What is Erectile Dysfunction (ED)?
Erectile dysfunction is a form of sexual disorder in which a man becomes unable to attain and maintain an erection required for intercourse.
Erection problems can occur temporarily for many reasons, such as short-term stress. But if they persist, it means there is a more serious underlying cause that needs to be addressed.
Types of ED
ED is generally divided into four types by experts. These are:
Vascular erectile dysfunction
This form of ED occurs when blood vessels fail to deliver or retain enough blood in the penis to produce or maintain an erection. The reduced blood flow is often due to damaged or narrowed vessels. It is the most common form of ED in men.
Neurogenic erectile dysfunction
Proper nerve signals from the brain or spinal cord are required to form an erection. Impaired signals, due to a damaged nerve or a similar problem, can result in an inability to achieve an erection despite arousal. It’s called neurogenic erectile dysfunction.
Psychogenic erectile dysfunction
Sometimes a person’s mental state affects sexual response and leads to erectile problems. This form of ED is common among men having anxiety, depression, stress and similar mental health conditions.
Hormonal erectile dysfunction
As the name suggests, this type of ED happens due to hormonal problems, especially the male sex hormone testosterone. Data suggest that 30% of men with ED also have co-occurring testosterone deficiency.
How Do Erections Happen?
Erection formation is a multi-step process in which each step triggers the next, ultimately leading to an erection.
When you are aroused, brain nerves stimulate blood flow into the erectile chambers located in the penis. These chambers are made of corpus cavernosum muscles that trap blood and create pressure, making the penis firm. When you ejaculate, these muscles relax and release trapped blood, making the penis limp again.
How Common is Erectile Dysfunction?
ED is quite common, especially in older men. Studies indicates 40% of men in their 40s experience it sometime in their life. The rate increases with age, becoming 70% for men in their 70s.
Erectile dysfunction data 2025 states that more than half of men in the UK experience ED.
Causes of Erectile Dysfunction
There are a number of possible causes for ED. These include both physical and emotional conditions, among others. The causes of ED can be complex and a combination of a number of different things. Here are some of the most common causes of ED:
Physical Causes of ED
About 80% of ED cases have an underlying physical cause. Some of the common physical causes of ED include:
- Nerve damage in the pelvic area due to surgery, injury or trauma
- Reduced blood flow to the penis
- Hormone imbalance (testosterone deficiency/hypogonadism, thyroid hormone problem)
- Cardiovascular disease (heart disease, stroke, etc.)
- High blood pressure
- Diabetes
- Kidney disease
- High cholesterol
- Atherosclerosis (clogged blood vessels)
- Obesity
- Using tobacco
- Parkinson’s disease
- Cushing’s syndrome
- Peyronie’s disease
- Multiple sclerosis
- Consuming too much alcohol
- Sleep disorders (obstructive sleep apnoea and insomnia)
- Recreational drug use (opioids, cocaine, nicotine)
- Certain medications (diuretics, antihypertensives, antidepressants, anticonvulsants, antihistamines, fibrates)
- Enlarged prostate treatment
- Prostate cancer treatment (radiation therapy and chemotherapy)
Psychological Causes of ED
ED can have some emotional causes as well, such as:
- Stress
- Anxiety
- Depression
- Low self-esteem
- Fear of sexual intercourse or sexual activity
- Sexual trauma
- Relationship problems
Can ED be Caused by Low Testosterone?
Yes, low testosterone is one of the hormonal causes of erectile dysfunction, but it may cause ED only when T levels are very low. Other signs of low T that may indicate you have this hormonal issue are: muscle mass loss, reduced bone density, low mood, low sexual desire and brain fog. If you are experiencing any of these signs, you should consult a doctor and get your hormone levels checked through blood tests.
Does Masturbation Cause ED?
No, various studies show that masturbation does not induce ED. However, masturbating too frequently or harmfully may temporarily affect sexual response due to stress, anxiety, or overstimulation, rather than physical damage.
Symptoms of Erectile Dysfunction
ED has basic symptoms that are all related to erection. You should not confuse it with ejaculation problems (premature ejaculation, etc.), as they belong to another category of male sexual dysfunction.
A man with ED may notice one or more of these signs:
- Problems achieving an erection
- Problems maintaining an erection
- Reduced penis sensitivity
- Less frequent morning erections
- Needing too much sexual stimulation to achieve an erection
- Losing erection during intercourse
- Reduced sex drive/interest in sex or related sexual problems
If you experience any of these erectile dysfunction symptoms temporarily due to work stress, excessive alcohol consumption, etc., then your erection will return soon. It is usually not a cause for concern. But if this problem lasts longer (for weeks or months), get professional help for a proper diagnosis.
