Erectile Dysfunction Treatment

An Evidence-Based Guide to Erectile Dysfunction

Out of every 100 men, anywhere from five to 20 will experience Erectile dysfunction (ED) symptoms severe enough to impact their quality of life. It isn’t just restricted to older men; it can affect young men as well. This statistic just goes on to show that even young men are at risk of experiencing erectile dysfunction.  

Further, a study published in The New England Journal of Medicine suggests that about 20 to 30 million men in the United States suffer from erectile dysfunction [1]. An increase in awareness over the past few decades has resulted in more men seeking treatment for the problem.

According to the  World Health Organisation (WHO), it affects the quality of life of both patients and their partners. Thus, it is crucial to understand the condition and all the aspects associated with its causes and treatment. 

What Is Erectile Dysfunction?

Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection hard enough for satisfactory sexual intercourse.

In the past, it was believed that ED was primarily caused by psychological problems or just due to age. But in the current time, Urologists consider physical problems a major contributor to the issue.

Erectile Dysfunction Symptoms

The symptoms of Erectile Dysfunction include the following-

• Getting weak erections is one of the early signs of erectile dysfunction. It is a condition where one is unable to maintain an erection. 
• Unable to get an erection every time you want to get intimate. 
• Reduced sexual desire. 
• Being unable to get an erection at all. 

Causes Of Erectile Dysfunction

The three main factors that contribute to erectile dysfunction are disorders associated with your nervous system, endocrine system, and vascular system. 

ED Induced By Medication-

Erectile Dysfunction may be a side effect of many medications, such as

• Ulcer Medicines
• Blood Pressure Medicines
• Appetite Suppressants
• Antidepressants 
• Medicines used for prostate cancer therapy, also known as antiandrogens.
• Tranquilizers Or Sedatives. 

Lifestyle-Related Factors-

Causes of weak erection also include lifestyle factors, as listed below. 

• Smoking 
• Overweight
• Alcohol consumption
• Being physically inactive 
• Using drugs 

Health Conditions Causing ED-

Suffering from health issues mentioned below can also contribute to Erectile Dysfunction-

• Type 2 diabetes 
• Chronic Kidney Disorder
• High blood pressure
• Heart and blood vessel disease 
• Atherosclerosis- a condition that causes thickening or hardening of the arteries. 
• Peyronie’s disease- A health issue that is associated with the formation of fibrous tissue under the skin of the penis. 

Types Of Erectile Dysfunction

Based on the key reasons or causes for experiencing erectile dysfunction, it can be categorized into the following four types. 

Vascular erectile dysfunction-

It arises from conditions involving abnormalities in the penile arteries, veins, or both and is especially seen in older men. This is also one of the most common types of ED. 

Hormonal Erectile Dysfunction-

It is a type of ED that occurs due to testosterone deficiency and thyroid issues. Testosterone is a hormone that helps in the development of secondary sexual characteristics. 

Neurogenic Erectile Dysfunction-

It results from nerve issues that prevent signals from traveling from your brain to the penis for a firm erection. This may also arise due to radiation therapy, pelvic surgery, trauma, or neurologic conditions like multiple sclerosis (MS), stroke, and spinal stenosis. 

Psychogenic Erectile Dysfunction-

This involves psychological conditions such as- 

• Anxiety
• Depression
• Stress
• Low Self-Esteem
• Guilt
• Relationship Problems.
  

Erectile Dysfunction: Who, When, And Why?

So, to start with, let’s find who is most likely to suffer from ED or at what age Erectile Dysfunction starts. 

Men of all ages may suffer from erectile dysfunction. Due to a sedentary lifestyle and stressful work life, younger men are also seen suffering from ED. However, most men suffering from Erectile Dysfunction are between 50 and 70 years old, as established in a 2003 study as shown in the graph (A) below. 

The second graph (B) represents how respondents rated their overall ability to function sexually. 

Erectile Dysfunction In Young Adults

A report by Healthline suggests that around 26% of men younger than 40 years suffer from Erectile Dysfunction. However, in most cases, ED can be reversed in young people, as they suffer from ED mostly due to stress and a poor lifestyle. 

Erectile Dysfunction Percentage By Age

Age Group	Prevalence of ED in Men
Erectile Dysfunction in 20s	About 8% of men between the ages of 20 and 29 suffer from ED.
Erectile Dysfunction in 30s	11 percent of men in their 30s suffered from ED based on a 2004 study.
ED Risk at 40s	About 1 in 4 men under age 40 are seen to suffer from some form of ED. The Massachusetts Male Aging study indicates that 17% of men in their 40s experience at least mild ED.
Risk of ED in 50s	Men in their 50s have a 50% chance of experiencing Sexual dysfunction. Atherosclerosis, a cardiovascular disorder resulting from the thickening of arteries due to the buildup of plaque, is one of the most common causes of ED in men over 50 years of age.
ED risk in 60s	Men over the age of 60 years have about a 60% chance of experiencing ED.
In the 70s and 80s	By 70 years, about two-thirds of men suffer from Erectile Dysfunction.

