Erections are neurovascular events, meaning that nerves and blood vessels (arteries and veins) are involved in the process of an erection and all must work properly to develop a hard erection that lasts long enough. Erection begins with sexual stimulation. Sexual stimulation can be tactile (for example, by a partner touching the penis or by masturbation) or mental (for example, by having sexual fantasies, viewing porn). Sexual stimulation or sexual arousal causes the nerves going to the penis to release a chemical, nitric oxide. Nitric oxide increases the production of another chemical, cyclic GMP (cGMP), in the muscle of the corpora cavernosa. The cGMP causes the muscles of the corpora cavernosa to relax, and this allows more blood to flow into the penis. The incoming blood fills the corpora cavernosa, making the penis expand.
Diabetes is an example of an endocrine disease that can cause a person to experience impotence. Diabetes affects the body’s ability to utilize the hormone insulin. One of the side effects associated with chronic diabetes is nerve damage. This affects penis sensations. Other complications associated with diabetes are impaired blood flow and hormone levels. Both of these factors can contribute to impotence.
Malleable implants usually consist of paired rods, inserted surgically into each of the corpora cavernosa. The rods are stiff, and to have an erection, one bends them up and then when finished with intercourse one bends them down. They do not change in length or width. The malleable implants are the least mechanical and thus have the lowest risk of malfunction. However, also have the least "normal appearance."

In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time. In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. These are not ‘allergic reactions'.

Your GP will check your blood pressure, cardiovascular health (heart and blood vessels) and perform blood tests to check your cholesterol and blood sugar levels. If you are over 50, it is important that your GP also examines your prostate. Depending on your general health, the GP may need to do other tests, for example blood tests for hormone levels.
Excess alcohol causes erectile dysfunction in a variety of ways. Have one too many, and it decreases the production of NO in your penis, decreasing blood flow. It can even prevent the prescription pills from working. A little alcohol may get you aroused, but a lot actually blunts desire in your brain and can make it hard to reach climax as well. Over time excess alcohol damages the nerves to the penis that trigger an erection, and eventually, when the liver gets damaged, testosterone levels plummet. If you drink, practice moderation.
CBT is perhaps one of the most useful forms of therapy for addressing ED, especially related to performance anxiety, low self-esteem, and loss of sexual arousal. CBT is a proactive and actionable therapy targeted at helping you change the way you think and behave. It privileges the idea that thoughts, feelings, and physical sensations are all interlinked.

Alcohol is a depressant, not an aphrodisiac or a libido enhancer. Excessive consumption can interfere with the ability to achieve an erection at any age, and even occasional drinking can make erectile dysfunction worse in older men. Feloney advises using alcohol in moderation: "In small amounts, alcohol can relieve anxiety and may help with erectile dysfunction, but if you drink too much, it can cause erectile dysfunction or make the problem worse."

A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube makes a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis. This holds the blood in the penis (and keeps it hard) for up to 30 minutes. With proper training, 75 out of 100 men can get a working erection using a vacuum erection device.


Men who present with symptomatic benign prostatic hyperplasia and lower urinary tract symptoms have an increased incidence of sexual dysfunction. Overall, 72.2% of men with lower urinary tract symptoms had erectile dysfunction compared with 37.7% in those without lower urinary tract symptoms.43 Although surgery and various therapies can improve lower urinary tract symptoms, some of these treatments also cause or exacerbate erectile dysfunction and ejaculatory dysfunction.43
Your ability to orgasm is not connected to the prostate gland, although a man who has had a radical prostatectomy will have a dry orgasm with no ejaculation. As long as you have normal skin sensation, you should be able to have an orgasm with the right sexual stimulation. This means that treating your ED should allow you to resume a normal, healthy sex life.
Association between metabolic syndrome (MetS) at baseline and incidence of major adverse cardiovascular events (MACE) during a mean follow-up of 4.3 years. Panel A represents the Kaplan Meier curves for incidence of MACE in a population of 211 men aged 18–52 years having or not MetS at baseline. This group represents the first tertile of age of a sample of patients (n=619) consulting the Sexual Medicine and Andrology Unit of the University of Florence for erectile dysfunction and followed-up for a mean of 4.3 years for the occurrence of MACE. Panel B represents the Cox analyses for the age- and smoking habit-adjusted incidence of MACE associated with the number of MetS components at baseline (glycaemia ≥100 mg/dL, triglycerides ≥150 mg/dL, HDL <40 mg/dL; blood pressure ≥135/80 mmHg, waist circumference >102 cm), according to the tertile of age, in the same population, during the same follow-up. The first, second and third tertile include 211, 199 and 209 patients aged 18–52, 53–60 and 61–88 years, respectively.
The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
When looking at the potential causes of erectile dysfunction, it's important to understand that often more than one factor is involved or, as the American Urological Association puts it, "erectile function is the result of a complex interplay between vascular, neurologic, hormonal, and psychologic factors." Keep this in mind as you read through the wide-ranging list of causes and risk factors for ED, which includes medications, health conditions, injury, smoking, and more.

