The U.S. FDA (Food and Drug Administration) has a list of 29 OTC products that claim to treat erectile dysfunction. Patients should avoid these because many contain harmful ingredients. Other natural or herbal remedies such as DHEA, L-arginine, ginseng, and yohimbe are supplements that have been used but have not been proven safe and effective according to some researchers. Before using such compounds, individuals should consult their doctor. According to some experts, acupuncture does not effectively treat erectile dysfunction. Other home remedies for reducing ED symptoms include diet changes such as eating blueberries and citrus fruits and drinking red wine.
Another common reason for failures of oral therapy is the absence of sexual or genital stimulation prior to attempting sexual intercourse. These medicines facilitate an erection by increasing blood flow to the penis, but they do not act as an aphrodisiac or as an initiator of the erection. A man who is not “in the mood” or does not have adequate physical stimulation will not respond with an erection.
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.

Surprisingly, one of the main causes of erectile dysfunction (ED) or impotence may be in that icy mug of beer you are enjoying right now! A common cause of difficulty with erection is overuse of alcohol. Small amounts of alcohol can help us relax and help remove inhibitions, which can help the sexual mood and actually increase sexual activity. Nevertheless, as the amount of alcohol in the blood increases, the alcohol only serves to depress the brain’s ability to sense sexual stimulation.

"Smoking is a short- and long-term cause of erectile dysfunction," warns Feloney. "In the short-term nicotine constricts the blood vessels that you need to get an erection, and in the long-term nicotine contributes to hardening of the arteries that can cause erectile dysfunction." Some approaches for quitting include making a clean break, avoiding the triggers of smoking, trying a nicotine patch or gum, and joining a smoke cessation program.
While these are the two most comparable datasets on this subject, there’s a problem with both of these studies, which is that they don’t tell us anything about the severity of the difficulties experienced. Having erectile “difficulty” doesn’t necessarily mean that these guys can’t get an erection at all or that they have problems every time and with every partner. Also, we don’t know whether guys who had very mild problems answered these questions consistently (e.g., if it only happened once or you didn’t think it was a big deal, would you still report it as a problem?).
An erection is a "neurovascular event" meaning that in order to have an erection there needs to be proper function of nerves, arteries, and veins. An erection involves the central nervous system, the peripheral nervous system, physiologic and psychological factors, local factors with the erection bodies or the penis itself, as well as hormonal and vascular (blood flow or circulation) components. The penile portion of the process leading to an erection represents only a single component of a very complex process.
It's also important to remember that your mental health plays as much a part of your sexual ability as your physical health. Stress and other mental health concerns can cause or make erectile dysfunction worse. Minor health problems may slow your sexual response, but the accompanying anxiety that comes with the slow sexual response can shut things down entirely.
Premature ejaculation was reported by 36 out of 96 (37.5%) subjects, out of which, 27 (28.12%) had complaints of ejaculating within the first minute itself and the rest (9.38%) ejaculated within three minutes of intromission. The next most frequent sexual dysfunction reported was low sexual desire, which was reported by 36 out of 100 subjects. Erectile dysfunction was reported by 33.3% of the subjects with difficulty in achieving erection in 19 subjects (19.79%) and difficulty in maintaining erection in 13 subjects (13.54%).
In many of these cases, a discussion between the physician, the man with erectile dysfunction, and possibly his partner can help to resolve the issues leading to treatment failure. For men who experience severe side effects, can’t take the drugs for other reasons (such as taking medicines such as nitroglycerin), or don’t respond in spite of further education on the correct use of the drugs, there are other treatment options that can help most men remain sexually active.

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.


Medications used in the treatment of other medical disorders may cause erectile dysfunction. If you think erectile dysfunction is caused by a medication, talk with your doctor about drugs that might not cause this side effect. Do not just stop taking a prescribed medication before talking with your health care provider. Common medications associated with erectile dysfunction are:
We can partially speak to this issue by looking at data from the first wave of the National Survey of Sexual Health and Behavior (NSSHB), a nationally representative US sex survey conducted in 2009 with thousands of Americans aged 14-94 [3]. As part of this study, male participants were asked whether they’d experienced any erectile difficulties the last time they had sex via a single item with five response options, ranging from “not difficult” to “very difficult.” Obviously, this is a quite different question compared to the other studies because it only focused on a single event (the most recent one in memory) and it was more complex than a simple yes/no answer. The researchers also divided men into slightly different age groups.
Surprisingly, one of the main causes of erectile dysfunction (ED) or impotence may be in that icy mug of beer you are enjoying right now! A common cause of difficulty with erection is overuse of alcohol. Small amounts of alcohol can help us relax and help remove inhibitions, which can help the sexual mood and actually increase sexual activity. Nevertheless, as the amount of alcohol in the blood increases, the alcohol only serves to depress the brain’s ability to sense sexual stimulation.
Yes, excessive alcohol intake can affect sexual function. Erectile dysfunction is more common in people who abuse drugs and alcohol. Lifestyle changes such as drinking less alcohol and quitting smoking may help improve sexual function. Chronic heavy alcohol consumption can affect erectile ability through altered hormone metabolism and nervous system involvement.

Medications for erectile dysfunction don't work for everyone and may cause side effects that make a particular drug hard to take. "Work with your doctor to find the right treatment. There are still options for people who fail at medical treatment," advises Feloney. Alternatives to erectile dysfunction drugs include vacuum pump devices, medications injected into the penis, testosterone replacement if needed, and a surgical penile implant.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

Obesity and metabolic syndrome can cause changes in blood pressure, body composition, and cholesterol which may lead to ED. Other conditions that may contribute to erectile dysfunction include Parkinson’s, multiple sclerosis, Peyronie’s disease, sleep disorders, alcoholism, and drug abuse. Taking certain medications can also increase your risk for ED.
In most young men with ED, additional testing to assess for the origin of ED is unnecessary as the history gives you the information that you need. With this said, it may be therapeutic for the patient to know his laboratory assessments are normal, in which case additional testing does add significant value to the assessment. From the history alone, we find that most of these men will have situational erectile dysfunction that responds well to low dose oral PDE-5 inhibitors. If the patient does respond well to these medications, the diagnosis of neurogenic erectile dysfunction, clinically significant arterial insufficiency, or venous-occlusive dysfunction can efficiently be ruled out. If the patient responds inconsistently or does not respond to the oral medications, additional workup should be considered, dependent on the additional history provided.
The improvement of both man and woman sexual function in couples whose male partner is treated with PDE5i has been further confirmed by randomized clinical trials (RCTs) comparing the effectiveness of PDE5i vs. placebo in improving couple sexual function (91-95). In a more recent RCT, the use of vardenafil 10 mg oral dispersible tablets has been compared to the use of the drug itself in association with cognitive behavioral sexual therapy (CBST) for 10 weeks in 30 couples with ED male partners, randomly assigned to one study arm (96). Results from this RCT showed that vardenafil is able to improve male sexual function, but this improvement is maintained only in patients receiving both vardenafil and CBST. Furthermore, female sexual function and satisfaction are enhanced only in the arm with vardenafil and CBST combined therapy, thus suggesting that a therapy healing the couple is more effective and has a longer-lasting efficacy than the use of a medication focusing only on ED.
Chlamydia and erectile dysfunction: What's the link? Some people who have chlamydia also experience erectile dysfunction (ED), which involves problems getting or maintaining an erection. Chlamydia can infect the prostate gland, leading to prostatitis, pain, and ED. In this article, learn more about the link between this common infection and ED, and treatments for both. Read now
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