Erectile dysfunction affects the mind, body, and intimate relationships. Here’s what to look for.

Erectile dysfunction (ED) involves the persistent or recurrent inability to get or maintain an adequate erection for the duration of sexual activity.

Though it becomes more common with age, ED can occur at any age due to a variety of physical and psychological reasons.

ED can lead to emotional distress and relationship difficulties. When it occurs, both partners may grapple with anxiety, low self esteem, or feelings of inadequacy.

Not being able to get an erection from time to time is a natural occurrence. This may be due to alcohol consumption, excessive tiredness, or anxiety. But if it begins to happen on a regular or semi-regular basis, there may be an underlying problem.

ED symptoms may involve the following:

  • not being able to get an erection every time you want to have sex
  • being able to get an erection but not having it last long enough
  • not being able to get an erection at any time

Early symptoms

Though ED can happen suddenly, symptoms typically progress over time.

The earliest signs of ED might include slowly losing your ability to get or maintain an erection. You might find it takes longer than is typical to get an erection, or you might lose the erection before sex is over.

You also might experience a loss of sensitivity and require more and more stimulation to achieve or maintain an erection.

Reduced desire for sex is not uncommon, particularly in individuals with a hormonal imbalance or an emotional problem underlying the ED.

Psychological symptoms

For many, sex is an important part of intimacy and relationships. So when something happens to prevent it, it can trigger uncomfortable feelings.

Research shows that men with ED often feel the following:

Anxiety, fear, and stress are common in ED, but research shows that the most common initial response is a sense of emasculation. This reaction can be particularly severe in young men, with one individual describing it as “total humiliation” and a “profound feeling of being less than anyone else.”

The partner may also experience:

  • feelings of rejection
  • frustration
  • feeling unloved or unwanted
  • doubting one’s own attractiveness
  • doubting their partner’s fidelity
  • questioning integrity of relationship
  • withdrawal of intimacy
  • sense of shame

Understandably, ED can deepen any previous insecurities and have a significant effect on a person’s ability to form intimate relationships. When the issue is severe and long-term, some individuals can have suicidal thoughts.

ED is not a disease. Instead, it is a symptom or side effect of a physical or psychological issue, or both.

Organic or physical causes include the following:

Age is also a strong indirect risk factor in that it’s associated with an increased likelihood of other risk factors.

Psychological causes may include:

Is erectile dysfunction a symptom of covid?

Some research suggests that COVID-19 might significantly increase the risk of developing ED.

One study, which involved 100 participants (25 COVID-positive; 75 COVID-negative), found that 28% of the COVID+ group had ED, compared to 9.33% of the negative group.

As one of the most common sexual health disorders in males, ED can occur at any age for a variety of reasons, but it’s most likely to start in your 50s or 60s.

From there, research shows that the risk for ED increases with age.

One review found that ED is present in:

  • 6% of men under 49
  • 16% of men ages 50-59 years
  • 32% of men ages 60-69 years
  • 44% of men ages 70-79 years

Accounting for all severity levels of ED, it’s estimated that about half of all men ages 40-70 will experience ED to some degree.

There’s no cure for ED, but it’s important to remember that ED isn’t a disease — it’s a symptom or side effect of other conditions, ranging from cardiovascular disease to medications to anxiety.

Identifying and treating the underlying cause is most important. This may include healthy lifestyle advice, such as eating well, exercising, and quitting harmful substances like smoking and alcohol.

Psychosexual therapy can be quite effective at treating the psychological symptoms of ED. This therapy involves discussing the client’s and partner’s perspectives and expectations around sex, and helping them gradually change their behaviors and thoughts that are making sex difficult.

The most common direct treatments for ED include:

  • Phosphodiesterase type-5 (PDE5) inhibitors: These first-line treatments induce smooth muscle relaxation and increase blood flow to the penis, leading to an erection. Viagra (sildenafil) is the most well-known PDE5 inhibitor. It’s important to note that about 30-35% of men fail to respond to initial treatment with PDE5 inhibitors.
  • Vacuum erection devices. This second-line treatment involves an external tube that passively pulls blood into the penis which is then maintained with a constriction ring.
  • Prescription medication alprostadil. This second-line treatment can be given with a self-administered injection to the penis or via a suppository. Alprostadil makes the blood vessels expand, allowing greater blood flow through the penis.
  • Penile prosthesis. This is the third-line treatment for ED. These implants are usually irreversible and should be used as a last resort treatment for ED.

Erectile dysfunction is one of the most common sexual disorders among men. ED can have significant effects on an individual’s mental health and relationships.

Although society has made significant progress in openly discussing sexual health within the last decade, many men still feel embarrassed to discuss these problems, and as a result, often do not seek help.

However, it’s important to remember that ED is a common condition with various treatment options. If it’s affecting your personal life or mental health, don’t hesitate to reach out to a health professional to discuss the best treatment plan for you.