysfunction often, you can speak to a GP, or visit a sexual health clinic. 

They could ask you personal questions about your lifestyle and sex life. They might also examine your:

  • blood pressure
  • pulse
  • weight
  • waist circumference
  • reflexes
  • penis
  • prostate — this is more likely if you are 50 or older

The GP might also do some blood tests. This will tell them about your blood sugar (HbA1c), cholesterol (lipids), and testosterone levels.  

Depending on what the tests show, they might refer you to another specialist, like a:

  • urologist — if the problem is with the tubes and organs which get rid of your body’s waste (urinary system)
  • endocrinologist — if hormones might be causing the issue
  • cardiologist — if you have heart problems like heart disease
  • mental health specialist — if the problem might be psychological or emotional

Remember that erectile dysfunction is very common. There’s no need to feel embarrassed about speaking to a professional about it.

Is there treatment for erectile dysfunction?

Treatment for erectile dysfunction depends on what’s causing it. 

A GP or sexual health nurse might suggest changes you can make at home first — like:

  • maintaining a healthy diet
  • staying active
  • stopping smoking
  • losing weight — if your BMI is too high

That’s because these can help with some of the underlying causes of erectile dysfunction.

If you ride a bicycle often, they might suggest that you cycle less. That’s because erectile dysfunction has been linked to cycling more than 3 hours a week. 

Other treatment options include:

  • changing medicines — if it’s causing your erectile dysfunction
  • medicine that will help you keep an erection
  • a vacuum pump device — to help blood flow around your penis
  • medicine to lower your blood pressure
  • medicine to manage your cholesterol levels 
  • hormone replacement — like testosterone
  • surgery — if your blood vessels aren’t working as they should

They could also recommend talking therapies, like cognitive behavioural therapy (CBT), or sex therapy. Talking therapies might help if emotional problems (like anxiety and depression) are causing your erectile dysfunction.

Talking therapies can also help if your erectile dysfunction is upsetting you.

Is erectile dysfunction preventable?

Changes to your everyday routine can reduce your erectile dysfunction risk, like:

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References

Bacon, C. G., Hu, F. B., Giovannucci, E., Glasser, D. B., Mittleman, M. A., & Rimm, E. B. (2002). Association of type and duration of diabetes with erectile dysfunction in a large cohort of men. Diabetes care, 25(8), 1458-1463.

Burnett, A. L., Nehra, A., Breau, R. H., Culkin, D. J., Faraday, M. M., Hakim, L. S., ... & Shindel, A. W. (2018). Erectile dysfunction: AUA guideline. The Journal of urology, 200(3), 633-641.

Heidelbaugh, J. J. (2010). Management of erectile dysfunction. American family physician, 81(3), 305-312.

Ludwig, W., & Phillips, M. (2014). Organic causes of erectile dysfunction in men under 40. Urologia internationalis, 92(1), 1-6.

Maiorino, M. I., Bellastella, G., Della Volpe, E., Casciano, O., Scappaticcio, L., Cirillo, P., ... & Esposito, K. (2017). Erectile dysfunction in young men with type 1 diabetes. International Journal of Impotence Research, 29(1), 17-22.

Malavige, L. S., & Levy, J. C. (2009). Erectile dysfunction in diabetes mellitus. The journal of sexual medicine, 6(5), 1232-1247.

McMahon, C. G. (2014). Erectile dysfunction. Internal medicine journal, 44(1), 18-26.

Patel, D. V., Halls, J., & Patel, U. (2012). Investigation of erectile dysfunction. The British journal of radiology, 85(special_issue_1), S69-S78.

The Urology Foundation (2018). Bitesize guide to erectile dysfunction. Retrieved 25 February 2022 from: https://www.theurologyfoundation.org/images/2018_Bitesize_Guides/181120_-_Bitesize_Guide_to_ED.pdf 

Thompson, I. M., Tangen, C. M., Goodman, P. J., Probstfield, J. L., Moinpour, C. M., & Coltman, C. A. (2005). Erectile dysfunction and subsequent cardiovascular disease. Jama, 294(23), 2996-3002.

Salonia, A., Castagna, G., Saccà, A., Ferrari, M., Capitanio, U., Castiglione, F., ... & Montorsi, F. (2012). Is erectile dysfunction a reliable proxy of general male health status? The case for the International Index of Erectile Function—Erectile function domain. The Journal of Sexual Medicine, 9(10), 2708-2715.

Shamloul, R., & Ghanem, H. (2013). Erectile dysfunction. The Lancet, 381(9861), 153-165.

Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., ... & Hellstrom, W. J. (2016). Erectile dysfunction. Nature reviews Disease primers, 2(1), 1-20.

Yang, Y., & Wang, X. (2016). Sexual dysfunction related to antiepileptic drugs in patients with epilepsy. Expert opinion on drug safety, 15(1), 31-42.