Erectile Dysfunction (Impotence) – Causes, Symptoms, and Treatment

One of the most common issues for men during any type of sexual activity is erectile dysfunction. Not only can it restrict sexual performance but it can create a detrimental impact psychologically. Across the board there are many causes for erectile dysfunction; scientifically the penis is not receiving enough blood to create the erection, but for most cases it is down to physical and mental health

Erectile dysfunction is a very common condition, particularly in older men between the ages of 40 and 70. Should you experience any erectile dysfunction, it is important to understand the causes and symptoms before you can think about the correct resolution idea. Physical causes can be identified in about 80% of cases. Psychological impotence is where erection or penetration fails due to thoughts or feelings; this is somewhat less frequent, on the order of about 10% of cases.

Today, we will discuss the causes, symptoms and treatment methods for erectile dysfunction:

What is Erectile Dysfunction?

Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is sometimes referred to as sexual impotence however erectile dysfunction is more commonly used as the understanding. There is currently no uniformed criteria detailing how congruous the issue has to be and for how long it must exist for it to be considered ED. The Diagnostic and Statistical Manual of Mental Disorder-5 specifies a duration of at least 6 months in its definition of ED.

Occasional ED isn’t unusual. For the majority of men, they will experience it at some point in their life. However when erectile dysfunction is frequent this can be a sign of health issues that need medical advice and potentially medical treatment. It can also be a sign of stressful and anxious difficulties in your life. More often it can be relationship difficulties between you and your sexual partner that may need to be conveyed to a professional so they can give you the best possible advice.

Several studies accessed the prevalence of ED. The Massachusetts Male Aging Study reported a prevalence of 52%. The study illustrated that erectile dysfunction is increasingly ubiquitous with age – approximately 40% of men are affected at age 40 and nearly 70% of men are affected at age 70. The prevalence of achieved ED increased from 5% at age 40 to 15% at age 70. Age was undoubtedly the variable most predominantly associated with ED.

Most doctors and health professionals identify two types of erectile dysfunction, primary and secondary. Primary occurs when a man has never been able to have or sustain an erection. Secondary occurs more commonly in people who have had erectile dysfunction or sometimes suffer temporarily. Secondary ED has had successful patients reverse their suffering but Primary could require a more intensive approach using medical based treatments. This is more rare.

For a deeper understanding of erectile dysfunction, here is some history:

History of Erectile Dysfunction

Erectile dysfunction surprisingly has some written history where there have been several different and odd attempts to reduce and cure this problem in men. ED has a long history from previous centuries and even before christ. Hieroglyphic drawings have been found in Egyptian tombs, on Greek paintings, and in the Old Testament Bible. King Louis XVI of France was rumored to have ED as early as age 15. The importance of understanding the history of erectile dysfunction is to prove it affects men of all races and across all social classes.

In a study by Am J Mens Health on Historical Treatments for erectile dysfunction, dating back to as early as the eighth century, men of Ancient Rome and Greece wore talismans of rooster and goat genitalia. They believed these talismans would serve as an aphrodisiac and promote sexual function. Romans consumed the genitalia of animals with high libidos, such as rabbits, and even drank the semen of hawks and eagles. 

During the 18th century, penile impotence was known to be a consequence of masturbation and optional downgrade of semen leading to male sexual dysfunction. A genital doctor at this time created a balm that was created to prevent a man’s desire to masturbate in return he claimed it would help to maintain semen levels.

About 100 years later, French neurologist Dr. Charles Edouard Brown-Séquard began injecting himself with extracts from the testicles of dogs and guinea pigs. This turned to Russian surgeon Dr. Serge Voronoff performed testicular graft transplantations from apes into human testes. Testosterone levels were known at this time for being the ultimate reason in erectile dysfunction. The attempts by Dr Voronoff and Sequard were unsuccessful at increasing testosterone levels, they were however a step toward the artificial combination of testosterone from cholesterol by Adolf Butenandt in 1935.

