Erectile Dysfunction (ED): Causes, Symptoms, Treatment and Prevention.

Erectile dysfunction (ED) is the inability to get or maintain an erection long enough to have sexual intercourse. There are many different causes, which can include conditions affecting your blood vessels, neurological conditions, mental health conditions, and injuries. A healthcare provider can diagnose and treat erectile dysfunction. 

Table of content: 

1. Overview
2. Symptoms and Causes
3. Diagnosis and Tests
4. Management and Treatment
5. Prevention
6. Outlook / Prognosis
7. Living With
8. Additional Common Questions
9. Resources

Overview:

What is erectile dysfunction?

Erectile dysfunction (ED) is a type of penis disorder. This affects your ability to get and maintain an erection strong enough for intercourse.

Your emotions play a major role in getting and maintaining an erection. It is important to feel relaxed, confident and excited. But sometimes it is normal to have erection problems. Erection problems may occur if you feel nervous, anxious, depressed, or tired. Drinking alcohol and/or using substances can also have an impact. It may also be caused by other conditions or as a side effect of certain medications or cancer treatments.

If you are having difficulty getting or maintaining an erection, it is a good idea to make an appointment with a healthcare provider to discuss it further.
In many cases, ED may be the first symptom of another underlying problem, including heart disease. It is important to talk to a healthcare provider if you have trouble getting and maintaining an erection.

Other names for erectile dysfunction include:

• Impotence.

• Impotency.

What are the types of erectile dysfunction?

Healthcare providers separate ED into several categories:

• Vascular erectile dysfunction. Vascular ED includes causes that affect the blood vessels that send blood to the tissues in your penis that allow you to get and maintain an erection, or the valves in the penis that normally keep blood inside. Vascular ED is the most common type of ED.

• Neurogenic erectile dysfunction. Neurogenic ED occurs as a result of nerve problems, which prevent signals from traveling from your brain to your penis to produce an erection. This may be caused by trauma, pelvic surgery, radiation therapy, or neurological conditions such as stroke, spinal stenosis, and multiple sclerosis (MS).

• Hormonal erectile dysfunction. Hormonal ED refers to ED that results from testosterone deficiency or, in some cases, thyroid problems.

• Psychogenic erectile dysfunction. Psychogenic ED includes psychological conditions (conditions that affect your thoughts, feelings, or behavior) that can cause ED. 

How common is erectile dysfunction?

Erectile dysfunction is the most common sex-related condition that men and people who are male at birth (AMAB) report to healthcare providers, especially as they age and develop other health problems.

What is the normal age for erectile dysfunction?

Providers and medical researchers estimate that erectile dysfunction affects more than 50% of men who identify as male between the ages of 40 and 70. And these numbers may be higher – many people do not seek help for the condition because of embarrassment or shame.

Symptoms and causes:

What are the symptoms of erectile dysfunction?

Symptoms of erectile dysfunction include:

• Only sometimes being able to get an erection before intercourse.

• Being able to get an erection before intercourse but not being able to maintain it during intercourse.

• Complete inability to get an erection.

• Maintaining an erection requires a lot of stimulation.

What causes erectile dysfunction?

There are several possible causes of ED, including conditions that affect you:

• Circulatory Systems: Your circulatory system consists of blood vessels that carry blood throughout your body. Your penis needs adequate blood flow to become erect and maintain an erection. Your penis also relies on a series of valves to close when they fill with blood – in some cases, these valves stop working as they should.

• Nervous system: Your nervous system includes your brain, spinal cord, and nerves. They work together to send electrical impulses that help your body, including your penis, move and feel.

• Endocrine system: Your endocrine system includes glands that make and release hormones. Hormones help tell your body to do certain things. Testosterone can help your blood vessels open (vasodilate), which helps blood flow to your penis. 

