Not enough info for you? No problem. Nerd out on all the causes of erectile dysfunction with research from the most trusted sources on the interwebs. If you have any questions or you think we missed something important, leave a comment or book a consultation with one of these trained professionals and we’ll get you on the way to a healthier manhood.

A physical exam checks your total health. Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate. These tests are not painful. Most patients do not need a lot of testing before starting treatment.
Neelima V. Chu, MD, is an endocrinology fellow in the Division of Endocrinology and Metabolism at the University of California, San Diego. Steven V. Edelman, MD, is an associate professor of medicine in the Division of Endocrinology and Metabolism at the University of California, San Diego, and the Division of Endocrinology and Metabolism at the San Diego VA Health Care Systems in San Diego. He is founder and director of Taking Control of Your Diabetes, a nonprofit organization, and an associate editor of Clinical Diabetes.

The natural history of ED in people with diabetes is normally gradual and does not occur overnight. Both vascular and neurological mechanisms are most commonly involved in people with diabetes. Atherosclerosis in the penile and pudendal arteries limits the blood flow into the corpus cavernosum. Because of the loss of compliance in the cavernous trabeculae, the venous flow is also lost. This loss of flow results in the inability of the corpora cavernosae to expand and compress the outflow vessels.

Intermountain Healthcare is a Utah-based, not-for-profit system of 23 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.


Multiple authors have demonstrated that anxiety, depression, and stress clearly produce major neurochemical and neuroendocrine changes in the brain (10,11). Changes in neurobiology would be expected to contribute to impaired erectile function. Stress and anxiety lead to increased epinephrine production, and heightened sympathetic tone leads to exaggerated cavernosal smooth muscle contraction, inability of smooth muscle to relax, and subsequent erectile dysfunction (6,7). Failure to achieve a fully rigid erection may aggravate performance anxiety leading to a vicious cycle.
Diabetes leads to vascular complications throughout the body and the penis is no exception. A large survey reported that the majority of men with diabetes and ED had never even been asked about their sexual function. That means they never received treatment for ED. If you think you might have diabetes or even prediabetes, talk to your doctor about ED.
These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.
The vacuum device creates a vacuum to pull blood into the penis. Unlike a normal erection, the inflow of blood does not continue once the individual removes the vacuum device. The rubber band placed at the base of the penis constricts the penis to prevent the blood from leaving the penis. As there is no inflow or outflow of blood when the rubber band is in place, it is uncommon for the tip of the penis (the glans) to appear a little blue and the penis to be cooler. Once intercourse is completed, the individual removes the rubber band and the blood drains out of the penis.

Cognitive behavioral therapy (CBT) is a common and highly effective treatment for psychological issues in general, but also for ED. Facilitated by a therapist, this type of treatment helps you to identify and change unhealthy patterns of thought and action which may be contributing to your erectile issues. This kind of treatment is based on the idea that the situation itself (your inability to achieve or maintain an erection) is not the core problem, but rather your reaction to it. If you can learn to better understand yourself and your thought patterns, you can change them in a positive way to resolve your issues.
Supplements are popular and often cheaper than prescription drugs for ED. However, supplements have not been tested to see how well they work or if they are a safe treatment for ED. Patients should know that many over-the-counter drugs have been found on drug testing to have ‘bootlegged' PDE 5 Inhibitors as their main ingredient. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements is not under quality control and may differ from pill to pill. The FDA has issued consumer warnings and alerts.
A daily glass of wine, beer or single malt over dinner or after work with your buddies will not lead to erectile dysfunction (ED), inability to get or maintain an erection during sex. Overindulging, though, will short-circuit your sex life. Besides waking up with a major hangover, overdoing it will eventually lead to hardening of the arteries and cardiovascular disease, which interferes with blood flow to your  equation is simple: the less blood flow, the soft and skimpier the erection. Unless you can drink in moderation, avoid alcohol if you want to be at your best in bed.
Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain a hard enough erection for satisfactory completion of sexual activity. Erectile dysfunction is different from other health conditions that interfere with male sexual function, such as lack of sexual desire (decreased libido) and problems with ejaculation release of the fluid from the penis (ejaculatory dysfunction) and orgasm/climax (orgasmic dysfunction), and penile curvature (Peyronie's disease), although these problems may also be present. ED affects about 50% of men age 40 and over. This article focuses on the evaluation and treatment of erectile dysfunction.

At the same time, people with diabetes are susceptible to a type of blood vessel damage known as endothelial dysfunction. A recent study found that men with ED are at a greater risk of heart disease, which is also associated with endothelial dysfunction. If blood vessels aren't in good working order, the penis may not get enough blood for an erection.

Vacuum therapy devices have a few disadvantages. One must interrupt foreplay to use them. You must use the correct-size tension ring and remove it, to prevent penile bruising, after sustaining the erection for 30 minutes. Initial use may produce some soreness. Such devices may be unsuitable for men with certain bleeding disorders. In general, vacuum constriction devices are successful in management of long-term ED.
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