How to Know If You Have Erectile Dysfunction?
If you experience persistent difficulty achieving or maintaining an erection, it may indicate erectile dysfunction. However, a doctor’s assessment is needed for an accurate diagnosis. They will review your medical history and may carry out tests to identify the underlying cause.
ED Diagnosis
ED diagnosis generally involves the following:
Physical Examination
During the physical exam, your medical professional may examine your testicles and penis. They may also conduct a rectal exam to examine the prostate and see if any underlying physical issues are contributing to ED.
Medical History and Psychosocial Examination
Your doctor may ask you a series of questions or have you fill out a questionnaire to learn about your symptoms, overall health condition, sexual history and lifestyle. It will help them determine what may be contributing to ED.
Here are some of the questions that you may be asked during this stage of your exam:
Are you having problems having sex?
How long have you been experiencing symptoms?
Do you have difficulty achieving or maintaining an erection?
How firm are your erections?
How often do you have sex?
Are there any current issues in your relationship?
Do you wake up in the morning with erections?
Do you currently have a lot of stress?
Are you on any prescription medications?
Do you have any disease?
These questions are designed to learn about your health and sexual life so that your medical professional can provide you with a proper diagnosis and advice.
Erectile Dysfunction Tests
Your healthcare provider may also conduct a few tests to rule out ED causes. Common tests that may be done include:
- Complete blood count (CBC)
- Lipid profile
- Liver function test
- Kidney function test
- Testosterone levels test
- Thyroid test
- Urine test (urinalysis)
- Penile Doppler ultrasound to check blood flow
- Nocturnal Penile Tumescence test (evaluates the quality of erection during sleep)
How Can I Test for ED at Home?
There is no definitive way to test for erectile dysfunction at home. However, you can track your symptoms and note down how often you feel them to explain everything correctly to your doctor in future.
If you suspect you have a hormonal issue, you can test your hormone levels through finger-prick test kits that measure testosterone levels, although these should not replace a professional medical assessment.
Is Erectile Dysfunction Permanent?
Erectile dysfunction is not always permanent. Sometimes it is just temporary and goes away on its own. In other cases, it is linked to a medical, psychological or lifestyle-related issue that may require medical treatment or lifestyle changes to improve.
Treating Erectile Dysfunction: How to Fix ED?
If you are suffering from ED, you should know that there are several different types of treatment for ED. Depending on the cause of your ED, there is likely to be a specific treatment method for that. Here are some of the most common treatments for ED:
Medicines for Erectile Dysfunction
Phosphodiesterase-5 (PDE-5) inhibitors are the most commonly prescribed medicines for ED. They work by increasing blood flow to the penis.
In England, the following four PDE-5 inhibitors are used for ED:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
- Avanafil (Spedra)
These medicines work for most of the people and take 30 to 60 minutes to start their magic. They come in different doses and have various side effects that you should be aware of before taking any. Common PDE-5 inhibitor side effects are headache, backache, flushing and vision changes.
Vacuum Pumps
Penis pumps, also known as vacuum erection devices (VED), are tube-like devices. They are placed over the penis to increase blood supply and help achieve/maintain an erection for up to 30 minutes.
A vacuum pump is a pretty simple device that consists of a few simple parts. There is a plastic tube, which is what is placed over the penis, a pump, which creates suction within the tube, and an elastic ring that creates the seal that allows the pump to be effective and generate suction.
These pumps can be manual or battery-powered – both drug-free options have a high success rate (around 90%). They may be prescribed if the above-mentioned oral medications are ineffective or contraindicated for you.
Testosterone Replacement Therapy (TRT)
This form of hormone replacement therapy (HRT) is prescribed to men who have ED due to testosterone deficiency. These men are given synthetic testosterone that helps restore their low testosterone levels.
Testosterone comes in multiple forms, such as injections, topical gels/creams, skin patches, pellets and pills. Each form has its own benefits and side effects. It’s essential to discuss them with your provider before starting your treatment.
Starting TRT can help you tackle other low T signs as well. It can help improve sex drive, energy levels, muscle mass, bone density and mood in men with testosterone deficiency.
Self-Injection Therapy
Alprostadil is directly injected into the penis – also called intracavernosal injection. Here, it relaxes muscles and increases blood flow towards the penis, causing an erection.
It should not be combined with ED medications or other treatments. Men with a risk for priapism (a painful erection that lasts for several hours) should also avoid it.
Surgery or Penile Implants
This option is usually prescribed only when all the above treatments have failed to produce desired results. Surgery may also be suggested for young males who have an anatomical problem with their penis or have a pelvic area injury that’s causing ED.
