Erectile Dysfunction Treatment Treatments

Causes Erectile Dysfunction

Erectile dysfunction can have physical causes, psychological causes, or a mix of both. Many men will experience occasional erection problems, but persistent ED is worth addressing because it can sometimes be linked to underlying health conditions.

Common physical causes can include narrowed blood vessels (often linked to high blood pressure, high cholesterol or diabetes), hormone problems, injury/surgery, and side effects from certain medicines.

Psychological causes can include anxiety, depression, stress and relationship issues.

Psychological vs Physical Causes of Erectile Dysfunction

ED can be situational (for example, you can get an erection during masturbation but not with a partner), which may suggest a stronger psychological component. If you cannot get an erection under any circumstances, a physical cause is more likely.

In reality, many cases involve both physical and psychological factors, so a balanced assessment is important.

The psychological causes of impotence include:

• Stress or tiredness.
• Anxiety or mental health issues.
• The pressure to perform sexually.

The physical causes of impotence include:

• Smoking.
• Alcohol consumption.
• Recreational drug use.

Here Are Some Tips That May Help Reduce Your Risk of ED:

• Maintain a healthy weight.
• Exercise regularly.
• Eat a balanced diet.
• Stop smoking.
• Limit alcohol (within UK guidance).
• Manage stress and anxiety.
• Prioritise sleep.
• Treat any underlying medical conditions.

A Breakdown of Known Causes of ED: 

Stress, Depression or Anxiety

The risk of erectile dysfunction occurring is increased by stress and/or depression/anxiety. A delicate balance of hormones and nerve impulses is required to gain and maintain an erection. Stress and depression both disrupt this balance, resulting in ED.

Low Testosterone Levels

Testosterone levels naturally decrease as men get older, which can cause erectile dysfunction. If you believe you have low testosterone levels, consult your GP as they may offer you male hormone replacement therapy. 

Porn-induced Erectile Dysfunction

Studies have shown that the overconsumption of pornography in younger males is a psychological factor that has resulted in erectile dysfunction. This can be treated by reducing the use of pornography and seeking appropriate professional support, such as counselling and therapy.

Drinking and Smoking

Alcohol and nicotine (the addictive substance in cigarettes) both restrict the blood flow to the penis. Heavy episodes of smoking or drinking can induce erectile dysfunction. This can be treated by reducing the amount you smoke and/or drink. Both smoking and drinking also have long-term effects on a man's sexual performance. Counselling and therapy can also help those who are looking for support to reduce their smoking, drinking or use of drugs. 

High Blood Pressure

Untreated high blood pressure over a long period of time can damage your arteries, causing them to narrow, which restricts blood flow to the penis, which can result in erectile dysfunction.
However, high blood pressure medications can also cause erectile dysfunction. These medications reduce the intensity of blood flow to the penis, which may result in erectile dysfunction.
This is a frustrating situation for many men, as not treating high blood pressure can cause erectile dysfunction, but so can the medications that treat high blood pressure.

Psoriasis

Psoriasis is a skin condition that causes flaky, silvery, itchy patches of skin, which commonly appear on the elbows, knees, scalp and back. Psoriasis has been linked to erectile dysfunction for the following reasons:

• Psoriasis is a risk factor for cardiovascular disease, which can lead to ED.
• Psoriasis may appear on the penis, and the change in skin can affect self-esteem.
• Psoriasis is chronic inflammation. This inflammation can damage blood vessels in the penis, which can cause ED.
• Psorosis can lead to changes in hormone levels and lead to a decline in testosterone, and therefore contribute to ED.
• Some Psoriasis medications, such as methotrexate, can lead to sexual dysfunction.

Erectile Dysfunction Treatments

Oral Medications for Erectile Dysfunction (ED)

Oral erectile dysfunction tablets are the most popular treatment. They have been proven to be effective against physiologically induced erectile dysfunctions. These may be used for short-term or long-term treatment depending on what your healthcare professional recommends.

Examples include Generic Viagra (sildenafil), Cialis (tadalafil), Daily Tablet Tadalafil, and Levitra (vardenafil). The examples given all come under a drug class called PDE5 inhibitors, which work by increasing blood flow to the penis. It is important to note that taking these medications alone will not achieve an erection. To achieve an erection after taking these tablets, sexual stimulation and arousal are still required.

How Well Do Erectile Dysfunction Tablets Work?

The success rate of ED treatment varies depending on the underlying cause of the ED and the specific treatment used. However, most men see a significant improvement in their ED symptoms with treatment.
According to a study published in the journal Urology, 70-80% of men with ED respond to oral medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). Other treatments, such as penile injections and vacuum erection devices, have even higher success rates, but they may be less convenient or less desirable for some men.

Natural Treatments/Lifestyle Changes

Healthy lifestyle changes can sometimes help erectile dysfunction, especially when blood pressure, cholesterol, weight, stress or alcohol are contributing.

• Surgery: Usually only considered if all other treatments have not helped. Age and medical history may affect whether surgeons will operate on an individual.
• Counselling: can be helpful if ED is linked to mental health or relationship concerns, and can also be used alongside medication.
• Smoking: Stopping smoking can improve blood vessel health.
• Diet and exercise: aim for regular activity and a balanced diet to support blood flow and overall health.
• Alcohol: keep within UK guidance and consider reducing if you notice alcohol affects your erections.
• Stress and communication: stress and anxiety are common contributors; talking to a partner, friend or clinician can help.
• Vacuum constriction devices (VCDs): may be recommended in some situations, particularly if tablets are not suitable. It’s best to discuss these with a clinician first.
• Testosterone replacement therapy (TRT): only appropriate if testosterone is low and should be guided by a clinician.

Pros and Cons of Erectile Dysfunction Treatments

Pros:

Improved sexual function and confidence.
A more satisfying sex life and reduced performance anxiety for many men.
A prompt to address underlying health risks (for example, blood pressure, cholesterol, diabetes).

Cons:

Potential side effects and interactions, so suitability checks matter.
Not every treatment works the same for everyone, and you may need to try alternatives.

Tips for Men Considering Seeking Treatment for Erectile Dysfunction

If ED keeps happening, consider a health check, as it can be linked to conditions like high blood pressure, diabetes or heart disease.
Be honest in your assessment about symptoms, lifestyle and medication, so the safest treatment option can be recommended.
If you have chest pain, take nitrates for angina, or have been told to avoid sexual activity for medical reasons, speak to a clinician before using ED medication.

Useful Patient Information About Treatment for Erectile Dysfunction

NHS Inform: Treating Erectile Dysfunction

NHS - Patient Information Leaflet: Information for patients with erectile
Dysfunction