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With a deeper understanding of ED, it is important to be aware of the symptoms:

Symptoms of Erectile Dysfunction

The symptoms of erectile dysfunction are pretty self explanatory. The main symptoms are:

  1. Trouble getting an erection
  2. Difficulty maintaining an erection during sexual experiences
  3. Reduced interest in having sex

Having erection issues from time to time might not necessarily be a cause to raise alarms. If erectile dysfunction is an ongoing problem, however, it can lead to stress, significantly affecting your self-confidence and contribute to relationship problems. Now these are the obvious symptoms but some subjects may suffer even more heavily with erectile dysfunction. Other sexual symptoms and disorders related to ED include:

  1. Premature ejaculation
  2. Delayed ejaculation
  3. Anorgasmia, or the inability to reach orgasm after enough time of stimulation

It is highly recommended to speak with your local GP, doctor or health professional if you do have any of these symptoms, especially if they have lasted for longer than a 3 month period. 

They should be able to help determine whether your symptoms are being caused by an underlying physical or mental condition that requires treatment or therapy and can also be a sign of heart disease. Some studies have shown men with ED are at significant risk of getting a heart attack, stroke or circulatory problems in the legs.

Other symptoms of erectile dysfunction might include low-self esteem, depression and significant stress for the man and his partner especially when trying to conceive. These symptoms are more regularly linked with being causes of ED but it works both ways and can sometimes happen once during a sexual experience and spiral into further ED moments. 

With those symptoms in mind, let’s take a look at the most common causes and risk factors:

Erectile Dysfunction: What are the Causes and Risk Factors?

Before taking any treatment measures it is important to understand the causes of erectile dysfunction and the major risk factors that lead to a failed erection. One study found that 1 in 4 men who are seeking treatment for ED were under 40 years old. For the younger generation there was a much stronger association between smoking, drug use, and erectile dysfunction, observed compared with men above 40. This suggests that lifestyle choices are an important factor for ED in younger men.

Erectile dysfunction is most commonly caused by an underlying physical cause but around one quarter of all cases are caused due to psychological reasons.

Mental causes

For many, there can be mental causes that cause ED. The most common psychological causes are:

  • Stress: Stress can be caused by many factors from jobs, relationships and money issues.
  • Anxiety: Once a man experiences ED, he may become overly worried that the problem will happen again. This can lead to a fear of sexual failure, and consistently lead to ED.
  • Guilt: Not being able to satisfy their partner sexually.
  • Depression: A very common cause of ED. cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED.
  • Low self-esteem: This can be due to prior periods of ED or other issues unrelated to having sex.
  • Indifference: This may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple’s relationship.

Although the risk of ED grows with age, it can happen to anyone. As a whole, the healthier your lifestyle the better your sexual performance and chances of holding and sustaining an erection. 

Physical causes 

On the other hand, there are also many physical causes for ED. They can sometimes coincide with mental causes or be stand alone. The most common physical causes are due to:

  • Poor blood flow to the penis – Health issues reduce blood flow into the penis caused by hardened arteries, heart disease and diabetes
  • Nerve signs from the brain or spinal cord do not reach the penis – Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis.
  • Cancer treatments close to the pelvis affect the penis’ performance – Surgery and treatment for cancer in the lower abdomen or lower region of the torso can cause ED. Most of the time, treating prostate, colon-rectal or bladder cancer often leaves the patient with ED.
  • Drugs used for other health issues negatively impact erections – Patients should check with their prescriber what the potential side effects are
  • Low Testosterone – Some men suffer from low testosterone and find it not only hard to get an erection but also to get into the sexual mindset. 

At the University of Wisconsin, the Urology department concluded that about 5% of men that are 40 and above years old have complete erectile dysfunction, and that number enlarges to around 15% of men at the age of 70. Mild and moderate erectile dysfunction affects approximately 10 percent of men per generation. Erectile dysfunction can occur at any age, but it is more common in men that are older. Older men are more susceptible to having health conditions that need medication. 

Apart from an underlying health condition and psychological reasons it is often very common for men to have ED due to lifestyle choices. There are many risk factors which make erectile dysfunction worse especially if the patient suffers from one of the above already.

