Erectile dysfunction:Causes, symptoms, treatments

Erectile dysfunction is the persistent or recurrent inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse. It can be occasional or chronic and may have physical causes (cardiovascular problems, diabetes, hormonal imbalances), psychological causes (stress, performance anxiety, depression), or a combination of both. ED is diagnosed when difficulties persist for at least 3 months. It is important to consult a doctor to identify the underlying cause and receive appropriate treatment.

Occasional erection problems can occur at any age and are not necessarily concerning, especially during periods of fatigue, stress, or alcohol consumption. However, their frequency increases with age due to vascular and hormonal aging. Approximately 10% of men at 40, 20% at 50, and 40% after 60 experience it regularly. A medical consultation can help identify the causes (vascular, hormonal, psychological) and propose a suitable treatment, which may be occasional with medications like Viagra or Cialis, or regular depending on the identified causes. Erectile dysfunction is not an inevitable consequence of aging and can be treated effectively at any stage of life.

First-line treatments include PDE5 inhibitor medications such as Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil), as well as their more affordable generic versions. These medications have a 60-75% success rate and facilitate blood flow to the penis. Other options include behavioral and sex therapies (for psychological causes), Kegel exercises (pelvic floor strengthening), lifestyle adjustments (physical activity, balanced diet, smoking cessation), intracavernosal injections (70-90% effectiveness), vacuum pumps, and in severe cases, penile implants. The choice depends on specific causes and requires a medical prescription to ensure safety and effectiveness.

A healthy lifestyle forms an essential foundation: regular physical exercise (150 minutes per week of aerobic activity improves blood circulation), Mediterranean diet rich in fruits, vegetables and omega-3s, stress management through meditation or yoga, quality sleep (7-8 hours per night), and limiting alcohol and tobacco. Some dietary supplements may help: Panax ginseng (moderate effectiveness of 30-40%), L-arginine (nitric oxide precursor), and zinc (for testosterone production). However, these natural approaches are not always sufficient, especially if erectile dysfunction is linked to an underlying medical problem such as diabetes or cardiovascular disease. In these cases, medication treatment remains more effective. Natural products are better suited for mild disorders or as a complement to other measures.

Yes, it's extremely risky. According to the World Health Organization, more than 50% of medications sold on unregulated websites are counterfeit and may contain harmful substances (industrial paint, printer ink, rat poison), incorrect dosages, or no active ingredient at all. These counterfeits can cause serious, even fatal side effects and offer no therapeutic benefit. Additionally, purchasing without a prescription is illegal in many countries and exposes buyers to penalties. It is essential to consult a doctor for a prescription after evaluating your health status and to purchase medications from a licensed pharmacy displaying official certifications. Legal telemedicine services allow you to obtain an online prescription securely.

You should consult a doctor if problems persist for more than 3 consecutive months, if you have difficulties in more than 50% of your sexual attempts, if these disorders significantly affect your self-confidence or couple relationships, or if you have other associated symptoms such as pain during erection, unusual fatigue, significant loss of libido, or penile deformation. Erectile dysfunction can reveal a serious underlying health problem such as diabetes (40-50% of diabetic men develop ED), cardiovascular disease (ED can appear 3-5 years before cardiac symptoms), hypertension, or hormonal imbalance. The earlier the treatment, the better the results. Do not hesitate to discuss it with your doctor: it is a common medical problem and healthcare professionals are accustomed to discussing it.

Yes, very often. Erectile dysfunction is considered an early marker of cardiovascular health. The same factors that affect the blood vessels of the heart (atherosclerosis) also affect those of the penis, but symptoms appear first at the genital level because penile arteries are smaller. Approximately 80% of men who have a myocardial infarction experienced erectile dysfunction in the previous 3-5 years. ED can also be an early symptom of type 2 diabetes (present in 35-75% of diabetic men), high blood pressure, hormonal imbalances (particularly testosterone deficiency), sleep apnea, or neurological diseases. Consulting a doctor allows for a complete assessment (blood tests, cardiovascular evaluation) to detect and treat potential underlying pathologies before they become more serious.

Absolutely. Psychological factors are involved in 10-20% of pure erectile dysfunction cases, and in an additional 20-30% in combination with organic causes. Chronic stress increases cortisol, a hormone that can reduce libido and interfere with erection mechanisms. Performance anxiety creates a vicious cycle: the fear of not being able to achieve an erection itself causes the dysfunction. Other psychological factors include depression (70% of depressed men have erectile disorders), relationship problems, lack of self-confidence, or past trauma. Working on stress management through relaxation techniques (meditation, deep breathing, yoga), regular physical activity, quality sleep, or consulting a sex therapist can help overcome these difficulties. Cognitive-behavioral therapy is particularly effective. In some cases, temporary medication treatment can help restore confidence.

In many cases, yes, erectile dysfunction is reversible or can be significantly improved. The prognosis depends on the underlying cause and the speed of treatment. For lifestyle-related causes (sedentary lifestyle, overweight, smoking), adjustments such as weight loss (a 10% reduction in body weight can improve erectile function by 30%), smoking cessation, and regular exercise can completely restore function. For psychological causes, therapy often allows complete resolution. Medications like Tadalafil or Sildenafil offer an effective solution in 60-75% of cases. Even with organic causes (diabetes, cardiovascular problems), optimal control of these pathologies combined with appropriate treatment generally allows significant improvement. Early treatment considerably increases the chances of success: the longer you wait, the more the disorders can become chronic and difficult to treat.

The doctor will begin with a detailed interview about your medical history, current treatments, lifestyle, and the nature of your erectile disorders. A physical examination will check your blood pressure, pulse, and the condition of your genitals. Blood tests are usually prescribed to evaluate: fasting blood glucose and glycated hemoglobin (diabetes screening), lipid profile (cholesterol, triglycerides), hormones (total and free testosterone, LH, FSH, prolactin), thyroid function (TSH), and kidney function. Depending on the results, additional tests may be necessary: penile Doppler ultrasound (blood flow assessment), intracavernosal injection test (vascular response evaluation), nocturnal erection recording (distinction between organic and psychological causes), or psychological tests. This comprehensive assessment precisely identifies the causes and proposes the treatment most adapted to your situation.