Mental causes of sexual dysfunction include: depression, stress, anxiety and insomnia.  When one of these conditions leads to ED, usually once the condition is cured normal sexual behavior returns.  If you believe you have one of these conditions, see your doctor for an evaluation before beginning any treatment.  One side effect of antidepressants is erectile dysfunction.
Dr. Jonas Bovijn is the co-first author of the study and is from the Big Data Institute at the University of Oxford. He said: “We know that there is observational evidence linking erectile dysfunction and type 2 diabetes, but until now there has not been definitive evidence to show that predisposition to type 2 diabetes causes erectile dysfunction.”
Talk with your doctor before trying supplements for ED. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba (seen here) are popular, but there isn't a lot of good research on their effectiveness. Some men find that taking a DHEA supplement improves their ability to have an erection. Unfortunately, the long-term safety of DHEA supplements is unknown. Most doctors do not recommend using it.
Wing, R. R., Rosen, R. C., Fava, J. L., Bahnson, J., Brancati, F., Gendrano, I. N. C., … Wadden, T. A. (2010, January). Effects of weight loss intervention on erectile function in older men with type 2 diabetes in the Look AHEAD trial. The Journal of Sexual Medicine, 7(1), 156-165. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461030/
For obvious reasons, ED can be a sensitive subject, one that until relatively recently men were more likely to try to hide than to deal with. Fortunately, a deeper understanding of the variety of causes of erectile dysfunction has led to medications, therapies, and other treatments that can be more individualized and more likely to be effective—and more open discussion about addressing the concern.
In some cases, ED can be a warning sign of more serious disease. One study suggests ED is a strong predictor of heart attack, stroke, and death from cardiovascular disease. The researchers say all men diagnosed with ED should be evaluated for cardiovascular disease. This does not mean every man with ED will develop heart disease, or that every man with heart disease has ED, but patients should be aware of the link.
Though it's most common among older men, it's possible for young men to get erectile dysfunction. When young men develop ED, it's usually a result of psychological problems such as anxiety, stress, depression or relationship problems. However, physical problems such as diabetes, nerve problems, injury or other medical conditions may also lead to erectile dysfunction in younger men. If you're having frequent or ongoing trouble getting or keeping an erection long enough to have sex, talk to your doctor.
This man’s history is adequate to rule out arterial or venous insufficiency as he can masturbate to produce a rigid, sustainable erection and he responds well to tadalafil. Due to his report of gradual onset, his lack of response to ongoing sexual therapy, and his tremendous anxiety associated with the issue, the decision was made to offer a PCDU to assess for a vascular etiology for his disorder. PCDU revealed normal peak flow bilaterally of 40 cm/sec with no end diastolic flow and 100% rigidity obtained. His erection lasted more than 2 hours and required phenylephrine to resolve the erection.
The recommended starting dose of vardenafil is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher or lower depending on efficacy and side effects. The maximum recommended dose is 20 mg, and the maximum recommended dosing frequency is no more than once per day. Patients can take vardenafil with or without food. As with sildenafil, for vardenafil to be effective, sexual stimulation must occur.
Lifestyle changes: One of the first things a young man can do to potentially improve or eliminate ED is make positive choices that will also have an impact on the rest of his life. Some changes a man can consider include increasing exercise, eating a heart-healthy diet, quitting smoking, and drinking alcohol only in moderation. Where a man has relationship problems, seeking counseling may also be helpful.
I think that a very powerful argument to young men who want to perform at the highest level is to point out the destructive nature of what they’re doing. If they’re having 18 drinks per week, if they’re having three, four, five drinks at any one time, they’re going to guarantee that their erections are not going to be at the highest level. I can’t tell you the number of men who come in saying, they went out, they had a date, they had a big dinner– which, by the way, is also not a great thing for erections, because all the blood is now going to your gut instead of to the genital area. And how important lifestyle changes are to improving your performance, as well, if not better, than the medications. So make certain that you exercise modestly, not excessively. Make certain that you have a smaller meal on an evening or a day that you want to have a sexual encounter, because you want the blood to go, once again, to the penile area and not to your gut. And really, the whole idea of stress– if you’re stressed out, if you’re worried about a lot of things, if you’re distracted, you can’t initiate that psychic stimulus to your spinal cord and then ultimately to your penis. So stress management is incredibly important.
Wing, R. R., Rosen, R. C., Fava, J. L., Bahnson, J., Brancati, F., Gendrano, I. N. C., … Wadden, T. A. (2010, January). Effects of weight loss intervention on erectile function in older men with type 2 diabetes in the Look AHEAD trial. The Journal of Sexual Medicine, 7(1), 156-165. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461030/

If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.
The National Institutes of Health estimates that erectile dysfunction strikes as many as 30 million men in the United States. Its prevalence does increase with age — 4 percent of men in their 50s are affected by ED, 17 percent in their 60s, and 47 percent of those over 75. But research has also found that 5 percent of those affected were between 20 and 39.
Hormonal disorders, such as low testosterone, may contribute to ED. Another possible hormonal cause of ED is increased production of prolactin, a hormone produced by the pituitary gland. Additionally, an abnormally high or low thyroid hormone level can result in ED. Young men who use steroids to help build muscle mass are also at a higher risk for ED.
If you answer “yes” to any of these questions, your ED may well have a psychological link. To confirm this diagnosis, you may want to complete a full psychological evaluation. This is particularly important if you suspect that your ED has something to do with a mental health issue like anxiety or depression that might require additional treatment, either medical or psychosocial.
Penile Injection Medication: This is just what it sounds like. Injected at home directly into the penis, the medication alprostadil produces erection by relaxing certain muscles, increasing blood flow into the penis and restricting outflow. Although some sources report an 80 percent success rate, the therapy has disadvantages, such as risks of infection, pain, and scarring—fibrosis—in the penis, and it may also cause priapism. A popular version of this medication is Upjohn Corporation’s Caverject. The MUSE System, by VIVUS, involves the same medicine (a pellet of alprostadil) applied with an eye-dropper-like applicator, directly into the urethra.
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