The most common risk factors are:

  • Being over age 50 
  • Diabetes
  • High blood pressure – Often caused by bad lifestyle choices increasing your risk of serious health problems.
  • High cholesterol – It damages the linings of blood vessels, including those in the penis. It also might affect the arteries towards your genitals.
  • Smoking – which restricts blood flow to veins and arteries
  • Using drugs – damage every blood vessel in your body and reduce the quality of your blood
  • Drinking too much alcohol – Having more than two drinks a day could hurt your capability to get an erection. Alcohol reduces blood flow to the penis and can obstruct the production of testosterone.
  • Being obese – Carrying extra weight increases your risk of blood vessel disease, a cause of ED.
  • Little exercise – Regular exercise increases the health of the body’s cardiovascular system. And when your heart and lung health improve, you have more energy and drive.

It is evident that erectile dysfunction has a whole host of causes and risks, some of which are manageable and some which need medical help. They are both psychological and physical. Reducing your risk factors will reduce the chances of erectile dysfunction should you not have any health conditions. But if you are still struggling with ED there are a variety of different steps you can take to improve your chances of creating and sustaining erections for better sexual performances.

Like causes and risk factors, there is a lot to know about treatment methods. Again, they vary from person to person:

Treatment of Erectile Dysfunction 

Earlier we looked at historical methods of treating ED but now, in the present 21st Century there is an abundance of different treatments, measures and advice on offer which can be a little confusing. 

The most popular treatment methods are simply to reduce the risk factors which cause erectile dysfunction in the first place. The five most natural ways of reducing the chances of having ED during a sexual experience are:

Natural Treatments:

  • Exercise regularlyIn a Harvard study, 30 minutes of walking a day was linked with a 41% drop in risk for ED. Other research suggests that moderate exercise can help restore sexual performance in middle-aged men suffering with ED.
  • Quit Smoking Severely damages the cardiovascular system and reduces blood flow
  • Reduce Alcohol intake – Alcohol is known as a depressant and greatly decreases sexual desire. Alcohol makes it difficult for a man to achieve erections or reach an orgasm.
  • Eat healthy foods – Eating a diet abundant in natural foods like fruit, vegetables, whole grains, and fish with fewer processed foods and red meat, decreases the likelihood of ED
  • Pay attention to your vascular health – High blood pressure, high blood sugar, high cholesterol, and high triglycerides all damage arteries in the heart and the brain leading to the penis, causing erectile dysfunction. It’s very important to check with your doctor to find out if your vascular system is in good condition.

Exercising regularly is one of if not the most imperative non medical remedy of reducing ED. Not only does it improve your flexibility and body shape, it also improves your psychological thoughts. It brings confidence and reduces stress and anxiety. There are even exercises recommended by doctors to improve sexual experiences and reduce ED. 

Kegel exercises, Yoga and Aerobic exercises all help improve blood flow and increase strength around the pelvic area. A strong pelvic area enhances stiffness during erections and keeps blood from leaving the penis by pressing on a vital vein. A British trial found, three months of daily sets of Kegel exercises, worked far better at reducing ED than just advice on lifestyle changes.

Aside from the lifestyle changes you can make, some medical professionals may provide you with advice or medication to treat ED. 

Non-surgical Medical Treatments:

Some patients may need further treatment with the help of supplements, drugs or herbal medicine. For these types of methods it is highly recommended to seek professional medical advice as they can have serious side effects depending on the usage.

Obviously the most well known medical aid is Viagra along with other oral agents. The drugs have fast results within 1 hour and around 70% of men are happy and have better erections, hence the popularity. The main chemical in Viagra is sildenafil which is what improves normal blood responses and greatly enhances blood flow by relaxing the muscles in the penis. Oral medications such as Viagra or BlueChew Pill work to create firmer erections.

Herbal medicines and supplements have previously been shown to successfully treat erectile dysfunction. Often called the herbal Viagra, they can be effective in improving a man’s sexual function, but there is little evidence to support the use of any herbal medication in the treatment of ED. Some of these herbs and supplements include:

The most popular consumption method of these herbal supplements are male enhancers such as MaleExtra or VigRx. The ingredients above are regularly found in these products and in some cases have proved to be very effective. 

=> To find out more on male enhancers read our article about the best male enhancers on the market here.

