If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is erectile dysfunction?

Erectile dysfunction (ED) is when a man cannot get or keep an erection. The condition prevents the man from having sex or finishing sex. This condition used to be called impotence. ED can occur at any age, but it is more common in men older than 75 years of age.

Erectile dysfunction doesn’t have to be a part of getting older. It’s true that as you get older, you may need more stimulation (such as stroking and touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.

SYMPTOMS

The primary symptom of ED is not being able to get or keep an erection for sex.

CAUSES & RISK FACTORS

What causes erectile dysfunction?

Erectile dysfunction can be caused by:

• Diabetes (high blood sugar)
• Hypertension (high blood pressure)
• Atherosclerosis (hardening of the arteries)
• Stress, anxiety or depression
• Alcohol and tobacco use
• Some prescription medications, such as antidepressants, pain medicine and medicine for high blood pressure
• Fatigue
• Brain or spinal-cord injuries
• Hypogonadism (a condition that leads to low levels of the male hormone, testosterone)
• Multiple sclerosis
• Parkinson’s disease
• Radiation therapy to the testicles
• Stroke
• Some types of prostate or bladder surgery

Problems in your relationship with your sexual partner can also cause erectile dysfunction. Improving your relationship may help your sex life. If you decide to seek therapy, it will probably be most effective if your sex partner is included.

Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections.

Feelings that can lead to erectile dysfunction

• Feeling nervous about sex. This could be because of a bad experience or because of a previous episode of ED
• Feeling stressed, including stress from work or family situations
• Feeling depressed
• Feeling self-conscious about your body or performance.
• Thinking that your partner is reacting negatively to you

DIAGNOSIS & TESTS

How is erectile dysfunction diagnosed?

ED is usually easy to diagnose. If you are tempted to self-diagnose, talk to your healthcare provider. They may want to make sure it isn’t related to another health condition.

Your healthcare provider may do a physical exam and ask you questions about your symptoms. They may do a blood or urine test. Your healthcare provider may consider other tests to rule out other conditions.

PREVENTION

Can erectile dysfunction be prevented or avoided?

This depends on whether you know what it is causing your ED. There are some things you can do that may help prevent ED, including:

• Avoid drinking too much alcohol, smoking, or abusing drugs.
• Ask your healthcare provider if ED is a side effect of a new or current medicine you are taking. They may have an alternative medicine.
• Control your blood sugar and blood pressure.
• Try to relax and avoid stress.

TREATMENT

Treatment depends on what is causing it. If it is caused by uncontrolled blood sugar and high blood pressure, take your medicine and follow your healthcare provider’s instructions.

If your healthcare provider rules out other causes, they may prescribe Sildenafil (brand name: Viagra), tadalfil (brand name Cialis), and vardenafil. These medicines are taken by mouth to help you maintain an erection.

Not everyone can use these medicines. Your healthcare provider may talk to you about alprostadil if oral medicines aren’t an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra (the hole at the end of the penis). Your healthcare provider can help you decide which treatment is best for you.

Follow your healthcare provider’s instructions when taking ED medication. Usually, a man takes 1 tablet 30 minutes to 1 hour before he plans to have sex. You should not take more than 1 tablet in 24 hours.

Even if you take the medicine, you still need physical and mental stimulation and desire to have an erection. If your first dose doesn’t help, contact your healthcare provider. Your healthcare provider may want to change your tablet strength.

The side effects of ED medicine are mostly the same. Sildenafil and vardenafil can cause:

• Headache
• Flushing (face and upper body turning red and warm)
• Stomach upset
• Runny nose (sniffles)
• Vision changes (things look blue)

Tadalfil has the same side effects, except for the flushing and possible changes in vision. It can also cause back pain and muscle aches. For each of the medicines, headache is the most common side effect. Vision changes are the least common. Contact your healthcare provider if you have any side effect that bothers you.

Contact your healthcare provider right away if you take sildenafil and have a prolonged erection that lasts 4 hours or longer. This condition may cause permanent impotence if not treated.

Can everyone use ED medications?

 You shouldn’t use this medicine if you take nitroglycerin or any other nitrates for chest pain. If you have heart problems, tell your healthcare provider before taking and ED medicines. These medicines can have serious side effects in people who have heart problems.

If you use sildenafil, tadalfil, or vardenafil and get chest pains, be sure to tell the paramedics, nurses, or healthcare providers at the hospital that you use it and when you used it last.

Living with erectile dysfunction

If the medicines aren’t right for you, you could also try using a penile implant, vacuum pump devices, or you could have surgery. Your healthcare provider may send you to an urologist to talk about these options.

FOR MORE INFORMATION

Canadian Men’s Health Foundation
https://menshealthfoundation.ca/