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Erectile Dysfunction is a medical condition where a man is consistently unable
to achieve and maintain an erection that allows for satisfactory sexual function


Can erectile dysfunction (ED) be a symptom of other medical conditions?

Erectile dysfunction (ED) has been associated with a number of other medical conditions:
Cardiovascular disease (heart disease). It’s quite common for men with ED to have cardiovascular disease. The connection usually stems from atherosclerosis, or hardening of the arteries. When a man has an erection, his penis fills with blood. So, to have an erection suitable for sex, he needs to have good blood flow to the penis.

Plaque buildup in the arteries from atherosclerosis interferes with this blood flow. With less blood in the penis, a man has erectile dysfunction. Often, ED is a sign of cardiovascular disease, as atherosclerosis usually begins in smaller arteries, such as those in the penis.

Diabetes. Diabetic men may be four times more likely to have ED than men without diabetes. Also, diabetic men may start having erectile problems at a younger age, sometimes 10-15 years earlier than men without diabetes.

High blood sugar from diabetes can damage blood vessels and lead to hardening of the arteries, preventing good blood flow into the penis. It can also cause neuropathy, or nerve damage, which interferes with the transmission of messages between the brain and the penis that start an erection.

In addition, diabetes can interfere with the production of nitric oxide, an important chemical for erections. It may also contribute to the stiffening of erectile tissue. High cholesterol. Too much low-density lipoprotein (LDL or “bad” cholesterol”) can build up on artery walls, leading to atherosclerosis and erection problems. Obesity. It’s estimated that obese men are two and a half times more likely to have erectile dysfunction than men who are not obese. Obesity raises a man’s risk for cardiovascular disease and diabetes which, in turn, can lead to erectile dysfunction. Respiratory disorders. Research has shown that men with ED are more than twice as likely to obstructive sleep apnea as men without ED.

ED has also been associated with chronic obstructive pulmonary disease (COPD), possibly because of atherosclerosis that develops from smoking cigarettes. Neurological problems. Because erections depend largely on communication between the brain and penis through a network of nerves, men with neurological problems such as stroke, multiple sclerosis, Parkinson’s disease, and spinal injuries may have trouble with erections.

Kidney disease. Chemical changes prompted by kidney disease can cause problems with nerve function, hormones, and blood flow, all of which can lead to erectile dysfunction. Some medications used to treat kidney disease can cause ED, too. Liver disease. Hormones, including testosterone, may fluctuate in men with liver disease, prompting ED.


Men with ED who are concerned about any of these conditions should speak to their doctor.

Sexual Health Q&A

What is the difference between sexual performance anxiety and erectile dysfunction (ED)?

Sexual performance anxiety and erectile dysfunction (ED) are both troublesome issues, and it’s possible for a man to have both. But they do have some clear differences

A man with sexual performance anxiety occurs worries about his sexual function or his ability to please his partner sexually. He might have questions like these:
Will I be able to get a firm erection?
Will I ejaculate too quickly?
Will I have an orgasm?
Does my partner find me attractive?
Is my penis big enough?
Am I sexually skilled enough?
Will my partner reach orgasm?
What will happen if my partner is not sexually satisfied?

Men who use pornography can develop sexual performance anxiety if they compare their real life experiences to what they see in adult films and videos. Usually, such depictions are not realistic, but men may feel nervous or inadequate if they don’t perform the same way.

Sometimes, a man may become so concerned about his performance that he develops erectile dysfunction (ED). The anxiety triggers the production of stress hormones (such as epinephrine and norepinephrine) which can narrow blood vessels in the penis and make it difficult for blood to flow in and form an erection.

Erectile dysfunction (ED) occurs when a man cannot get and maintain an erection firm enough for sex. As noted earlier, ED can be a result of performance anxiety. But health situations can affect erections, too. Here are some examples:

  • Diabetes
  • Heart disease
  • High cholesterol
  • High blood pressure
  • Smoking
  • Nerve damage
  • Cancer treatment (such as prostatectomy – removal of the prostate gland)
  • Thyroid disorders
  • Low testosterone
  • Medication side effects
  • Attention deficit (especially in young men)

Sometimes, ED leads to performance anxiety. A man who has had trouble with erections in the past may become anxious about his ability to perform sexually in the future.