Surgical Medical Treatments:

Some people who suffer from primary erectile dysfunction may decide to seek serious surgical or physical changes. 

Surgical methods are only used when there is a health condition or severe lack of self-confidence should the patient want to proceed in this manner. A popular method to manage ED is the Vacuum erection device. It was first developed by Vincent Monday in the 1800s and is still in wide use 200 years later albeit in a much more modern way. The pump works by applying downward pressure to the penis to enhance blood flow, resulting in an erection. 

A more effective, yet also more invasive, method commonly used is an injection to the penile area. This relaxes vascular smooth muscle, resulting in increased penile blood flow.  There is one main injection therapy method called, Intracavernosal (ICI), which is also in a drug format. FDA approved Alprostadil is injected into the penis with a very small needle. According to the Urology Care Foundation, the success rate for having a firm enough erection for sex is 85% with this treatment.

The main surgical method more commonly known is the penile implant which manually helps to create an erection. In 1936, Nicolos Bogoras fashioned the first penile implant using rib cartilage and bone, which was reabsorbed by the body a few years after implantation. This was the first time the world had ever seen an attempt at combating ED by using an invasive mechanical method. 

Penile implants placed fully inside your penile area. They create an erect penis allowing normal sex. There are two types of penile implants:

Semi rigid Implant

This implant is made from two bendable rods that are usually made of silicone. These silicone rods give the penis the stiffness needed for sex. The implant can be bent downward for peeing or upward for sex.

Inflatable Implant

The other penile implant is inflatable. Plastic cylinders are placed in the penis. There is a pump placed between the testicles. When the pump is used, pressure in the cylinders inflate the penis and make it stiff. Inflatable implants are for serious erectile dysfunction and create a normal looking erection. With this implant, men can control firmness and the size of the erection.

Penile vascular surgery is not recommended for aging males who have failed inhibitors and injection therapies so implants are usually the next step for these men. Of course surgical methods carry huge risks, should they be successful, they have the highest rates of success and satisfaction among all ED treatment options. 

Surgical methods are advised highly to avoid but can be very successful. It is worth highlighting all types of treatment known for erectile dysfunction so each patient can make an evaluated decision.  

With a deep understanding of causes and risks, there are also consequences to be aware of:

Consequences of Erectile Dysfunction

Erectile Dysfunction itself, for the majority, has very minor physical health problems and very major mental health problems. It is hugely important to know and understand the treatment you choose to undertake because most long term consequences and complications originate here.

Short Term Consequences

These types of consequences are most likely to be mental issues. Some of these issues might include:

  • Stress or Anxiety 
  • Relationship problems
  • Low self-esteem
  • An unsatisfactory sex life 
  • Unable to climax to get your partner pregnant

Even if the cause of ED is psychological, physical, or both, the effects are similar. A man’s sense of masculinity is hammered, with heavy effects on their feeling of worth to their partner and in the workplace. It is important to make sure that the chosen treatment is effective in a man with erectile dysfunction.

Long Term Consequences

Many consequences of ED are because of poor treatment methods of side effects of a particular treatment. When taking other medications it can be dangerous and even life-threatening to take Viagra because it can cause a severe drop in blood pressure leading to headaches, nasal congestion and even vision and hearing loss. Surgical treatments have much worse consequences at a higher risk. It can cause scarring, bleeding, infections and extreme pain. On the other hand, erectile dysfunction can be seen as a consequence of an underlying health condition so it is important to check with your doctor to avoid any concern.

Typically the long term results for men when treating themselves for ED are very good. There are a wide range of treatments so most will be able to find what works for them best. 

If you have any more queries or concerns, here are some of the most frequently asked questions about erectile dysfunction which may answer those:


What is the best natural home remedy for erectile dysfunction?

The most popular home remedies for ED are those acquired from plants and herbs, which have been used for centuries. There are very few studies to provide evidence on the safety of using these natural remedies. Some have been found to have side effects that vary from mild to severe.

The best natural remedy is to improve your lifestyle by eating healthier and reducing your alcohol intake and if possible stopping smoking. These changes affect the whole body and every system within. Incorporating exercises that are aerobic and kegel greatly improve the blood flow to the penis.