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by a physical cause. Common causes include:

• Heart disease

• Blocked blood vessels (atherosclerosis)

• High Cholesterol

• High Blood Pressure

• Diabetes

• Obesity

• Metabolic syndrome – a condition that includes increased blood pressure, high insulin levels, body fat around the waist, and high cholesterol

• Parkinson's disease

• Multiple sclerosis

• Certain prescription medications

• Tobacco use

• Peyronie's disease – development of scar tissue inside the penis

• Alcohol and other drug abuse

• Sleep disorders

• Treatment of prostate cancer or enlarged prostate

• Surgeries or injuries that affect the pelvic area or spinal cord

• Low testosterone

Psychological causes of erectile dysfunction

The brain plays a key role in initiating the chain of physiological events that begins with feelings of sexual arousal and leads to an erection. Many things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

• Depression, anxiety or other mental health conditions

• Tension

• Relationship problems due to stress, poor communication, or other concerns 

Other substances

Substances that have the potential to cause addiction can cause ED, including:

• Liquor.

• Amphetamine.

• Barbiturates.

• Cocaine.

• Marijuana.

• Methadone.

• Nicotine.

• Opioids.

These substances can affect and depress your central nervous system. They can also cause serious damage to your blood vessels, leading to permanent erectile dysfunction. 

What is the primary cause of erectile dysfunction?

Conditions that affect your body's ability to deliver blood to your penis are the most common causes of ED.

Who does erectile dysfunction affect?

You may be at greater risk for ED if you:

• Are 40 or older.

• Have diabetes.

• Body mass index (BMI) is greater than 25.

• Have depression.

• Are physically inactive.

• Smoke. 

Diagnosis and Testing:

How is erectile dysfunction diagnosed?

A healthcare provider can diagnose ED and determine its cause. They will review your medical history and perform a physical examination. They will also ask you questions about your personal and sexual history. These questions may make you feel embarrassed or awkward. But it is important to be honest with the provider to find out the cause immediately. Questions may include:

• Are you currently taking any medications, including prescription drugs, over-the-counter drugs, herbal supplements, dietary supplements, and non-prescription drugs?
• Has a healthcare provider ever diagnosed you with depression or anxiety?
• Do you often feel stressed?
• Are you facing any problem in relationship?
• How often are you able to get an erection?
• How hard is your erection?
• How long are you able to maintain an erection?
• Do you lose your erection because you ejaculate sooner than you want?
• When did you first notice symptoms of erectile dysfunction?
• What exactly happened when you first had symptoms of erectile dysfunction?
• Did you experience erections at night or in the morning?
• What sexual positions do you regularly engage in?

The provider may also ask to talk to your sexual partner. Your partner may be able to provide additional information on possible causes.
The provider may order tests to confirm their diagnosis and determine the cause of your ED. 

What tests will be done to diagnose erectile dysfunction?

It depends on what your healthcare provider suspects is causing erectile dysfunction. Your provider may order:

• Blood test.
• Complete blood count (CBC).
• lipid panel.
• liver function tests.
• Kidney function test.
• Thyroid test.
• Testosterone test.
• Urinalysis (urine test).
• Penile Doppler ultrasound.
• Tests that measure whether the nerves in your penis respond to vibration (penile biothesiometry).
• Medicines that temporarily make your penis erect (vasoactive injections).
• Magnetic resonance angiogram (MRA).

Before the test, your provider will explain what the test involves and answer any questions you may have. If you don't feel comfortable, you can decide not to have the test at any time. 

Management and Treatment:

What is the best way to cure erectile dysfunction?

The first step in treating erectile dysfunction is to identify the underlying cause. A healthcare provider will help determine the best treatment for you. Treatment options may include:

• Cardiovascular exercise. Vigorous cardiovascular exercise for at least 45 minutes three times per week may help reverse some cases of mild ED. Cardiovascular exercises may include brisk walking, jogging, swimming, cycling, and jumping rope.

• Quit smoking. For men with mild ED, quitting smoking may lead to improvement after several months.

• Talking to a sex therapist.

• Oral medications that help increase blood flow to your penis, including sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®) or avanafil (Standra®). Oral medicines start working within an hour. 
  
