Erectile Dysfunction: Symptoms, Causes, & Treatments

Are you experiencing difficulty achieving or maintaining an erection during sexual activity? If so, you may have erectile dysfunction (ED), a common condition that affects men worldwide. 

While many men feel uncomfortable discussing ED, the good news is that effective treatments are available. By understanding the condition, you’re already taking the first proactive step to reclaim your sexual health and confidence.

What is erectile dysfunction (ED)?

ED is more than just "trouble getting an erection" – it's a medical condition where a man cannot achieve or maintain an erection sufficient for sexual activity. It can be occasional (stress-related) or chronic (persistent over months), affecting sexual satisfaction, relationships, and even mental health.

Globally, it's estimated that over 150 million men experience ED, and the number is expected to grow due to ageing populations.

Types of erectile dysfunction

ED can occur in different ways and at different times. The main types include:

• Primary ED occurs when a man has never been able to achieve normal erections since the beginning of sexual life

• Secondary ED involves the loss of previously normal erectile function

• Situational ED occurs only in specific circumstances, such as with a partner but not during masturbation

• Generalized ED occurs consistently in all situations

Symptoms of erectile dysfunction

The primary symptoms of ED include:

• Difficulty getting an erection
• Reduced sexual desire (libido)
• Difficulty maintaining an erection during sexual activity

Recognising these symptoms can help you seek appropriate care and treatment, regain your confidence, and prevent ED from affecting your sexual satisfaction or even relationships.

Since ED can sometimes occur alongside other sexual concerns, such as premature or delayed ejaculation, it’s recommended that you consult a doctor if you notice persistent symptoms. Schedule an appointment with Thomson Medical, where our specialists can help to evaluate your condition and provide tailored treatment.

What causes erectile dysfunction?

ED usually results from a combination of physical and psychological factors.

Physical causes

Common physical causes include:

• Vascular problems:

  • Reduced blood flow to the penis due to atherosclerosis (a condition in which the buildup of fatty plaques inside artery walls narrows blood vessels and restricts blood flow) or heart disease

• Neurological disorders:

  • Damage to nerves controlling erection (spinal cord injury, multiple sclerosis, stroke)

• Hormonal issues:

  • Low testosterone or thyroid disorders

• Medications:

  • Consuming antidepressants, beta-blockers, or antihypertensives medication

• Lifestyle factors, such as actively smoking, heavy alcohol consumption, and obesity

• Chronic illnesses, such as diabetes (most common cause of vascular ED), kidney or liver disease

• Congenital conditions that can lead to primary ED since birth

Psychological causes

Your mental and emotional state plays a significant role in sexual function.

Psychological factors include:

• Stress and anxiety

• Depression or other mental health disorders

• Performance anxiety (fear of sexual failure)

• Relationship problems

Even if the primary cause is physical, psychological factors can worsen ED.

How is erectile dysfunction diagnosed?

A thorough evaluation is essential to identify the underlying cause and develop an effective treatment plan. Your doctor can determine whether you have ED through a combination of assessments. These tests include:

Medical history

Your doctor will review your sexual and general health background, such as:

• Your sexual history

• Past medical conditions and medications

• Lifestyle habits

Physical examination

A physical check helps identify any anatomical or cardiovascular issues, including:

• Penis and testes examination to check for abnormalities

• Blood pressure, pulse, and heart health

Laboratory tests

Blood tests can reveal underlying conditions contributing to ED, namely:

• Blood glucose (to detect diabetes)

• Lipid profile (to check cholesterol levels)

• Testosterone levels

• Thyroid function

Specialized tests (if needed)

In some cases, additional tests may be required to pinpoint the exact cause. These tests include:

• Nocturnal penile tumescence, to check if erections occur during sleep

• Penile doppler ultrasound, to measure blood flow to the penis

• Psychological evaluation, to determine stress or anxiety contribution

How is erectile dysfunction treated?

Most cases respond well to treatment once the underlying cause is identified.

Lifestyle modifications

Simple changes to your daily habits can significantly improve erectile function. Try these approaches:

• Exercise regularly to improves blood flow and supports heart health

• Follow a healthy diet, such as Mediterranean or low-fat diets, to support vascular function

• Quit smoking, because smoking can damage blood vessels and restricts blood flow to the penis

• Limit alcohol intake, since excessive alcohol consumption can lower testosterone levels

• Manage your weight, because obesity can increases your risk of ED

• Reduce stress, by practising yoga or meditation

Medications

Your doctor can recommend the best medication based on your health profile. Common options include:

• PDE5 inhibitors, such as sildenafil, tadalafil, vardenafil

  • Help increase blood flow to the penis

  • Usually taken before sexual activity

  • Should not be used with nitrate medications (for heart conditions)

• Hormone therapy, such as testosterone replacement therapy for men with low testosterone levels

Devices and surgery

For cases that don't respond to medication or lifestyle changes, these options are available:

• Vacuum erection devices (VED), which create negative pressure to draw blood into the penis

• Penile implants, which is asemi-rigid or inflatable prostheses for severe, treatment-resistant cases

• Vascular surgery, which is usually reserved for younger men with specific blood flow problems

Psychological therapy

Counselling and therapy can be highly effective when psychological factors contribute to erectile dysfunction. Treatment options include:

• Sex therapy or counselling, which helps with performance anxiety or relationship issues

• Cognitive behavioral therapy (CBT), that can help reduces anxiety and improves your sexual confidence

If these treatment options seem overwhelming or you're unsure which approach is right for you, schedule an appointment with Thomson Medical. Our specialists can help by recommending the most suitable treatment for your condition.

How can you prevent erectile dysfunction?

Taking these preventive steps can reduce your risk of developing erectile dysfunction.

• Maintain a healthy lifestyle by regularly exercising, having a balanced diet, and getting an adequate sleep

• Manage chronic conditions, such as keeping diabetes, high blood pressure, and cholesterol under control

• Avoid harmful habits by quitting smoking and limit alcohol consumption

• Schedule regular check-ups by visiting your doctor for routine health screenings

• Seek early intervention by consulting a doctor if you experience ED symptoms frequently

FAQ

Does age play a role in erectile dysfunction?

Yes. Men over 50 are more likely to experience ED due to vascular, hormonal, and neurological changes.

Can I still orgasm if I have erectile dysfunction?

Yes. ED affects erection, not necessarily the ability to ejaculate or orgasm.

Can masturbation cause ED?

No. Normal masturbation does not cause erectile dysfunction, though excessive pornography use can contribute to it psychologically.

Why am I losing my erection so easily?

Stress, anxiety, fatigue, alcohol consumption, or early signs of vascular or hormonal problems can all contribute to the loss of an erection. 

How long can the average man stay erect?

The average man can stay erect for 5-7 minutes during intercourse, although this can vary widely.

How can you tell if a man has erectile dysfunction?

ED is diagnosed when a man consistently cannot achieve or maintain an erection for satisfactory sexual activity, confirmed by medical evaluation.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situation, please consult a specialist at Thomson Medical. Schedule an appointment with Thomson Medical today.