Additionally, penile implants, also called penile prosthesis, are rod-like structures that are placed surgically inside the penis. These devices can help an ED man obtain and sustain an erection whenever they want.
Psychological Treatments
If your ED is because of a psychological factor, your doctor will provide you with the required psychological treatment, such as:
Psychosexual counselling: This is a relationship therapy in which you and your sexual partner discuss the emotional or psychological cause of the ED. This helps the person tackle their stress better and improve psychological factors affecting erectile function.
Couples therapy: It helps you remove the communication gap and improve understanding between you and your partner.
Cognitive behavioural therapy (CBT): CBT is designed to help you identify your negative thought patterns and work on them to change unhelpful behaviours and reduce performance anxiety.
Lifestyle Changes
For many men, the primary cause of their ED can be their poor lifestyle habits. For them, the best way out is to make positive changes to their lifestyle.
The following lifestyle changes may help you improve erectile dysfunction signs:
- Lose weight if you are overweight.
- Stop drinking too much alcohol or using illicit drugs. Get a treatment for that.
- Stop smoking.
- Do cardiovascular exercises.
- Spend quality time with your partner and openly discuss your problem to help them understand it.
- Avoid sitting still for long periods.
- Treat high blood pressure and high cholesterol through medications prescribed by your doctor.
- Take a break from extensive cycling (if relevant).
- Limit excessive pornography use (if relevant).
- Review medications with a doctor (some drugs affect erections).
How to Prevent ED?
You may be able to prevent ED if you adopt a healthy lifestyle and live an overall healthy life. Here are the most effective lifestyle habits that can help prevent ED:
- Have a balanced diet containing fewer or no processed food items and sugar
- Maintain a healthy weight
- Get quality sleep at night
- Manage your day-to-day stress
- Do regular exercise (especially exercises that strengthen the pelvic floor muscles)
- Become more physically active (especially increase your aerobic activity – swimming, jogging, etc.)
- Manage blood cholesterol and sugar levels
- Quit smoking
- Reduced or no consumption of alcohol
- Avoid recreational drugs and anabolic steroids
- Check medication side effects (if a medication you are taking causes ED, discuss your concern with the prescriber to get a suitable alternative)
Living with Impotence
Living with impotence can be challenging and cause feelings of embarrassment, low self-esteem and relationship strain. But know that you are not alone. More than half of the men experience this problem at some point in their lives.
The good news is that ED is a highly manageable medical condition. There are many treatments available today to help men restore their sexual health and address erection problems.
Adopting a healthy lifestyle can also play an important role. In addition to improving your erection, it can improve your overall health as well.
Equally important is the open communication with your partner. Without it, they may misunderstand the situation and assume a lack of sexual attraction. That’s why discussing your feelings and concerns is essential. It will not only reduce anxiety but can also help strengthen your connection.
FAQs about Impotence
Can ED be Cured?
In most cases, yes, ED can be cured, especially if it’s caused by treatable factors such as lifestyle issues, psychological problems and medication side effects. But sometimes it can be caused by chronic health conditions and may not be fully curable. In such cases, it is managed with ongoing treatment.
How Long Does Temporary ED Last?
There is no set timeframe for how long the temporary ED lasts as its duration depends on its cause, your overall health and lifestyle. Generally, it can last for a few weeks, but if it persists longer, visit your GP for evaluation.
How Does a Urologist Examine You for Erectile Dysfunction?
A urologist will take a detailed medical and sexual history, conduct a few tests and do a physical examination. During a physical exam, they may assess your penis for shape or abnormalities, check the size of your testicles and examine the prostate via a digital rectal exam if necessary.
Do Steroids Cause ED?
Yes, many studies show that anabolic steroids can cause ED along with other sexual health problems, including reduced natural testosterone production, low sperm count and infertility.
What is the Latest Treatment for ED?
Many new, more advanced ED treatments are being introduced over time, with shockwave therapy, platelet-rich plasma and step cell therapy being the latest ones. However, more research needs to be done on these to fully establish their effectiveness and long-term safety.
Key Takeaways
Erectile dysfunction is a complicated and often stressful condition in which a man has problems achieving and maintaining an erection. This problem is sometimes attributed to low testosterone, but it can also be caused by dozens of other factors, and even different combinations of all those factors.
There are a variety of treatments available for ED, ranging from medical to holistic. The best way to fix erectile dysfunction is to work closely with your medical professional to determine the right mix of medication, exercises, and lifestyle changes to address the underlying causes of ED.
If you are experiencing hypogonadism-induced erectile dysfunction, contact our team today to discuss the problem and find a possible way out!