  

• Penile low-intensity focused shockwave therapy (LiSWT). This non-invasive treatment improves blood flow using sound waves. It may take two months to see improvement.

• Medications that you inject directly into your penis to cause an erection include alprostadil (Caverject®), papaverine (Papacon®), phentolamine (Rezitine®), or a combination of several medications. The injected medicines start working within 10 minutes.

• Vacuum contraction device (penis pump). Penis pumps start working almost immediately.

• Testosterone replacement therapy, which is available in the form of gel, injection, patch, and pellets. Testosterone replacement therapy starts working within four weeks.

• Penile implant procedure. Penile implant is a procedure in which a surgeon inserts a device into your penis to make it harder. This device does not affect sensation, urination or sexual arousal. 

Read more to know: 

How to Use Viagra for Best Results: A Comprehensive Guide 

Viagra vs. Sildenafil: Understanding the Difference 

Will ED go away on its own?

ED will not go away on its own without changes in your lifestyle or some type of treatment. 

Prevention:

Can ED be prevented?

Some lifestyle changes may help reduce the risk of developing erectile dysfunction, including:

• Lowering your cholesterol.

• Being more physically active, especially doing cardiovascular exercise like running, jogging or cycling.

• Maintaining a healthy weight for you.

• Getting high quality sleep.

• Eating healthy foods low in saturated fat, such as fruits, vegetables and whole grains.

• Stopping smoking.

• Reduce or stop drinking alcohol.

Outlook/Forecast: 

What can I expect if I have erectile dysfunction?

The outlook for ED is good and it is a very treatable condition. Although there is no cure for some causes of ED, several treatment options can help you get and maintain an erection strong enough for intercourse.

Living With: 

When should I see a healthcare provider?

If you suspect you have erectile dysfunction, talk to a primary care doctor or urologist. They can help diagnose ED, identify its cause, and recommend the best treatment options for you. A urologist is a healthcare provider who specializes in diagnosing and treating conditions that affect your reproductive system and urinary system.

When should I go to the ER?

If you are taking medication for erectile dysfunction and erection pain lasts more than two to four hours, go to your nearest emergency room. This could be a sign of priapism, which can cause permanent damage to your penis without treatment.

What questions should I ask the healthcare provider?

• Is it normal to have erectile dysfunction?

• How do you know if I have erectile dysfunction?

• What is causing my erectile dysfunction?

• Which ED treatment option do you recommend?

• Can erectile dysfunction cause other conditions that affect my sexual health?

• Can I still have orgasms if I have ED?

• Can you recommend a sex therapist?

• Can you recommend a support group for people suffering from erectile dysfunction?

• Am I a candidate for a penis implant procedure? 

Additional Commen Question:

How does it feel when you can't get an erection?

You may feel a variety of emotions due to erectile dysfunction. You may feel embarrassed, disappointed, guilty, ashamed, angry, or "less than." This can lead to more serious long-term feelings like anxiety and depression. But you don't have to live with these feelings. ED is common, and it does not reflect your value as a person. Health care providers are available to assist.

What can I do if my partner has erectile dysfunction?

Erectile dysfunction is a sensitive topic for many people. The following tips may help you if your partner has erectile dysfunction:

• Encourage open communication. Let your partner know that you care about their feelings and well-being. Take appropriate time to talk to your partner so that he or she does not feel insecure.

• Remind your partner that they are not alone. ED is common, and treatment is available. Therapists and support groups can help your partner understand their feelings.

• Encourage healthy habits. Focus on the benefits of regular exercise, healthy eating, and reducing substances that cause ED.

• Get informed. Your partner will feel supported if you have accurate, up-to-date information on erectile dysfunction and its treatment options.

• Offer to accompany your partner to their appointments. You can help your partner ask questions, take notes, and give the healthcare provider information that can help them make a diagnosis. Respect their privacy if they prefer to see a provider alone.

• Express your feelings in other ways. Sex is not the only way to increase intimacy between partners. You can show your partner that you care through physical contact such as holding hands or rubbing the back, spending time with them, kissing, writing notes, being patient, and being a good listener.   