While it’s possible to have both sexual performance anxiety and ED, it doesn’t always happen this way. Men who feel confident in the bedroom and in their relationships can still develop ED.

Fortunately, both ED and sexual performance anxiety can be treated.

Men with performance anxiety may consider sex therapy. A therapist can help men work through their concerns, adjust their expectations, and become more focused on the pleasure of sex. For example, a man who is concerned about a small penis might be relieved to learn that his length is in the average range. Or a man who worries about his partner’s orgasm may learn ways to ask his partner what he or she likes.

If the man is in a relationship, it’s often a good idea for his partner to come to therapy with him. Sometimes, partners are the source of pressure and anxiety due to their own worries, sexual problems, or lack of knowledge. Attending therapy together can help a couple with relationship tension, too.

Men with ED have a variety of treatment options, including Focus Shock wave therapy, medications, self-injections, vacuum devices, and penile implants.





What are the treatment options for men with ED?

New curative therapy for erectile dysfunction – drug-free and painless – available Now

  • There are alternatives to drugs and pills when it comes to treating erectile dysfunction (ED). “Focus shock WAVE™ is a shockwave therapy that stimulates the growth of blood vessels in the penis using the body’s natural capacity. It is not a temporary solution as it helps cure the problem of poor penile blood flow.
  • Psycho-sexual treatments. These approaches may reduce both the man’s and his partner’s anxiety, enhance arousal, and offer pleasurable options, which may reduce the man’s stress. These interventions can be performed separately or parallel to medical treatments.
  • Oral medications. eg PDE-5 Inhibitor
  • Penile injections. Men can learn to inject medication into the penis. This medication helps blood vessels dilate, allowing more blood for erection.
  • Urethral suppositories. These medications are inserted into the urethra at the tip of the penis.
  • Vacuum erection devices. The man places his penis into a vacuum cylinder and pumps air out. He then places a constriction ring at the base of the penis, which keeps the erection.
  • Penile implants. Implants (sometimes called penile prostheses) are surgically placed inside the penis and allow a man to get an erection when he wishes. Nowadays, most penile implants are inflatable devices controlled with a pump.

Men who are having trouble with erections are encouraged to see a doctor. It’s not unusual for ED to have a combination of causes. It can also be a sign of a more serious medical condition like diabetes or heart disease, so it’s important to have a complete checkup

What Causees Erectile Dysfuction?


  • Poor blood flow to the penis. This is one of the most common causes of ED and can be the result of diabetes, heart disease, high cholesterol, and high blood pressure.
  • Nerve damage. When a man is sexually aroused, his brain sends messages to his penis to start the erection process. But if there is nerve damage, these messages cannot be transmitted properly. Thus, conditions that affect the nervous system – like diabetes, spinal cord injury, multiple sclerosis, and stroke – can lead to ED. Erectile nerves can also be damaged during cancer treatments, like radiation therapy or radical prostatectomy (removal of the prostate gland).
  • Hormonal issues. Men with low testosterone or thyroid disorders may have trouble with erections.
  • Medication side effects. ED is a side effect of some medications, such as those prescribed for high blood pressure, heart disease, peptic ulcers, insomnia, and depression. Not all medications in these categories have sexual side effects, however. For example, some antidepressants do, but other antidepressants do not.
  • Peyronie’s disease. Peyronie’s disease is a wound healing disorder marked by a distinct curvature of the penis. Many men with Peyronie’s disease develop ED, although experts aren’t sure exactly why.
  • Psychological and emotional issues. Fighting with a partner, anxiety, depression, stress, past sexual abuse, and concerns about sexual performance can all affect one’s sexual well-being. In these cases, sessions with a sex therapist or counselor may help. A man’s lifestyle can also interfere with his erectile function. Smoking, obesity, drug and alcohol abuse, an unhealthy diet, and poor exercise habits can contribute to other health conditions associated with ED.

