Erectile Dysfunction Condition Summarized By Smart Canadian Pharmacy Professionals: Background, Causes, Symptoms And Care

With our ultimate guide to ED and premature ejaculation, we aim to help you combat these problems fully armed with knowledge. From lifestyle choices to treatments, our Guide has everything you need to know to beat those problems once and for all.

Why you shouldn’t be embarrassed by Erectile Dysfunction

The difficulty in achieving and maintaining an erection during sexual intercourse, erectile dysfunction is seen as humiliating or a lessening of their status by some men (and 90% of men chose not to seek treatment), but ED is not something to be embarrassed about.  It is a much more common problem than you think. ED is particularly prevalent in mature men. According to recent estimates, some 50% of men aged between 40 and 70 experience ED to a lesser or greater extent. Younger males are also increasingly affected by ED, and it’s assumed that 75% of men will face with ED at a certain point in their lives.

What are the causes of Erectile Dysfunction?

ED can be caused by a variety of factors. Whether they are psychological or physical, the important thing is to locate the causes so you can confront ED as efficiently as possible.

For an erection to work, you need:

      • The adequate stimulation
      • Sufficient blood supply
      • Working nervous system

Lifestyle choices that can lead to Erectile Dysfunction

Alcohol. By keeping the blood vessels wide, alcohol can make it easier for the blood to drain out from your penis. The smaller amounts of alcohol can depress the body’s nervous system and thus inhibit the signals from the brain to the blood vessels in your penis. Heavier drinking can damage the nerves in your penis, potentially leading to permanent impotence.

Smoking. A link between smoking and ED is atherosclerosis, a buildup of fatty materials and plaque on the walls of blood arteries. The longer you smoke, the more clogged your arteries become, so that the blood flow is inhibited to areas that you want the blood to flow into.

Drugs. Prolonged use of drugs can lead to a variety of long-term ED-related health problems. For example, amphetamines restrict blood vessels and direct blood flow away from the pelvic area, and into the muscles instead. Some prescription drugs can impact your blood pressure and trigger a loss of libido.

Stress. Stress can restrict the blood flow to the penis by affecting the circulatory system. This is because of the release of the hormones cortisol and adrenaline into the bloodstream, which cause blood vessels to contract. High blood pressure triggered by stress can restrict blood flow and cause damage to the lining of the arteries. Stress can also cause depression, which may reduce the ability to achieve and maintain an erection by altering the biochemistry of the body.

Obesity. Obesity is directly linked to the formation of fatty deposits in the arteries (atherosclerosis). One of the smallest arteries in the body, the cavernous artery supplying the penis with blood, is one of the first to suffer from a reduced blood flow.

Fatty tissue produces aromatase which converts testosterone into estrogen, decreasing testosterone levels in the process. Lowered production of testosterone has direct negative consequences for men’s sex life.

Underlying Health Conditions. ED can be triggered by numerous underlying illnesses, such as heart disease and diabetes  – speak to your GP to develop the ED treatment plan taking into account your existing diagnosis.

Erectile Dysfunction in younger men

Family problems

A survey of 234 male students at three Chicago universities, conducted by the Chicago Children’s Memorial Hospital in 2006, revealed that while 13% admitted “difficulty achieving or keeping an erection,” only 1 of those 29 young men had talked about the problem with a physician. The rest 28 were self-medicating by taking ED drugs without a prescription.

It is true that ED is usually associated with older men, but in recent years an increasing proportion of young men suffer from ED, too. In fact, 25% of men seeking ED treatment were younger than 40, a study by Capogrosso revealed, which indicates that factors other than age can trigger the condition.

There are two main groups of reasons why young men develop the ED condition – problems of the body and problems of the mind.

Psychological causes:

  • Relationship problems
  • Guilty feelings
  • Nerves
  • Depressive conditions
  • Mental exhaustion

ED is likely to be of psychological nature if a man can get an erection from self-stimulation or can wake up with morning erections, as this proves that the physiological functions are in working condition. Psychological causes usually suggest a more tailored, customized approach.

Physiological causes:

  • Obesity
  • Smoking
  • Heavy alcohol consumption
  • Diabetes
  • Drug abuse
  • A history of injuries or surgeries

While drugs and alcohol can have a provisional impact, smoking and obesity can trigger a steady hardening of the blood arteries. A change in lifestyle and diet is required in order to reverse or mitigate the effects.

The problem of porn

A study called ‘Porn-Induced Sexual Dysfunction is a Growing Problem’ published in 2011 Psychology Today, argued that watching porn can turn you addictive and inhibit your brain’s response to a real-life sexual stimulation. While erotica has been available, in some forms,  for centuries, it’s the penetration of the internet that has enabled for users to achieve the constant flow of dopamine needed for an addiction to form.