What fruit is a natural viagra?

Although there are various medicinal herbs that are used in pharmaceutical viagra it has been reported that Watermelon can help increase erections thanks to high levels of citrulline. Although the research is still at very early stages, the amino acids in the watermelon act very similar to those in viagra pills. Citrulline is eventually converted into arginine which is a precursor for nitric oxide. This has much of the same effects as Viagra, by relaxing and dilating blood vessels improving erections.

Bananas are very high in potassium, which is great for your blood circulation and heart. Getting enough potassium keeps your sodium levels even, stopping your blood pressure skyrocketing and reducing your risk of heart problems.

Other fruits known for better sexual experiences are berries, pomegranates, grapes and citrus fruits.

What foods make you horny?

Although the effects may not be instant, eating these foods can lead to a healthier and hornier brain. Popular foods known to increase sexual desires, are: 

  • Avocados – Rich in fatty acids and Vitamin E
  • Pumpkin Seeds – Rich in Tyrosine, an amino acid known to boost your mood levels
  • Oatmeal – Rich in Vitamin B and testosterone boosting L-arginine
  • Honey – Several variations of Vitamin B
  • Figs – Rich in potassium

All of the above contain key vitamins and minerals that increase blood flow, virility and lead to healthy blood vessels. Vitamin B is known to boost energy levels and stamina which also is similar to potassium.

Can eating these foods help erectile dysfunction?

According to a new study, conducted by scientists at Harvard and the University of East Anglia, men who enjoyed a regular glass of red wine and plenty of citrus fruits, strawberries, blueberries, apples and pears were less likely to develop ED. Researchers found only three, maybe four portions of flavonoid-rich food and drink was associated with a reduced risk of the problem by up to 21 per cent.

Men who regularly consume foods high in flavonoids, vitamins and amino acids are less likely to suffer erectile dysfunction. In terms of how much to eat to reduce ED, we’re talking just a few portions a week.

Can I make viagra at home?

Taking pharmaceutical Viagra can cause side effects and for some they would prefer a natural source of Viagra. Eating foods from organic ingredients has been known to follow similar benefits as synthetic Viagra. It is recommended to mix some of these ingredients together to create one juice or smoothie of Viagra.  

At what age does a man stop getting an erection?

Although it is commonly understood that men above the age of 50 have a much higher chance of suffering from erectile dysfunction, the figure is only 33% of men suffer. Although between 65 and 85 the percentage gets close to around 50%

Some men may be able to sustain an erection with no trouble for their whole life but this is entirely dependent on managing risk factors and having a healthy lifestyle. 

At age 50, erections change. For some, the process is gradual, for others, it happens rapidly. In any case, older men can lose the ability to have erections solely from sexual fantasies.

Is there a fast way to get rid of erectile dysfunction?

To put it simply, no. In the short term Viagra may be helpful for sexual experiences but a constant use and reliance will only increase the suffering of erectile dysfunction. In some cases erectile dysfunction can be reversed. A study published in the Journal of Sexual Medicine found a revocation rate of 29% after 5 years of treatment.

It is important to highlight that even when erectile dysfunction cannot be healed, some treatment can reduce or eliminate symptoms. It is important to understand what is best for you with the best method being trial and error.

Now, let’s share our thoughts:


Erectile dysfunction has been reported dating as far back to the beginning of written history. In the days of the 18th century, Louis XVI had few effective treatment options available to him, and erectile dysfunction was often associated with public humiliation and ridicule. In the 21st century, men have much more effective choices for therapy with evidence-based results to support their use. 

As research continues and new advances in treatment are made, we can potentially provide men even more potent and less embarrassing options for treating ED. Although it may be difficult for some patients to address, it is not a problem that men have to hide silently; a variety of treatment options are available to help men and their partners maintain satisfactory sex lives.

To eliminate any struggle with erectile dysfunction, first you must look at reducing your risk factors. You must determine how detrimental your erectile dysfunction is having on your sex life before deciding on the correct treatment. Should you decide to proceed with any treatment it is imperative to understand all the risks and to seek advice for the best option available to you. 

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