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Frequently asked questions about erectile dysfunction

What is erectile dysfunction?

Erectile dysfunction (ED) is the inability for a guy to achieve and maintain an erection firm enough for sex. ED is the same as impotence, but impotence is used less often when referring to this common condition.

ED affects hundreds of millions of men. Statistics from the Massachusetts Male Ageing Study show that about 52% of men experience erectile dysfunction at some point in life.

As a man, it’s normal to have trouble getting or keeping an erection occasionally. However, if you frequently have difficulty getting an erection or maintaining a firm erection during sex, you might have ED.

Erectile dysfunction can occur for a variety of reasons. Sometimes, a psychological issue or nervousness can trigger ED. In other cases, ED can be a sign that you might also have an underlying health problem.

Factors like your use of tobacco products, other medications or alcohol can also contribute to erection issues, making it harder for you to maintain a fulfilling sex life.

When ED occurs at a bad moment, it can affect your self-confidence. Luckily, ED is one of the easiest sexual dysfunctions to treat. Today, a variety of effective medications and non-prescription treatments are available to help men of all ages treat ED.

What are the symptoms of erectile dysfunction?

The most common symptom of erectile dysfunction is difficulty developing and maintaining an erection during sex. Persistent erectile dysfunction can also affect your sexual confidence and potentially cause you to become less interested in sexual activity.

Difficulty getting an erection

Erectile dysfunction can make it difficult for you to get an erection, even if you're in the mood for sex. Erection problems can range in severity -- sometimes, you might find it difficult to get any erection, while in other cases you might find it difficult to get a firm enough erection for sex.

Difficulty maintaining an erection

Erectile dysfunction can make it difficult for you to maintain an erection during sexual intercourse. Even if you get an erection before sexual activity without difficulty, you may find it difficult or impossible to keep a firm erection during sex, which can impact your experience, orgasm and ejaculation.

Loss of interest in sexual activity

If you have erectile dysfunction, it can affect your self-confidence and make you avoid sexual activity. Many men with erectile dysfunction feel less interested in sex and lose some or all of their motivation to pursue sexual relationships.

What causes erectile dysfunction?

Erectile dysfunction can develop for a variety of reasons. Sometimes, erectile dysfunction is a sign that you might have an underlying cardiovascular health issue. In other cases, ED can be caused by psychological factors such as anxiety or nervousness about sex.

Physical Causes of Erectile Dysfunction

  • Heart disease. Persistent erectile dysfunction is a common sign of heart disease. Heart disease can contribute to dysfunction of the inner lining of your blood vessels, making it more difficult to get and maintain an erection.

  • High blood pressure. High blood pressure is an extremely common cause of erectile dysfunction. Many medications used to treat high blood pressure can also contribute to ED and worsen existing difficulties with sexual performance.

  • High cholesterol. High cholesterol levels can damage blood vessels, making it harder to get and maintain an erection. Several medications used to treat high cholesterol are linked to improvements in sexual function for men with ED.

  • Type 1 or Type 2 Diabetes.

  • Metabolic syndrome. Several studies have linked erectile dysfunction and metabolic syndrome, a cluster of medication conditions that can increase your risk of diabetes, heart disease and stroke.

  • Parkinson’s disease. Men with Parkinson’s disease frequently develop ED. Some of the medications used to treat Parkinson’s disease can also worsen erectile dysfunction and other sexual disorders.

  • Sleep disorders. Sleep disorders such as sleep apnea are closely linked with erectile dysfunction.

  • Multiple sclerosis. Erectile dysfunction is common for men with multiple sclerosis, with some studies indicating that up to 91% of men with MS will also experience ED at some point in life.

  • Alcoholism. Chronic use of alcohol can cause erectile dysfunction, even in men with no other physical health issues. Not only does alcohol decrease sexual performance on its own, but chronic use of alcohol can potentially cause permanent nerve damage.

  • Prostate cancer/enlarged prostate. Several treatments for prostate cancer or enlarged prostate can affect your ability to get and maintain an erection during sex.

Sources: Translational Andrology and Urology *

Psychological Causes of Erectile Dysfunction

  • Stress. If you feel stressed due to certain events in your professional or personal life, it might affect your sexual performance. Many men experience erectile dysfunction during stressful periods in their lives.

  • Anxiety or depression. Anxiety and depression can both contribute to sexual issues such as erectile dysfunction. In fact, studies indicate that psychological issues such as anxiety and depression are some of the most common causes of ED.

  • Relationship issues. If you're going through relationship issues that affect your level of trust in or attraction to your partner, this could cause or worsen erectile dysfunction and make sex more difficult.

  • Pornography. Although it hasn’t been extensively studied, some experts believe that frequent use of pornography can cause.

What ED treatments are available?

While you're probably familiar with some of the most common ED drugs like Viagra and Cialis, there are more choices out there. Not only should you consider prescription drugs, but there are also over-the-counter options as well as non-oral medications. Here is an overview of the different types of ED drugs available:

  • Sildenafil (Viagra®)

  • Tadalafil (Cialis®)

  • Vardenafil (Levitra®)

  • Avanafil (Stendra®)

  • Alprostadil suppository

  • Alprostadil injection

  • Papaverine

  • Phentolamine

What are the side effects of ED medication?

Because most ED drugs work similarly, they also have similar side effects. The side effects of ED drugs typically occur while the drugs are active in the body, although they can often last for slightly longer than the drug itself.

This means that if you're prone to side effects from ED drugs, you may notice them lasting for longer if you use a medication such as tadalafil, which has a very long half-life.

There are seven side effects that are most commonly reported by ED drug users. They are:

  • Headaches*, which are associated with all ED drugs. Headaches are most commonly caused by increased nitric oxide levels, which can increase blood flow and result in a temporary headache.

  • Dizziness*, which is also a result of increased nitric oxide levels. The dizziness from ED medication is typically not severe, but it can potentially lead to discomfort and fainting in people with underlying health conditions.

  • Muscle aches, which may also be caused by the increase in blood flow caused by all widely available ED medications.

  • Nasal congestion, or a stuffy nose. This typically occurs when ED medications are at peak concentration and reverses as the drugs are metabolised and excreted.

  • Facial flush, which can range from mild facial redness to bright red skin that looks like it’s affected by a rash. Like other side effects, this usually reverses as the levels of the medication in your system decline.

  • Vision issues, including temporary blurry vision and blue-tinted vision. This condition is called cyanopsia and is thought to result from diminished enzyme activity.

  • Digestive issues, ranging from diarrhoea to indigestion and bloating. These are usually temporary and can be made worse by consuming alcohol, caffeine, carbonated drinks and dairy products.

*These side effects are particularly important to watch for if you have other medical (heart) conditions that require you to take nitrates.

How long do ED medications take before they start working?

In general, it takes some time for ED medication to start working before engaging in sexual activity. The best approach is to prepare ahead of time and make sure ED medication is consumed 30-60 minutes before sex, depending on the specific drug and your doctor's recommendation.

Cialis activity is not affected by food. Viagra's effect may be diminished if taken soon after a high fat meal (which may also delay how fast it works). For this reason, Viagra is best taken on an empty stomach.

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