myDr myDr provides comprehensive Australian health and medical information, images and tools covering symptoms, diseases, tests, medicines and treatments, and nutrition and fitness.Related ArticlesGum disease linked to erectile dysfunctionAdvanced gum disease (periodontitis) has been linked to an increased risk of erectile dysfunction, wAdvertisement
Heart disease and diabetes are often linked together because coronary artery damage is a complication of diabetes as well. Coronary artery disease also can affect sexual function on its own, but erectile dysfunction is nine times as likely in men who suffer from both coronary artery disease (CAD) and diabetes than men who have diabetes without the addition of CAD. Erectile dysfunction is so prevalent in both coronary artery disease and diabetes that it could be considered a risk factor for both. 
A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube makes a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis. This holds the blood in the penis (and keeps it hard) for up to 30 minutes. With proper training, 75 out of 100 men can get a working erection using a vacuum erection device.
“No question these impact erectile function,” says Landon Trost, MD, head of andrology and male infertility at the Mayo Clinic in Rochester, Minn. It is not clear why these blood pressure lowering medications can cause ED, but it reverses if a patient quits taking the drug. Unfortunately, however, “people usually can’t get off of these, but if the medication can be switched for another blood pressure drug, angiotensin receptor blockers or ACE nhibitors are preferred,” adds Trost.
The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.
As you can imagine, these symptoms can make it difficult to take pleasure in much of anything, let alone sex. A study published in a 1998 edition of Psychosomatic Medicine shows a clear link between depression and erectile dysfunction in men. Using data obtained from the Massachusetts Male Aging Study, researchers were able to conclude that a relationship between depressive symptoms and erectile dysfunction existed and was independent of aging and demographics.

Surgical intervention for a number of conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply.[9] Erectile dysfunction is a common complication of treatments for prostate cancer, including prostatectomy and destruction of the prostate by external beam radiation, although the prostate gland itself is not necessary to achieve an erection. As far as inguinal hernia surgery is concerned, in most cases, and in the absence of postoperative complications, the operative repair can lead to a recovery of the sexual life of people with preoperative sexual dysfunction, while, in most cases, it does not affect people with a preoperative normal sexual life.[14]
Are you a man struggling with erectile problems? You may believe that you will have difficulty with this forever or that is not solvable unless you take medication for the problem but a pill may not fix all of the trouble. No doubt if you're experiencing a medical issue and cannot obtain an erection on your own due to vascular issues, a disability or other medical circumstance the Dr Ogudu herbal cure will be a life saver for you guys. I am speaking to the other men in the population who are dodging their sexual difficulties and hiding behind a prescription because it may be easier for them than figuring out why their penis's are not standing up during sexual encounters. I'm to testify about a man who brought joy and happiness back into my life after series of broken relationship and cheats from my spouse's, I'm not a shy guy a woo guys and get it upright but things normally get outburst after a sexual encounter with me, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the internet about this specialist called Dr Ogudu and decided to email him on his email i saw on the internet so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Weak erection, After 8days of using the herbal product i began to feel the enlargement of my penis,and now it just 4 weeks of using his products my penis is about 9 inches longer, Immediately i noticed some changes i started pleading with my ex to give me another chance that I'm a different guy now after giving it a though we got along again on her first visit i could not believe myself and she also testify after reaching climax the first in the relationship. I am sharing this testimony because i know they're a million men out here facing same predicaments give it a try and be the proud man you urge to be. Contact him now via email and whats-app

Psychotherapy can be beneficial for an individual, but couples therapy sessions are also helpful. Connolly says it's often good for a couple to attend an initial session together to address issues and concerns. Individual sessions can then address issues with each partner, leading up to the couple working together. This approach "can help reach under the outward problems and uncover what needs to be dealt with and talked about in order to enjoy physical and emotional intimacy," Connolly says.

