Erectile Dysfunction: Causes, Treatment and Medicines
Erectile dysfunction (ED) is a medical condition that causes difficulty getting or maintaining an erection firm enough for sexual activity. Although ED becomes more common with age, it is not an inevitable part of aging. It can also be associated with health conditions, medicines, lifestyle factors and emotional concerns.
Because ED can be uncomfortable to discuss, some people delay seeking help. However, it is a recognised medical condition and can often be treated once the underlying cause has been identified.
What Is Erectile Dysfunction?
Erectile dysfunction may involve:
- Difficulty getting an erection
- Difficulty keeping an erection
- Erections that are not firm enough for sexual activity
- Being able to get an erection sometimes but not consistently
Occasional difficulty does not necessarily mean someone has ED. However, persistent or recurring problems should be discussed with a healthcare professional.
What Causes Erectile Dysfunction?
ED can have several causes. Physical and emotional factors can also occur together.
Health Conditions
Conditions affecting blood vessels, nerves or hormones can contribute to ED. These include:
- Diabetes
- High blood pressure
- Heart and blood-vessel disease
- Obesity
- Chronic kidney disease
- Low testosterone
- Thyroid problems
- Certain neurological conditions
- Some reproductive-system conditions
Medicines
Some prescription and over-the-counter medicines can contribute to ED. These include certain medicines used for depression, allergies, high blood pressure and other conditions.
If you think a medicine may be contributing to ED, do not stop taking it on your own. Speak with the healthcare professional who prescribed it.
Stress and Emotional Factors
Stress, anxiety and depression can contribute to ED or make existing symptoms worse. Concerns about sexual performance can also contribute to the problem.
Lifestyle Factors
Smoking, excessive alcohol use, insufficient physical activity and recreational drug use can contribute to ED.
ED and Other Health Problems
ED can sometimes be a sign that another health problem needs attention.
Diabetes, for example, can damage blood vessels and nerves involved in sexual function. Men with diabetes are more likely to develop ED, particularly when blood glucose and other cardiovascular risk factors are poorly controlled.
High blood pressure, cardiovascular disease and other conditions can also be associated with ED.
For this reason, treating ED is not always just about treating the erection problem. A healthcare professional may need to assess your overall health and identify possible underlying causes.
How Is Erectile Dysfunction Diagnosed?
Diagnosis usually begins with a discussion about your medical and sexual history.
A healthcare professional may ask about:
- When the problem started
- How frequently it happens
- Current medicines and supplements
- Existing medical conditions
- Sexual desire
- Other symptoms
- Stress and emotional wellbeing
A physical examination and, when appropriate, laboratory or other tests may also be used to investigate possible causes.
The goal is to understand why the problem is occurring, not simply to treat the symptom.
How Is Erectile Dysfunction Treated?
Treatment depends on the underlying cause and the person’s overall health.
Possible approaches include:
- Treating an underlying medical condition
- Reviewing medicines that may contribute to ED
- Increasing physical activity
- Improving diet
- Stopping smoking
- Limiting excessive alcohol
- Addressing stress and emotional factors
- Prescription treatment when medically appropriate
- Other treatments recommended by a specialist
Healthcare professionals generally try to address the underlying cause where possible before selecting an appropriate treatment.
Common Medicines Used for Erectile Dysfunction
Prescription medicines are one of the most common treatment options for ED.
A major group of medicines used for ED is called phosphodiesterase-5 (PDE5) inhibitors. These medicines improve blood flow to the penis and can help some people achieve and maintain an erection when sexual stimulation occurs.
Common PDE5 inhibitors include sildenafil, tadalafil, vardenafil and avanafil.
Sildenafil (Viagra)
Sildenafil, commonly known by the brand name Viagra, is a PDE5 inhibitor used to treat erectile dysfunction.
It works by increasing blood flow to the penis when a person is sexually stimulated. Sildenafil does not automatically cause an erection and does not increase sexual desire.
Tadalafil (Cialis)
Tadalafil, commonly known by the brand name Cialis, is another PDE5 inhibitor used to treat ED.
One of its distinguishing features is its relatively long duration of action compared with some other medicines in the same class.
Vardenafil
Vardenafil is another PDE5 inhibitor prescribed for erectile dysfunction.
Like other medicines in this group, it works by helping improve blood flow to the penis during sexual stimulation.
Avanafil
Avanafil is a newer PDE5 inhibitor used to treat erectile dysfunction.
It works through the same general pathway as other PDE5 inhibitors, helping improve blood flow during sexual stimulation.
Which ED Medicine Is Right for You?
There is no single ED medicine that is right for everyone.
The appropriate treatment depends on factors such as:
- Your medical history
- Other medicines you take
- Existing heart or blood-vessel conditions
- Other health conditions
- How frequently you experience ED
- Your healthcare professional’s assessment
A medicine that is appropriate for one person may not be appropriate for another.
Important Safety Information
PDE5 inhibitors can interact with certain medicines. One particularly important interaction is with nitrate medicines, which are commonly used for some heart conditions.
