Erectile dysfunction is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse. Having an erection problem from time to time is not a cause for concern. However, if the problem is persistent and affects your sex life, it can cause stress, loss of self-confidence and relationship problems. Erectile dysfunction in men can be a sign of an underlying health condition requiring treatment, such as heart disease or diabetes.
If you are experiencing erectile problems or have concerns about this subject, do not hesitate to discuss it with your doctor. Sometimes treating an underlying condition is enough to eliminate the erectile problem; in other cases different treatments may be needed.
When should you see a doctor?
Your family doctor is a physician you can consult about your erectile problem and will refer you to a specialist if deemed necessary. You can consult your doctor in the following situations:
- If you have concerns about erections or are experiencing other sexual problems such as premature or delayed ejaculation,
- If you have diabetes, heart disease or another known health condition that may be linked to erectile problems,
- If you have other symptoms along with erectile dysfunction.
What are the causes of erectile dysfunction?
Male sexual function is a complex process involving the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
The causes of erectile dysfunction can be divided into organic and psychogenic; in other words, physical or psychological problems can cause erectile dysfunction. Sometimes a combination of physical and psychological problems causes it. For example, if physical conditions that slow sexual responses are combined with anxiety, serious erectile dysfunction can result.
Physical causes of erectile dysfunction
In many cases the cause of erectile dysfunction is a physical problem. A problem with cardiovascular health is one of the most common causes. The physical causes of erectile dysfunction can be listed as follows:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High cholesterol
- High blood pressure
- Diabetes
- Obesity (excess weight)
- Metabolic syndrome (a condition involving 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 (a condition involving the development of scar tissue inside the penis)
- Alcoholism and other substance addictions
- Sleep disorders
- Treatment for prostate cancer or an enlarged prostate
- Surgery or injuries affecting the pelvic area or spinal cord
Psychological causes of erectile dysfunction
The mechanism that produces an erection begins in the brain, triggered by feelings of sexual excitement. Certain conditions can therefore interfere with sexual excitement and cause erectile problems. The following are examples of such conditions:
- Depression, anxiety or other mental health conditions
- A stressful life
- Relationship problems with a partner and the anxiety and stress that develop as a result
What are the risk factors for erectile dysfunction?
As you get older, erections may take longer to develop and may be less firm. People over 40 and those with a certain medical history are more prone to erectile dysfunction.
Various risk factors can contribute to erectile dysfunction, including the following:
- Medical conditions, especially diabetes or heart problems
- Tobacco use, which restricts blood flow to veins and arteries (over time it can cause chronic health conditions that lead to erectile dysfunction)
- Being overweight
- Having received certain medical treatments such as prostate surgery or radiation therapy for cancer
- Injuries, especially those that damage the nerves or arteries controlling erections
- Antidepressants, antihistamines and certain medications used to treat high blood pressure, pain or prostate conditions
- Psychological conditions such as stress, anxiety or depression
- Drug and alcohol use (especially long-term drug users or people who consume large amounts of alcohol)
What are the complications of erectile dysfunction?
Complications resulting from erectile dysfunction may include:
- An unsatisfactory sex life
- Stress or anxiety
- Embarrassment or low self-esteem
- Relationship problems with a partner
- In very serious cases, inability to have children because intercourse with a partner cannot take place