What lifestyle changes can men make to improve their erectile function?

There are many things men can do to improve erectile function. Many of them provide other health benefits as well, so it makes sense to give them a try. Before considering these lifestyle changes, it’s helpful to remember the role of penile blood flow in forming and maintaining an erection. When a man is sexually stimulated, penile arteries widen and smooth muscle tissue relaxes. As a result, the penis fills with blood, which gives the erection its firmness. Often, erectile dysfunction occurs when there are problems with blood flow. Many of these suggestions improve blood flow, but there are other factors, like nerve damage, that can be involved.


Many men find that their erectile function improves when they exercise regularly. Exercise helps to keep blood flowing smoothly, including blood to the penis. Research has shown that men who are more physically active are at a lower risk of developing erectile dysfunction. Men should consult their doctors before beginning a regular exercise program to ensure that the type of exercise they choose is appropriate for them.

Maintain a healthy weight

Obesity can damage blood vessels that allow blood into the penis for an erection. Studies have shown that heavier men tend to have more erectile problems, which may improve after the men lose weight. Weight loss may also help erectile function by decreasing inflammation, increasing testosterone, alleviating depression, and boosting confidence.

Don’t smoke (or quit if you do smoke)

Scientific studies have found that men who smoke are more likely to develop erectile dysfunction than non-smoking men. This likelihood appears to increase with the amount of cigarettes smoked over time. Men who stop smoking often see an improvement in their erectile function.

Eat a healthy diet

Research has shown that eating a Mediterranean diet may improve erectile function for some men. This diet includes fruits, vegetables, grains, and olive oil. Research has also shown that men without erectile dysfunction were more likely to eat lots of fruits, vegetables, nuts, and fish, and whole grains.

Control blood sugar and manage diabetes

Many men with diabetes have erectile problems. High blood sugar can damage blood vessels, nerves, and erectile tissue. Blood vessels may be more susceptible to atherosclerosis – hardening of the arteries – in diabetic men. This means that plaques build up in the arteries, making it more difficult for blood to flow freely into the penis and form an erection. Nerve damage, or neuropathy, can cause signaling problems between the brain and the penis. A man’s brain may register sexual stimulation, but if the “message” doesn’t reach the penis, there will be erectile problems. High blood sugar can also interfere with the production of chemicals needed for an erection, like the neurotransmitter nitric oxide. Other chemicals associated with diabetes can stiffen erectile tissue, leading to valve problems and “venous leak.” When this happens, the erection cannot be maintained because blood leaks out of the penis and back into the body.

Manage blood pressure

High blood pressure, or hypertension, is a common cause of erectile dysfunction, as it can interfere with penile blood flow. While it’s important to manage high blood pressure, medications for this condition may also affect erectile function. It appears that older drugs, such as diuretics and beta-blockers, are more likely to have sexual side effects than newer ones. A man’s physician can help him decide on the best treatment options.

Manage depression

Depression is associated with erectile dysfunction, although it is unclear whether one directly causes the other. A man’s depression may lead to erectile difficulties. However, erectile dysfunction may also make him depressed. Nevertheless, managing depression may help alleviate erectile dysfunction. It is important to note, however, that some commonly prescribed medications for depression, such as selective serotonin-reuptake inhibitors (SSRIs), have sexual side effects. A man may need to try different medications, with a physician’s guidance, to determine which one works best for him.

Remain sexually active

In a Finnish study of men between the ages of 55 and 75, men who had intercourse less than once a week were twice as likely to have erectile dysfunction than those who had intercourse once a week. The researchers concluded that regular intercourse protects against erectile dysfunction.

Be careful when bike riding

Men put a lot of pressure on their genitals when riding a bike. Compressing the perineum (the area between the scrotum and anus) on a bicycle seat can stop blood flow to this area, causing sexual difficulties. Men are advised to use a noseless bicycle seat, adjust their position on the bicycle so that there is less pressure on the perineum, and limit the time they spent bike riding.


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