Combining PDE5 inhibitors with nitrates can cause a potentially dangerous drop in blood pressure.
For this reason, ED medicines should not be shared, borrowed or taken based only on another person’s experience.
Always seek appropriate professional advice before using prescription treatment for ED.
Other Treatment Options
Medicines are not the only treatment available.
Depending on the cause and severity of ED, healthcare professionals may consider:
- Counselling when psychological factors contribute
- Vacuum erection devices
- Injectable treatments
- Urethral medicines
- Testosterone treatment when low testosterone has been appropriately diagnosed
- Surgery in selected cases
Not every treatment is appropriate for every person.
Can Lifestyle Changes Help?
Lifestyle changes can support erectile and cardiovascular health.
Stay Physically Active
Regular physical activity supports cardiovascular health and blood flow. It can also help with maintaining a healthy weight.
Stop Smoking
Smoking is linked to blood-vessel disease, which can contribute to ED. Quitting can benefit both sexual and general health.
Limit Excessive Alcohol
Excessive alcohol consumption can contribute to ED. Reducing alcohol intake may therefore help.
Eat a Balanced Diet
Healthy dietary patterns can support cardiovascular health and may reduce the risk of ED.
Vegetables, fruits, legumes, whole grains, nuts and fish can form part of a balanced eating pattern.
Manage Existing Health Conditions
Managing diabetes, blood pressure, cholesterol and other chronic conditions can support overall vascular health and may help when these conditions contribute to ED.
Don’t Rely on Unverified Sexual-Health Products
Products marketed online as “natural” or “herbal” solutions for ED may not always be reliable or appropriate.
Some products may contain undeclared pharmaceutical ingredients or interact with other medicines.
For persistent ED, proper assessment is safer than relying on an unverified product or attempting to treat the condition without professional guidance.
When Should You See a Healthcare Professional?
Consider seeking professional advice if erectile difficulties:
- Keep happening
- Are affecting your wellbeing
- Begin suddenly
- Occur alongside other health symptoms
- Start after taking a new medicine
- Occur alongside diabetes, high blood pressure or cardiovascular disease
You should also seek urgent medical attention if you experience an erection lasting more than four hours after using an ED treatment.
How HubPharm Supports Confidential Healthcare
Sexual health is part of overall health, and concerns about it deserve professional attention.
At HubPharm Africa, our healthcare professionals can provide confidential guidance on medication-related questions and help patients understand when a health concern requires further assessment.
Whether you are concerned about a new symptom, an existing condition or a medicine you are taking, getting professional guidance can help you make safer healthcare decisions.
Have a health concern you’re unsure about? Speak with a HubPharm healthcare professional for confidential guidance.
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Frequently Asked Questions
Is erectile dysfunction a normal part of aging?
No. ED becomes more common with age, but it is not considered an inevitable part of aging.
Can diabetes cause erectile dysfunction?
Yes. Diabetes can affect the blood vessels and nerves involved in sexual function and is strongly associated with ED.
Can stress cause erectile dysfunction?
Yes. Stress, anxiety and depression can contribute to ED or make existing symptoms worse.
What medicines are commonly used for ED?
Common prescription medicines include sildenafil (Viagra), tadalafil (Cialis), vardenafil and avanafil. They belong to the PDE5 inhibitor class and are not appropriate for everyone.
Which is better: sildenafil or tadalafil?
Neither is universally “better.” The appropriate medicine depends on the individual’s health, other medicines, treatment needs and professional assessment.
Can lifestyle changes improve erectile dysfunction?
Lifestyle measures such as regular physical activity, stopping smoking, limiting excessive alcohol and following a healthy eating pattern can support erectile and cardiovascular health.
Should I stop a medicine if I think it is causing ED?
No. Speak with the healthcare professional who prescribed it. They can determine whether the medicine may be contributing to the problem and whether an alternative is appropriate.
The Bottom Line
Erectile dysfunction is a medical condition that can often be treated.
It may be associated with diabetes, cardiovascular disease, hormonal problems, certain medicines, lifestyle factors or emotional stress. Persistent ED therefore deserves proper assessment rather than being ignored.
Treatment may include lifestyle changes, counselling, prescription medicines such as sildenafil, tadalafil, vardenafil or avanafil, or other medical interventions, depending on the underlying cause.
If you experience persistent erectile difficulties, speak with a qualified healthcare professional who can help identify the cause and discuss appropriate treatment.
Medical note: This article is for general health education and does not replace individual medical advice, diagnosis or treatment.
References
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Erectile Dysfunction (ED).
- NIDDK. Symptoms & Causes of Erectile Dysfunction.
- NIDDK. Diagnosis of Erectile Dysfunction.
- NIDDK. Treatment for Erectile Dysfunction.
- NIDDK. Eating, Diet, & Nutrition for Erectile Dysfunction.
- NIDDK. Diabetes, Sexual, & Bladder Problems.
- NHS. Erectile dysfunction (impotence).
- American Urological Association. Erectile Dysfunction Guideline.