Erectile Dysfunction Test And Diagnosis

Erectile dysfunction in men is diagnosed and treated by Urologists and endocrinologists. However, if your condition is associated with a heart disorder, it can be treated by cardiologists. At the same time, psychological erectile dysfunction can be treated by mental health professionals. 

The following tests can help in diagnosing ED-

• Physical examination of the testicles and the penis. 
• Blood test
• Checking Complete blood count (CBC)
• Lipid panel
• Kidney and liver function tests.
• urine test
• Penile Doppler ultrasound.
• Magnetic resonance angiogram (MRA).

Erectile Dysfunction Medicine

Oral phosphodiesterase-5 inhibitors such as Sildenafil, Vardenafil, and Tadalafil are the first-line treatments for ED.

Generic Viagra

Sildenafil, also known as generic Viagra, is available in other brand names, such as Cenforce, Aurogra, Fildena, and Malegra, to name a few. It is considered the first and one of the best erectile dysfunction pills on the market due to its safety profile and high efficacy. 

Pros	Cons
Approved by the FDA for treating  pulmonary arterial hypertension (PAH).	It can be taken once a day for ED.
Off-label uses include treating secondary Raynaud’s phenomenon.	It may interact with other medications and supplements if taken with Sildenafil.
Apart from oral tablets, they are also available for sublingual (dissolved under the tongue) and intravenous administration.	It is advisable for men under the age of 18 to treat ED.

Vardenafil Or Generic Levitra-

Vardenafil, also available as generic Levitra, is a PDE5 inhibitor formulated for oral administration.

Pros	Cons
It is also effective in the treatment of premature ejaculation.	Has no other off-label uses or benefits.
Lacks vision adverse effects, which are seen in other ED pills.	It is not recommended for people under the age of 18 without consulting a doctor.
The action lasts up to 5 hours.	Vardenafil has a risk of drug interaction and should not be taken with other medications and supplements.

Generic Cialis-

Tadalafil, also available as generic Cialis, Vidalista, and Tadarise, to name a few, is a PDE5 inhibitor that treats erectile dysfunction in men by increasing the blood flow to the penis.

Pros	Cons
It is also effective in treating benign prostatic hyperplasia and pulmonary arterial hypertension.	It is not recommended for people under 18 or women without consulting a doctor.
It works within 30 minutes of intake, and its action lasts up to 36 hours.	It can interact with other health supplements and medicines if coadministered.
Lower risk of side effects, which gradually decreases with continued administration.

Erectile Dysfunction Self-Care

It is important to note that the permanent cure for erectile dysfunction is through lifestyle changes. Medication will help you get and maintain an erection as long as its effect lasts. 

The right nutrients and lifestyle have been recognized as central factors in influencing Nitric Oxide (NO) production, which plays a key role in getting and maintaining an erection, according to a 2015 study [2]. 

Some effective natural remedies for erectile dysfunction, listed by the Healthline website, are mentioned below [3].

Diet-

Eating a balanced diet is very effective in improving sexual functions, thus reducing the risk of suffering from ED. 

A 2020 review states that processed or red meat contributes to erectile dysfunction significantly. Explore more about the best and worst foods for erectile dysfunction on our page, The Best and Worst Foods for Erectile Dysfunction. 

Erectile Dysfunction Exercises-

Staying physically active may help prevent Erectile Dysfunction. Doing 20 to 40 minutes of moderate-to-intense aerobic exercises for 6 months helped reduce ED, according to a 2018 research study. Thus, exercises such as swimming, running, bicycling, brisk walking, and skiing are advisable. 

Weight loss-

Obesity is considered one of the most common factors contributing to erectile dysfunction, which was further reported in a 2020 study by Damiano Pizzol et al. [4].

Exercise and eating a balanced diet can effectively help with weight management. 

Alcohol And Smoking Reduction-

Studies show that alcohol when taken in moderate amounts, is associated with a lower risk of ED. In contrast, men who regularly consume alcohol have a significantly higher chance of suffering from sexual disorders. 

Smoking is another common contributor to erectile dysfunction, as frequent usage can damage blood vessels, which can prevent blood from reaching the penis. It may also reduce the availability of nitric oxide in the body, which is essential for an erection.