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It is common for men with erectile dysfunction to have an underlying physical basis for it, particularly in older men. However, psychological factors may be present in 10% to 20% of men with erectile dysfunction. Experts say stress, depression, poor self-esteem, and performance anxiety can impair the ability to have an erection. These factors can also make erectile dysfunction worse in men whose sexual dysfunction stems from something physical.
You must be willing to look at what is going on between the two of you. You may want to have a discussion with your clothes on about the way you guys are going about being sexual. Are you satisfied with the frequency? Are you pleased with the script of what you are doing in bed (kissing, foreplay, and intercourse)? Do you feel like you guys are connecting during a sexual experience? Are we reading each other's cues correctly? When couples have sex less than twice a month you are guaranteed to have an anxiety laden experience. The reason is that you fall out of a routine of intimate touch and then it becomes very anxiety producing to get back into bed with each other. If you are not able to be sexual at least twice a month than at minimum you should spend time laying in bed and holding each other so as not to move too far away from intimacy and touch as a part of what we do. Couples with bad frequency set themselves up to be nervous that each experience has to "knock it out of the park". Since that can't be guaranteed you are better off to have more frequent experiences and learn how to handle "natural failures" by discussing this, confronting your anxiety about failures and learning how to being intimate in other ways than penetration with your penis.
Performance anxiety can be another cause of impotence. If a person wasn’t able to achieve an erection in the past, he may fear he won’t be able to achieve an erection in the future. A person may also find he can’t achieve an erection with a certain partner. Someone with ED related to performance anxiety may be able to have full erections when masturbating or when sleeping, yet he isn’t able to maintain an erection during intercourse.
The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina; it is now mostly replaced by more precise terms, such as erectile dysfunction (ED). The study of ED within medicine is covered by andrology, a sub-field within urology. Research indicates that ED is common, and it is suggested that approximately 40% of males experience symptoms compatible with ED, at least occasionally.[48] The condition is also on occasion called phallic impotence.[49] Its antonym, or opposite condition, is priapism.[50][51]

The key to treating erectile dysfunction is to identify the underlying cause. In many cases, it takes a fair bit of trial and error. Because the majority of ED cases are caused by physiological issues, your first step should be to talk to your doctor about your concerns. After completing a physical examination and reviewing your medical history, your doctor will ask you some questions and run some tests to rule out medical causes for your ED.
If you are experiencing ED, you should talk with your doctor about your potential risk for cardiovascular disease. And if you’re already taking certain medications such as nitrites for your heart or alpha-blockers to manage blood pressure, your doctor will discuss whether ED medications are right for you or whether other options may be more appropriate.
It is important to understand the nature of your ED in order to get the right treatment. If the cause of your ED is psychological, using medication targeting physically-induced ED alone may not always be very effective. Viagra, for example, will only work if you are sexually aroused. Many men might also prefer a non-invasive means of approaching their ED, as an alternative to penile injections.

Of course, this is easier for some people than others – it’s important to remember that there’s no such thing as a ‘normal’ sex drive. Libido varies from person to person so some people have low libido compared to others. If there is a drastic difference between the sex drive levels of you and your partner(s), this can lead to problems in your relationship, but it doesn’t have to.


The U.S. FDA (Food and Drug Administration) has a list of 29 OTC products that claim to treat erectile dysfunction. Patients should avoid these because many contain harmful ingredients. Other natural or herbal remedies such as DHEA, L-arginine, ginseng, and yohimbe are supplements that have been used but have not been proven safe and effective according to some researchers. Before using such compounds, individuals should consult their doctor. According to some experts, acupuncture does not effectively treat erectile dysfunction. Other home remedies for reducing ED symptoms include diet changes such as eating blueberries and citrus fruits and drinking red wine.


If your doctor says it's OK, you may be able to stop taking blood pressure medications temporarily to see if your sex life improves. To make sure your blood pressure remains within a safe range, you may need frequent blood pressure readings while you're not taking the blood pressure lowering medication that may be causing your sexual difficulties. This can be done with a home blood pressure monitoring device for convenience.
The following products are considered to be alternative treatments or natural remedies for Erectile Dysfunction. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Erectile Dysfunction.
As shown in Figure 2, in younger patients consulting for ED, the organic component plays the predominant role. These data provide evidence for the need to adequately investigate possible organic causes of ED in younger and apparently fit men. The organic causes of ED can be classified into three categories: metabolic and CV, endocrine and neurologic conditions.

There are risks to prosthetic surgery and patients are counselled before the procedure. If there is a post-operative infection, the implant will likely be removed. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. If a penile prosthesis is removed, other non-surgical treatments may no longer work.

Currently, placement of a penile prosthesis is the most common surgical procedure performed for erectile dysfunction. Penile prosthesis placement is typically reserved for men who have tried and failed (either from efficacy or tolerability) or have contraindications to other forms of therapy including PDE5 inhibitors, intraurethral alprostadil, and injection therapy.


The impact of malignancy and its treatment on both the individual and his or her partner can have a significant negative influence on their sexual relationship. Many of the cancer treatments can lead to sexual dysfunction. As common examples, long-acting gonadotrophin-releasing hormone agonists used for prostate and breast cancer result in hypogonadism, with subsequent reduction in sexual desire, erectile dysfunction in men42, vaginal atrophy and dyspareunia in women as well as orgasmic dysfunction.34
Getting (and maintaining) an erection requires a surprising amount of things to go right. You have to get aroused, then pass that signal from your brain, through your nerves and hormones, to your blood vessels and muscles before an erection can even happen. If one thing goes wrong in that complicated exchange between your cardiovascular, and nerve system, and your hormone levels, blood vessels, and even your mood the result is usually erectile dysfunction. In other words, getting an erection is hard.
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