Read more:

Top 10 Questions/Answers About Viagra 

is viagra safe for take dialy? what are the benefits?

Resources:

• Erectile Dysfunction medicines 

Meds Online Delivery (MOD) is the Online pharmacy in USA that provides fastest delivery of hassle-free and reliable medicine at your doorstep in pan United states. 

A Note from MOD Pharmacy

Erectile dysfunction (ED) is common, especially as we age. This can lead to embarrassment, low self-esteem, and other serious psychological conditions. But you shouldn't feel ashamed or embarrassed about having ED. This may be your body's way of telling you that something is not right. It's important to have an open conversation with a healthcare provider about your symptoms and how they affect your quality of life. They can diagnose ED, determine its cause, and recommend the most appropriate treatment for you. 

5 Reliable Online Places for Purchasing ED Medications in 2023.

If you search "buy erectile dysfunction drugs" online, you will find approximately 22 million web sites. You can find well-known ED drugs for sale, as well as many "natural" treatments that promise to give you similar results.  Are they safe to buy? Experts say think twice before shopping online.

The Food and Drug Administration (FDA) warns against purchasing ED pills from websites that do not require a doctor's prescription. 

A quick look at online pharmacy to buy ED pills online safely

• Best for generic options: Roman | Skip to review
• Best range of ED pills: Hims | Skip to review
• Best for health services: Lemonaid | Skip to review
• Best for free consultations: RexMD | Skip to review
• Best for fast delivery in USA: MOD Pharmacy | Skip to review

According to a 2021 study, the number of ED products available online and in retail stores is increasing. However, people should remain cautious and avoid unapproved ED treatments, including those from manufacturers claiming to be "natural supplements."

This article discusses some medications that help with ED, the risks associated with purchasing them online, and where to get ED pills safely. In this, alternative methods of treatment of ED will also be discussed.

Comparing places where to get ED medications online 

In today's digital age, the convenience of purchasing medications online has become increasingly popular, including medications for Erectile Dysfunction (ED). However, it's crucial to choose a reputable and safe source when considering these sensitive treatments.

We chose the following brands based on user ratings, discretion, and our product selection guidelines. This includes verifying Hims, Roman's, Lemonade and MOD Store claims that a doctor or other qualified or licensed medical professional is involved in determining the appropriateness of the prescribed drug.

Where to get ED pills safely

The best place to get ED pills is a licensed pharmacy. A pharmacist can answer a person's questions about ED pills and provide them with information about possible side effects.
People should not obtain ED pills from websites without contact details, which offer much lower prices than pharmacies, and which do not ask for a doctor's prescription. 

Those who prefer to fill their prescriptions online should select a reputable online pharmacy in the USA that has a pharmacist available to assist with any problems or questions.

The reputable online pharmacy has received the seal of approval from the National Association of Boards of Pharmacy. This proves that the pharmacy is legitimate and does not sell counterfeit medicines.

What to Look for When Buying ED Medicines Online  

In today's digital age, the convenience of purchasing medications online has become increasingly popular, including erectile dysfunction (ED) medications. However, it is important to choose a reputable and safe source when considering these sensitive treatments. This article will guide you through the process of comparing different online platforms where you can get ED medications, helping you make an informed decision. 

Selects online pharmacies for ED medications that meet the following criteria:

Safety and Legality:

• Discuss the importance of obtaining medications from licensed and regulated online pharmacies.
• Highlight the risks associated with counterfeit or substandard ED drugs.

Product Quality:

• Evaluate the quality and authenticity of medicines offered by various online sources.
• Discuss the importance of FDA-approved generic or brand-name medications.

Price Comparison:

• Compare the price of ED drugs on different websites, including any possible discounts or promotions.
• Provide information on how to balance cost with quality.

Prescription Requirements:

• Explain the importance of getting prescriptions for ED medications from a health care professional.
• Check the prescription policies of different online platforms.

Delivery and Shipping:

• Discuss shipping options, delivery times and packaging discretion.
• Highlight any international shipping considerations.

