What is erectile dysfunction?

Erectile dysfunction (ED) is the persistent or recurrent difficulty getting or maintaining an erection firm enough for sex. If you’ve ever struggled with this, you’re not alone. Maybe stress from a busy period at work is spilling over into your sex life, or perhaps anxiety is stopping you from getting out of your head and enjoying the moment.

Performance issues can happen occasionally, but these aren’t the same as ED. In fact, a study found that 41.5% of men in the UK have reported experiencing ED at varying levels of severity. We understand that ED can leave you feeling embarrassed, ashamed, or isolated, particularly if it impacts your relationships. But it’s common––and more importantly, it can be treatable.

In this article, we’ll explain what’s really going on down there when ED rears its head. Plus, we’ll take a look at some of the common causes behind it and what treatments are available.

What is the physiology of erectile dysfunction?

Getting hard isn’t as easy as it sounds. An erection occurs when there is an influx of blood to the penis, often triggered by sexual arousal through sensory or mental stimulation, though this can also happen spontaneously, even during sleep. From there, its muscles tighten to prevent blood from exiting the penis––then, it goes away when arousal decreases or after an orgasm.

ED can be linked to several underlying and potentially overlapping physical or mental causes. Sometimes, there may be no apparent cause at first––this is where consulting with a healthcare professional becomes important, as understanding the contributing factors will help guide treatment.

What are the main causes of ED?

You wouldn’t fix a car by taking a tool to the exhaust, you’d start by popping the hood to see where the issue is coming from. The same goes for ED.

Part of why ED can be troubling is that the cause may not be apparent. In 90% of cases, it is estimated that men will have at least one underlying physical condition that leads to ED, while a purely psychological problem is observed in just 10%. Either way, it’s important to get to the root of the issue to tackle it most efficiently.

Physical causes

Certain physical factors may prevent or limit blood flow to the penis or stop signals from being sent between the brain and the genitals. For example:

• Cardiovascular (heart) disease
• Hormone problems such as low testosterone
• Diabetes
• Trauma to the pelvis, for example, due to surgery
• Peyronie’s disease (causing abnormal penile curvature)
• Side effects from medication such as antidepressants

Psychological causes

ED can be an emotional cycle. While everyday psychological factors, such as stress or anxiety, may lead to initial performance issues, they can create self-reinforcing patterns that are difficult to break. Other causes may include:

• Depression
• Stress
• Anxiety

Lifestyle factors

As with many medical conditions, an imbalanced lifestyle can often contribute. Penis-owners may notice repeated ED symptoms due to:

• Smoking
• Excessive alcohol consumption
• Physical inactivity
• Unhealthy diet

ED symptoms and when to see a doctor

Even the most seasoned performers get stage fright from time to time, especially when the lights go off and the curtain rises. But if you’ve noticed repeated difficulty getting or keeping an erection––or even reduced firmness compared to normal––you may be experiencing ED.

The NHS recommends speaking to a pharmacist, consulting a GP or booking an appointment at a sexual health clinic if your symptoms persist.1B We understand that opening up about what’s going on down there, even to a trusted professional, can be daunting. But you’re not alone. ED is extremely common, with over a third of men in the UK reportedly experiencing some degree of erectile difficulties according to one study––and sharing your symptoms can make it easier to find and manage the root cause.

How erectile dysfunction is diagnosed

“Alright, trousers off.” While this phrase might be exciting in certain contexts, it may not be something you really want to hear in a doctor’s office.

We won’t pretend that speaking to a professional about ED is easy, but we can help ease your anxiety by telling you what you might expect at your appointment. The doctor or nurse might:

• Ask some lifestyle questions, for example, about your smoking or drinking habits
• Conduct some basic tests to check your cholesterol levels or blood pressure
• Examine your genitals to check for a possible physical cause

Feeling nervous? That’s completely natural. The key thing to remember is that these tests and checks are usually simple and non-invasive. The healthcare professional will then use their observations and any relevant results to determine whether the cause is physical, mental, or a mix of both, which will help inform treatment.

ED treatment options

No two penises are alike––the same goes for an ED treatment plan. With symptoms being attributed to a wide array of underlying causes, the right medication for a person with heart disease may be different to someone whose ED is purely psychological. As such, there’s not a one-size-fits-all approach. Here are a few treatment options your healthcare professional might suggest.

Lifestyle changes

The NHS recommends lifestyle changes as the first line of treatment for ED. Your doctor or nurse may suggest the following:

• Increased physical activity
• Weight loss
• Healthier diet
• Reduced alcohol consumption
• Stopping smoking
• Management of any pre-existing conditions, such as diabetes, high blood pressure, and high cholesterol

Medication

In many cases, medication like sildenafil can help improve ED. These inhibitors won’t increase your sex drive, they improve blood flow temporarily to the penis during sexual stimulation, making it easier to get and maintain an erection.

Some of these treatments are available to access over the counter, without the need for a prescription, following a consultation with a pharmacist who will ensure there is no contraindication. For example, sildenafil should not be taken by anyone with high blood pressure, a history of stroke, or other pre-existing conditions determined relevant by a healthcare professional.

If medication can’t be given, your doctor may talk to you about vacuum pumps. These manual or battery-operated devices are placed over the penis to increase blood flow before sex, thus creating an erection that can be maintained with the help of a constriction ring––however, note that this is different to a typical cock ring.

Psychological support

Whether your ED has an entirely psychological cause or not, consistent performance issues can take a toll on your mental health. Which is why a medical professional may also recommend psychosexual support, such as:

• Cognitive and behavioural therapy
• Couples’ counselling
• Treatment for anxiety

Living well with ED

Problems in the bedroom can often leave you and your partner feeling isolated and embarrassed––but this is far from the reality. ED is very common, with 4.3 million men in the UK estimated to be experiencing the condition.

And while there are plenty of treatment options to help you combat the symptoms of ED, communication can also play an important role in navigating ED.

By opening up to male friends, you might discover that many of them have dealt with performance issues themselves, or perhaps that they’re currently going through ED treatment. By sharing your anxieties with your partner, you may be able to explore different avenues of intimacy beyond penetration, while you work with a healthcare professional to treat your symptoms. But above all, remember to be patient with yourself.

ED is not the end

While ED may be a sensitive subject, it’s far from uncommon––and most importantly, it can be managed with the right treatment.

Occasional performance issues can happen. But if you’re finding it increasingly hard to… well, get hard… it could be time to consult a healthcare professional. And in the meantime, your sex life doesn’t have to run dry––check out our Performance range which can help sex last longer and start practicing with a partner.

Durex Sildenafil 50mg film-coated tablets. For erectile dysfunction problems in adult men. Always read the label. Ask your pharmacist if this medicine is suitable for you.

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