Essentially, porn desensitizes the user’s response to the neurochemical dopamine, a  chemical creating our sense of motivation – it is what drives our search for rewards. The more dopamine portions a brain gets, the weaker its ability to respond to the next signals becomes. As with most addictions, a more intense experience is needed to achieve the same hit. The problem comes to light when men try to have real life sex and find erections unachievable.

Myths and Facts about Erectile Dysfunction

No matter if you are 18 or 68, experiencing erectile dysfunction can drop a bombshell and make you assume that your sex life is doomed for the rest of your life. This is only one myth, among many others that surround this delicate topic. Let`s explore the main myths and try to debunk them.

ED Is an Old Man's Problem

As mentioned earlier in the Guide, erectile dysfunction may be more common in older men, it increasingly affects the young ones, which doesn’t mean that you are prematurely ageing, in fact, ED occurs can frequently be triggered by lifestyle choices, such as drug and alcohol consumption, unhealthy diet, smoking, etc. The good news is that with a few basic behavior corrections, ED is often reversible.

It’s 100% in the Mind

Just 30-40 years ago the majority of ED cases were assumed to have a psychological root, but this point of view has turned 180° in recent years, and most cases have now been proved to have a physical origin. Often, ED begins with a physical problem, with several failures to achieve an erection, and then converts into a psychological condition. Although it’s true that ED can be psychologically driven, it is definitely not always the case.

Failure to Start Means a Lack of Attraction

One of the major fallacies around ED is assuming that because the body parts aren’t functioning as expected, it means the feelings have gone. Many men can verify that they feel aroused, but, unfortunately, their lower areas decline to co-operate. Blood flow can be constrained, nerve signals can get hindered, and hormone levels can fall out of balance. It is, therefore, a good idea to reassure your partner that it’s not the lack of attraction that is to blame.

ED is New Normal for Older Men

Although ED is common in older men, it doesn’t mean that it’s their new normal. It can often be a manifestation of an underlying health problem, so it’s always smart to get a medical check-out.

Natural Remedies Are the Only Safe Treatment

The web is swarming with “miraculous” natural herbs for every malady, including ED. Keep in mind that no herb has been so far proved 100% successful at treating ED. Always discuss with your GP before purchasing natural food supplements to avoid potentially harmful choices.

It’s Just a Low Testosterone

A lack of testosterone can indeed be a factor, but it is definitely not the only reason ED occurs. An erection won’t happen if blood is constrained from flowing into the penis. Similarly,  a problem with your nervous system can prevent signals from the brain from reaching your pelvic area, so that erection does not occur.

Excessive Masturbation Can Cause ED

Excessive masturbation has not been scientifically linked to an increased risk of ED. But do not get too excited just yet; recent research has demonstrated that watching too much porn can grow into an addiction that numbs your body to real-life sensations. If you sense this may be your case, avoid watching porn and stop masturbating for a month or two. Your sex life must slowly get back to normal.

Viagra is the Only Salvation

A household name and the world`s #1 ED drug, Viagra is definitely not the only treatment. Should you try Viagra and find it unhelpful, there are several other drugs, of similar class (Levitra and Cialis) that can work for you. They last for longer periods of time and are more compatible with some pre-existing health conditions. If you don’t find pills effective, you can try alprostadil injections and vacuum pumps, as well as psychological methods. For more details, see the Treatment for Erectile Dysfunction section later in this Guide.

As you can see, ED isn’t that scary – it’s very treatable in most cases. On the other hand, because ED is a common condition it doesn’t mean that it can be self-diagnosed at home. Always discuss with a physician before ordering ED drugs to opt for the best possible treatment.

Treatment for Erectile Dysfunction

Since prehistoric times, there have been plenty of cures created to confront the male flaccidity. From pills to vacuum pumps, no stone has been unturned in ED treatment research. If you’re suffering erectile dysfunction and don’t know where to start looking for a solution, then help is within your grasp as we walk you through five of the most effective treatments.

Tackling Underlying Conditions

Many ED treatments will help you keep the problem under control, but they don’t combat the original problem. You can minimize the risk of developing ED by reducing your drug and alcohol intake, giving up smoking, getting in shape, and reducing your stress levels. Introducing healthy habits into your lifestyle is the best way to ensure that your ED evaporates completely.

Phosphodiesterase 5 Inhibitors (PDE5)

PDE5 inhibitors are one of the most common ways to treat erectile dysfunction, and they work by enhancing the body’s natural reaction to stimulation – increasing blood flow to the penis.