Customer Feedback:

• Share testimonials and reviews from individuals who have purchased ED medications online.
• Emphasize the importance of considering real user experiences.

Online Ratings and Rankings:

• Mention online platforms or resources that rank and review online pharmacies for reliability and customer satisfaction.

Regulatory Compliance:

• Discuss the regulatory landscape for online pharmacies and the importance of following legal guidelines.

Privacy and Data Security:

• Discuss privacy concerns related to purchasing sensitive medications online.
• Provide tips for protecting personal information. 

Criterias for Identifying a Trustworthy Online Pharmacy or Health Platform?

There should be several obvious ways to contact a customer service representative, such as a pop-up chat window, an email to send questions, a contact form you can submit, or a phone number you can call.

The company may have a medical advisory board and a network of licensed health care professionals.

As a user of their services or platform, it should be easy for you to view information about the nurse practitioners and physicians you work with, such as medical licenses and credentials.

Is it safe to buy ED pills online?

People should not buy ED pills online unless they have a doctor's prescription and are purchasing them from a reputable online pharmacy or telehealth company. The FDA doesn't regulate online ED products – unless it's an approved drug like sildenafil (Viagra) – to make sure they're safe.

A reliable source at the FDA says it has found unknown ingredients in several products claiming to enhance sexual performance. Some of these ingredients are found in prescription drugs like Viagra and Cialis, and may interact with drugs or supplements.

This means that online ED products may contain harmful substances or high amounts of medications that consumers are not aware of.

The FDA maintains a database of contaminated drugs, which is available for viewing online. A non-exhaustive list of products containing unknown PDE-5 inhibitors includes: 

 

• 4EVERON
• Actra-Rx
• Actra-Sx
• Adam Free
• Blue Steel
• Energy Max
• Erextra
• Hero
• HS Joy of Love
• Lady Shangai
• Libidus
• Liviro3
• Lycium Barbarum L.
• Nasutra
• Naturalë Super Plus
• NaturalUp
• Neophase
• Rhino V Max
• Shangai Ultra
• Strong Testis
• Super Shangai
• True Man
• V.Max
• Vigor-25
• Yilishen
• Zimaxx
  

FDA-approved erectile dysfunction medications work by increasing blood flow to the penis. Like any other medicine, these medicines can also have side effects. If you buy these online – without a prescription – you will not have the chance to discuss them with your doctor before taking them.

Generic pills to treat ED

Phosphodiesterase-5 (PDE-5) inhibitors are medications that individuals can use to help treat ED. These drugs enhance erections by blocking the action of the phosphodiesterase enzyme, which triggers the end of the erection. However, for PDE-5 inhibitors to work the person must have a sexual drive or libido.

The FDA has approved the use of four PDE-5 inhibitors for ED:

• Sildenafil (Viagra)   25 mg, 50 mg, 100 mg
• Tadalafil (Cialis)         2.5 mg, 5 mg, 10 mg, 20 mg
• Vardenafil (Levitra) 2.5 mg, 5 mg, 10 mg, 20 mg
• Avanafil (Stendra) 50 (mg), 100 mg, 200 mg

Depending on the efficacy and side effects a person may experience while taking any of these medications, the doctor may recommend a different dosage.

Additionally, doctors may recommend alternative treatments for ED if they determine that PDE-5s are not appropriate.

Is it safe to take ED pills without a prescription?

It is not safe to take ED pills without consulting a doctor or pharmacist. Taking ED (Erectile Dysfunction) pills without a prescription raises important safety concerns. These medications, which are typically prescribed by healthcare professionals, are designed to address a specific medical condition.

Additionally, PDE-5 inhibitors can cause serious interactions with other medications. For example, people who take sildenafil with medications containing nitrates may experience severely low blood pressure.

Drug interactions and pre-existing conditions are some of the factors a doctor may take into account before prescribing an ED medication to ensure that it will be safe and effective.

Therefore, it is important to consult a doctor before purchasing ED pills. 

