Erectile dysfunctions: causes and treatment

Erectile dysfunctions make a very embarrassing problem that not many men turn to a specialist with. However, they might be a sign of a serious underlying condition. What causes impotence and how to treat it? What can one do to improve the quality of their sex life?

Erectile dysfunctions are a problem that affects many men. Whereas temporary problems in bedroom aren’t an indication to start a treatment in themselves, if one in four intercourses ends in a failure, it’s a good idea to seek professional help. Trivializing the problem might only make it worse.

On top of strictly physiological factors, there’s also the psychological factor: fear of failure – which in turn leads straight to full-blown impotence.
The only way to break out of the vicious circle is to start a therapy.

What causes erectile dysfunctions?

Erectile dysfunctions might be caused by many different factors. In young males, the most common cause is psychological problems: insecurities, inexperiences, fear of unwanted pregnancy. In middle age, the causes are very often overworking, chronic stress, difficulties in personal relations.

Dysfunctions are caused by such illnesses and afflictions as atherosclerosis, diabetes, hypertension, ailments related to impaired functioning of the cardiovascular system, hormonal and neurological disorders.
Therefore, in many cases erectile dysfunctions are not a separate medical conditions, but a symptom pointing to more serious health problems. Difficulties with achieving and maintaining an erection might also be a result of past surgical procedures, aging body, substance abuse, bad diet, sedentary lifestyle, certain medicines. Erectile dysfunctions might also be a side effect of strict religious upbringing.

How to treat erectile dysfunctions?

The type of therapy should depend on how severe the condition is. In the cases, so to speak, the least problematic the measures taken are psychotherapy, vacuum devices and orally administrated medicine or supplements.

If such measures fail, the result achieved is not satisfying or there are any contraindications against oral medicines, a treatment may include injections in the cavernous bodies of the penis or applying preparations administrated through the urethra.


Psychotherapy is a non-pharmacological form of treating erectile dysfunctions and it only shows results when the underlying cause of erectile problems is psychological factors.

erectile dysfunctions

It might be both the only form of therapy as well as supplementation of pharmacological or surgical treatment. Depending on the nature of dysfunction, a suggested solution might be an individual therapy just for the patient himself, or a couple therapy where the partner participates as well.
The techniques used in an individual therapy depend on the specifics of the problem. The array of available therapeutic procedures is so broad that it’s impossible to list all methods in detail here.

The most common option are behavioral training methods that cover things like training communication and interpersonal skills, focusing on sensual experiences, desensitization. A couple therapy, on the other hand, consists of marital or partner psychotherapy, or of a strictly sexual therapy.

The key elements of psychotherapy focused on treatment of erectile dysfunctions are education, change of existing perceptions of sexuality, developing the ability to overcome the fear related to sexual contacts and solving relationship problems.
The effectiveness of psychotherapy is strictly correlated with accuracy of the diagnosis, which should be based on detailed medical history, complemented with an array of psychological tests and, when needed, examinations.
Psychological tests allow to obtain a relatively clear perception of the problem. It is obvious that failures in professional life will require using different methods than troubled relations with the partner, for example. Which makes a proper diagnosis the starting point to choosing adequate ways to deal with erectile dysfunctions.

Oral therapy

Oral therapy mostly utilizes phosphodiesterase 5 (PDE5I) inhibitors – they stimulate blood flow to cavernous bodies, which directly results in an erection. This group of medicines includes three substances:

  • sildenafil (it starts working after 30–60 minutes and lasts for about 12 hours),
  • tadalafil (the first effects can be observed as early as after 30 minutes, and it works for about 36 hours),
  • vardenafil (works similar to sildenafil).

After 12-24 weeks of taking medicines, a significant improvement of erection can be observed. Such preparations can be used both as a part of long-term treatment, consisting of taking small doses every day, or as an interim measure (if we suspect that the problem is of temporary nature).

A serious contraindication to using PDE5I is taking medicines that contain nitrates – the side effects of such mix might even include death. That’s why medicines from this group should never be taken unprescribed – they always require consulting a doctor who can only prescribe them based on a detailed medical history.

Injection treatment

Contraindications to injection treatment are illnesses that lead to chronic erections: sickle cell disease, multiple myeloma and leukemia, as well as all kinds of penal deformations.

Injections might also make the existing changes more severe. It is not a good treatment method for men with phimosis, as the erection achieved through use of pharmacological means might cause difficulties with retracting the foreskin, and in turn — development of paraphimosis.
Other contraindications are cardiac problems and having a penile prosthesis – injections might damage it.

Vacuum devices

Vacuum devices make an alternative to orally administrated medicines, they might also be a supplementation to pharmacological treatment.

They have a cylindrical form that fits the shape of the penis. Once the organ is placed inside the cylinder, a special pump is used to create vacuum around it, which causes blood to flow to cavernous bodies responsible for erections.

An erection is maintained thanks to a ring that slides down to the base of the penis. Vacuum devices make a very effective method of treating potency dysfunctions – in as many as 90% cases they allow to perform an intercourse that is satisfying to both parties.
Among side effects of frequent use of vacuum devices are bruises, sensory disturbances and pain. Such inconveniences cause as many as 30% of patients to quit using vacuum devices by the two year mark.

Hydraulic penile prostheses

Hydraulic penile prostheses are the last resort in treating erectile dysfunctions. They can be used only in extreme cases, when no other measures can help.

A hydraulic penile prosthesis is a closed system filled with liquid and consisting of three elements:

  • a pair of cylinders,
  • a reservoir,
  • a pump that allows to control the prosthesis.

The implant is not visible, so one shouldn’t worry about aesthetic defects. Modern prostheses are completely safe, they restore the ability to be sexually active and contribute to improved quality of the patient’s life.
They can be controlled freely, expanding to a full erection or shrinking in order to give a natural look of a limp penis. Hydraulic implants have been used to treat erectile dysfunctions for over four decades now – they have become a proven and incredibly effective way to restore sexual prowess.

Erectile dysfunctions, due to multitude of possible causes, require different forms of treatment.
Above we have characterized all of the currently available treatment methods, even including the most extreme ones (hydraulic penile prostheses).
Which shows that the selection of measures for battling impotence that modern medicine has to offer is, as we can see, pretty broad.

Men struggling with erectile dysfunctions are not left on their own, and the ailment doesn’t affect the quality of their sex life. It’s a good idea to try the available solutions and visit a specialist in case of observing the problems discussed in this article.