Erectile Dysfunction – ed (Impotence)

Kemboi Kibet

Erectile dysfunction is when a man cannot get an erection firm enough for satisfactory sexual intercourse. He may not have an erection at all or may lose erection during intercourse. Inability to get an erection may happen once in a while but if it happens all the time, then it is erectile dysfunction. Erectile dysfunction can occur at any age but it’s more common in men age 45 and above. An erection problem can damage a man’s self-esteem and destroy a relationship.

You should note that male infertility is different from erectile dysfunction. Male infertility is when you are unable to produce sperms that can fertilise an egg. You can however get an erection. People with erectile dysfunction however may be able to produce sperm that can fertilise an egg. Premature ejaculation which is reaching orgasm too quickly is also not the same as impotence.

If impotence is caused by underlying disease such as diabetes, treating the disease may reverse the condition. There are also other treatment methods available if your impotence is not caused by underlying disease.


Sexual arousal in men is a complex situation that involves the brain, nerves, hormones and blood vessels. Anything that interferes with their normal function can lead to erectile problems. Psychological issues like stress and depression can also cause impotence.

Physical Causes of Erection Problems

diseases such as diabetes, heart disease, multiple sclerosis, high blood pressure, thyroid problems, Parkinson’s disease, atherosclerosis etc.
high cholesterol
alcohol, tobacco or cocaine use
spinal cord injury
low testosterone
treatment for prostate cancer and enlarged prostate
surgery or injury to the pelvic area
medications such as blood pressure medications especially beta blocker, heart medication especially digoxin, antidepressants, sleeping pills etc

Psychological Causes of Erection Problems

anxiety, depression and other mental heath problems
low self-esteem
fear of sexual failure

Physical causes of impotence is more common in older men. Younger men usually experience impotence associated with psychological problems.


Erectile dysfunction may present symptoms like the following :

trouble having an erection

trouble keeping an erection

reduced sexual desire


A physical exam and medical history may be enough to diagnose impotence. However, in some cases where an underlying problem or condition is the cause of the erectile dysfunction, further testing may be needed.

Blood test : Blood sample is sent to the lab to check for diseases like diabetes, cardiovascular problems, low testosterone and so on. It also checks for the levels of various hormones in your body (hormone profiling).

Physical Exam. This is done to check the penis and testicles for any abnormalities. Your nerves for feeling may also be checked.

Urine test : This is done to check for diabetes and other health problems.

Penile ultrasound : It creates a video image that helps your doctor check for blood flow to your penis.

Nocturnal penile tumescence (NPT) : It checks for night-time erection. If it is found out that you do have night-time erection, then your impotence may be psychological and not physical.

Psychological exam : Your doctor will screen you for depression, anxiety and other psychological problems.


First treatment for erectile dysfunction is to treat the underlying medical condition.

Other treatment options for impotence depends on the severity and type of underlying condition causing the erectile problem. They include the following :

Oral Medications : This includes Sildenafil (Viagra),Tadalafil (Cialis) and Vardenafil (Levitra, Staxyn). They are called phosphodiesterase-5 (PDE5). They increase blood flow to the penis and only work when you are sexually aroused. Do not use these drugs with medications such as nitroglycerin as they can cause a drop in blood pressure. Ask your doctor before using these medications because they can cause problems if you have heart disease, uncontrolled diabetes, very low blood pressure and other health problems.

Testosterone replacement uses skin patches, gel or injections into the muscle . This option is for people with low testesterone levels.

Alprostadil self-injection – Medication is injected into the penis to improve blood flow to the penis. It works better than oral medication. The medication can also be inserted into the urethra, in which case it is called Alprostadil penis suppository.

Penile implants: It involves surgically placing devices into the two sides of the penis. It is usually the last resort if other treatment options do not work.

Penis pumps : A penis pump is placed over your penis. This creates a vacuum that pulls blood into your penis.

Psychotherapy : This is done if stress, anxiety, depression and other psychological issues are the cause of your erectile problems.


Alternative treatment for erectile dysfunction include :

Korean red ginseng (Panax ginseng) is known to increase energy, stamina, and sexual function.
L-arginine signals smooth muscle surrounding blood vessels to relax and dilate increasing blood flow.
Ginkgo is used especially in people who experience sexual dysfunction as a side effect of antidepressant drugs. It relaxes smooth muscle and enhance blood flow to the penis.


Erectile dysfunction can lead to :

low self-esteem
marital or relationship problems
poor sex life


The following steps can help prevent impotence.

Maintain a healthy weight.
Do not smoke, drink alcohol in excess or abuse street drugs.
Manage your health conditions like diabetes, heart diseases and so on.
Exercise regularly
Minimize your stress level and get help for depression and anxiety.


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