There are three types of PDE5 inhibitors widely used, and they each work for a different period of time. Sildenafil (generic Viagra) typically starts working within 40 minutes and lasts for up to 4 hours, Tadalafil (generic Cialis) has the onset of action within 30 minutes and duration effects of up to 36 hours (the “weekend pill”), and  Vardenafil (generic Levitra) begins working within 20 minutes and continues for up to 12 hours. All of the pills require stimulation before the erection will take place. All three PDE5 inhibitors have been proved effective in the general population of men with ED.

A series of studies were undertaken to measure the success rate of PDE5 ED drugs:

  • The efficacy of Sildenafil was measured in a flexible-dose study of 329 patients (mean age 59-60 years; mean ED duration: 4.7-5.0). 74% of the patients taking Sildenafil said their erection was improved, compared to 16% of patients taking a placebo.
  • A similar study of Vardenafil (mean age 57-58 years, ED duration of 5.1-6.6 years) showed that 81% of patients stated that Vardenafil had improved their erections, compared to 39% patients taking a placebo.
  • The efficacy of Tadalafil was provided by data from eleven studies with over 1600 participants (mean age 56-57 years, ED duration ≥12 months for 90% of patients). In total, 84% of the 1050 patients taking Tadalafil reported their erections was improved, compared to 33% of patients taking a placebo.

Studies also proved that the PDE5 inhibitors can be successfully applied for patients with ED and diabetes, stable cardiovascular disease, or clinical depression. All three PDE5 treatments can be used in men with the cardiovascular disease if they are not taking nitrates.

Food (fatty food, in particular) tends to delay the absorption of Sildenafil and Vardenafil, but it has no effect on the absorption of Tadalafil, so this drug can be taken without regard to food. The pharmacokinetics of all three PDE5 inhibitors are not influenced by alcohol, although men are advised to refrain from alcohol, as consumption of alcohol has been linked to increased risks of ED.

PDE5 inhibitors should be taken with caution by patients taking α-blockers, since simultaneous co-administration may cause hypotension. Sildenafil must not be taken within 4 hours of taking an α-blocker, Vardenafil must not be taken within 6 hours of an α-blocker. Tadalafil is not recommended in combination with α-blockers.

Since PDE5 inhibitors are mainly metabolized by hepatic enzymes via isoform 3A4 of cytochrome P450, inhibitors of this enzyme (e.g. erythromycin, cimetidine, indinavir, ritonavir, ketoconazole, etc.) may reduce clearance of the PDE5 inhibitors.

The side effects profiles of all PDE5 inhibitors are similar, with most common (>1%) side effects, ranged by occurrence, as follows:

  • For Sildenafil: headache, flushing, dizziness, dyspepsia, nasal congestion and altered vision
  • For Vardenafil: flushing, headache, dyspepsia, nausea, dizziness and rhinitis
  • For Tadalafil: headache, dyspepsia, dizziness, flushing, nasal congestion, back pains and myalgia

Alprostadil

If you don’t find PDE5 inhibitors helpful, there is an alternative in the form of a drug called alprostadil. This artificial hormone boosts blood flow to the pelvic area and can facilitate an erection as soon as within 5 minutes. Alprostadil injections have resulted in successful erection in 85% of men who did not find PDE5 drugs effective.  Also available as a small pellet placed directly inside the urethra, alprostadil have been successful in 67% of patients unhappy with PDE5 drugs.

Vacuum Pumps

Vacuum pumps are another alternative if PDE5 inhibitors do not work for you or if you are worried about the side effects. Used correctly, pumps enable 9 out of 10 men to achieve an erection by creating a vacuum around a penis that makes the blood to rush in. The erection can be in place for about 30 minutes thanks to placing a band around the penile base. Potential side effects in the form of bruising are possible, but they occur in less than 33% of men. Unfortunately, this method is inappropriate for anyone with a bleeding disorder or for anyone taking anticoagulants.

Psychological Methods

It is true that lifestyle correction can go a long way in improving ED, there can be a psychological cause to ED. Counseling, sensate focus, and cognitive behavior therapy are the most effective psychological methods.

Counseling is a treatment that may prove effective if you have complicated unresolved sexual issues. Centered around your partner or something in your past, these problems must be properly addressed so that you are more likely to move on.

Sensate focus suggests a step-by-step intimacy buildup with a partner, from initially just exploring and touching, with no intercourse, to concluding with a regular penetrative sex. Since you know that sex is off the table, you can get rid of performance pressure and anxiety.

Cognitive behavioral therapy (CBT) is a treatment that is based around the concept that your thinking determines your feeling. If your ED is triggered by the negative thoughts, then CBT can help you look at things in a different light.