Many men experience erectile dysfunction (ED) as they get older but age is more of a risk factor than a cause. Some men get ED due to a treatable health condition or lifestyle factors, while medications and mental health issues frequently cause ED in otherwise healthy men. If you are struggling with ED, there is hope! Proper diagnosis and care, lifestyle changes, being proactive about mental health and innovative treatments for ED are the key to restored erectile function and a happy, healthy sex life.
What is erectile dysfunction (ED)?
Basically defined, erectile dysfunction refers to the inability to get and maintain an erection or hard penis long enough to have sexual intercourse. ED is also very prevalent, affecting about 30 million men in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
What are the symptoms of erectile dysfunction? There are varying degrees of severity of ED. According to NIDDK, the common symptoms of erectile dysfunction include:
· Able to get an erection sometimes but not every time you want to have sex.
· Able to get an erection but it doesn’t last long enough to have sex.
· Unable to get an erection at any time.
If you know what’s it like to have erectile dysfunction, you may also be wondering: how long can the average man stay erect? The duration of an erection varies from man to man but in general, most healthy men can expect the average erection to last around 10 minutes, which is certainly long enough to have sex. Of course, some men are naturally able to last longer, while others take oral ED medications to help sustain erections long enough to have sex.
Some men also ask: can one have a satisfying sex life with erectile dysfunction? Many couples do find ways to be intimate without having intercourse (hand massage, oral sex and so on) because having a full erection isn’t required to ejaculate and achieve an orgasm.
However, my question to those men is: have you identified the root cause of your ED (because the root cause may be treatable) or explored alternative treatment options to erectile dysfunction medications? ED medications don’t work for everyone but that doesn’t mean you don’t have options. (More on ED treatments below.)
What causes erectile dysfunction (ED)?
As I mentioned early in this blog, age is a risk factor for ED but it isn’t the cause. According to NIDDK, a variety of factors can disrupt the function of the vascular system, nervous system and endocrine system that may cause erectile dysfunction. These include:
Diseases and health conditions that cause ED:
- Diabetes (men with diabetes are 2-3X more likely to get ED than men who do not).
- Diseases of the heart and blood vessels, including atherosclerosis and high blood pressure. (Per Harvard Medical School, men with ED are 38% more likely to have high BP than those who do not.)
- Chronic kidney disease (CKD).
- Diseases of the nervous system like multiple sclerosis (MS).
- Peyronie’s disease, where scar tissue (plaque) forms under the skin of the penis causing the penis to curve or bend (usually during erection).
- Low testosterone levels (Low T).
- Injury sustained during treatment for prostate cancer, such as radiation therapy or prostate surgery.
- Injury to the penis, bladder, spinal cord or pelvis.
Medications that cause ED:
- Blood pressure medications which decrease blood flow to the penis, making it difficult to achieve an erection.
- Anti-androgens, a class of drugs used to treat prostate cancer that lower the amount of androgens (male sex hormones) made in the testicles.
- Some (but not all) antidepressants cause sexual dysfunction.
- Certain drugs that help you relax or make you sleepy, like tranquilizers.
- Appetite suppressants.
- Anti-ulcer drugs.
- Diuretics used to rid the body of sodium and water to treat heart failure, liver failure or kidney disorders.
- Others (see the NIH National Library of Medicine list of drugs that cause erection problems here).
IMPORTANT: Always speak with your healthcare practitioner before discontinuing a prescribed medication or supplement.
Mental health issues that may cause ED:
- Anxiety and depression.
- Worrying about sexual dysfunction.
- Feeling guilty about sexual performance or activities.
- Low self-esteem.
- Stress in general or about sexual performance.
Lifestyle factors that may cause ED:
- Smoking tobacco products.
- Drinking too much alcohol.
- Using recreational drugs, like amphetamines, barbiturates, cocaine, marijuana or heroin.
- Being obese.
- Not exercising regularly.
How is erectile dysfunction treated?
Since erectile dysfunction can result from a variety of factors (as noted above), it’s critical to speak with your healthcare practitioner when you start experiencing symptoms of ED. He or she can then determine the root cause of ED and prescribe treatment accordingly.
For example, if a prescription medication is to blame for your ED the practitioner could prescribe an alternate medication or form of treatment. On the other hand, if you live an unhealthy lifestyle the practitioner can provide guidance on how to deal with addictions, lose weight or find an exercise plan that works for you. Men who have erectile dysfunction and suffer from low testosterone often find their ED resolves following hormone replacement therapy.
Now, I know many men asking how erectile dysfunction is treated are inclined to want to know what pill they can take for ED, what are Viagra’s side effects or what ED medications have the least number of side effects? Others may want to know how to maintain an erection without pills.
Let’s talk about medications to treat ED and their side effects first. The most popular type of drugs used to treat erectile dysfunction today are phosphodiesterase type 5 inhibitors (PDE5 inhibitors,) including Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) and Stendra (avanfil).
While PDE5 inhibitors have helped many men suffering from ED to achieve erections firm enough and long enough to have sex, they do come with downsides and side effects (just read the labels). The downside of ED drugs is they only provide temporary relief, and you have to plan ahead to use them—they do NOT cure ED. The side effects of these drugs are also well known.
Some men who use PDE5 inhibitors for ED experience vision changes, nausea, headache, back pain, painful limbs, muscle aches and rash, among other side effects. In addition, oral ED meds don’t work for all men with ED, and priapism (an erection lasting longer than 4 hours) is a risk that may occur with oral medications for erectile dysfunction.
Aside from oral medications, there are other treatments available that may help alleviate ED in some men, like penis pumps (some men experience discomfort and bruising) or penile implants (usually recommended as a last resort).
If mental health issues are making it difficult to maintain an erection or perform sexually, oftentimes, speaking with a mental health professional can work wonders. Men shouldn’t be embarrassed to speak with a practitioner about ED and should be open about any depression, anxiety or performance fears they have. Overcoming that hurdle is often the first and best step forward to a better sex life.
Call Beyond Health today to make an appointment to discuss your personal health.