Other Aternative treatments for ED

A 2023 review suggests some other treatments for ED, such as:

• Seeking mental health counseling to reduce sexual anxiety
• treating any underlying conditions that may affect sexual performance, such as obesity, heart disease, and diabetes
• Implementing lifestyle adjustments, including maintaining a well-rounded diet and engaging in consistent physical activity

Some individuals may be candidates for combination therapy with PDE-5 inhibitors and testosterone.
Some procedures may improve sexual performance, including:

• Penile artery reconstruction
• Penile prostheses implants
• Extracorporeal shockwave therapy
• Stem cell therapy

What are the side effects and ED Medicine?

Viagra, also known as sildenafil, is a medication commonly prescribed to treat erectile dysfunction (ED). While it is generally considered safe and effective, like any medication, it carries certain side effects and risks. 

It's crucial to follow your healthcare provider's guidance and report any unusual or severe side effects. Here are some of the common side effects and risks associated with Viagra:

Common Side Effects:

Headache: Headaches are a relatively common side effect of Viagra, affecting a significant percentage of users.

Flushing: Some individuals may experience facial flushing or redness, especially in the cheeks.

Indigestion: Upset stomach or indigestion can occur as a side effect.

Nasal Congestion: Stuffy or runny nose is another possible side effect.

Dizziness: Some people may feel lightheaded or dizzy.

Visual Disturbances: In rare cases, Viagra has been associated with mild visual disturbances, such as changes in color perception or blurred vision.

Less Common Side Effects:

Priapism: An erection lasting longer than four hours (priapism) is a rare but serious side effect. If this occurs, seek immediate medical attention as it can damage the penis.

Sudden Hearing Loss: Although rare, there have been reports of sudden hearing loss associated with Viagra. Stop using the medication and seek medical help if you experience any sudden decrease or loss of hearing.

Risks and Considerations:

Heart Health: Viagra can affect blood pressure, so it's important to discuss any heart conditions or medications with your healthcare provider before using it.

Interactions: Viagra can interact with certain medications, particularly nitrates (often prescribed for chest pain) and alpha-blockers (used to treat high blood pressure). Mixing these drugs can result in a dangerous drop in blood pressure.

Allergic Reactions: Some individuals may be allergic to sildenafil, and allergic reactions can vary in severity. Seek immediate medical attention if you experience symptoms like rash, itching, swelling, severe dizziness, or difficulty breathing.

Alcohol and Grapefruit: Alcohol and grapefruit juice can interact with Viagra, potentially increasing side effects or reducing its effectiveness. It's advisable to limit or avoid these substances when taking the medication.

Priapism and Structural Abnormalities: Individuals with anatomical issues of the penis may be at a higher risk of priapism. Inform your healthcare provider about any known structural abnormalities.

Vision Changes: While rare, Viagra has been associated with vision changes. If you experience any sudden vision problems, discontinue use and seek medical attention.

It's important to remember that Viagra should only be used under the guidance of a healthcare professional, and they will consider your overall health and potential risks before prescribing the medication. If you experience any severe or unexpected side effects while taking Viagra, contact your healthcare provider immediately.

You also know: Top 10 Questions With Answers About Viagra

When the meet Doctor:

People who think they have ED can talk to a doctor. A healthcare provider can assess and recommend the most suitable treatment choices.

Anyone taking ED pills should consult a doctor immediately if they experience any side effects, such as:

• vision loss or changes
• hearing loss or change
• chest pain or pressure
• dizziness and fainting
• Allergic reaction, such as rash and difficulty breathing or swallowing

Additionally, taking high doses of PDE-5 inhibitors may cause:

• back pain
• muscle pain
• changes in vision
• low blood pressure, or hypotension
• priapism

Summary

Buying ED pills online can be unsafewhen consult a doctor, as these products are not subject to FDA regulations. They may contain harmful ingredients or high amounts of unlisted medicines. The FDA has already banned many ED products.

The safest way to take ED pills is to consult a doctor. If the medicine is suitable, the doctor will give a prescription. One can fill the prescription online or offline at any reputed pharmacy.