Common erection problems

What are the different types of erectile dysfunction?


For men, having a problem with their erection, whatever it may be, is seen as a sign of being less of a man.

A man who is experiencing erection problems may feel embarrassed and guilty, so much so that he finds it difficult to talk about the situation, even with his partner. He may even find himself manipulating events so that he avoids situations in which sexual intercourse may arise as being a possibility.

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What causes a man to have an erection?

During sexual arousal in a man, a number of systems of the body all come into play at the same time; hormones, muscles, nerves and blood vessels all work together in order to facilitate an erection.

Firstly, nerve signals are sent from the brain to the penis stimulating muscles to relax. Blood can then flow freely into the tissues of the penis allowing them to become engorged and so become erect, whilst at the same time, closing off the blood vessels which will allow the blood to flow out from the penis so that the erection can be maintained. When a sexual climax has been reached, these blood vessels will be allowed to open up again allowing the blood to flow out and the erection to subside.

If there is a malfunction in any of these systems, then problems may arise with the erection and for most men, this will happen at some time in their lives and provided these issues are no more than 20% of the time then it is unlikely to be an issue. If a problem starts occurring more than 50% of the time, then there may be a health problem that needs to be addressed.

When a man is unable to achieve or maintain an erection long enough to have satisfactory sexual intercourse then it is known as:

Causes of erection problems

There are a wide variety of issues that can be responsible for causing erection problems. Some are physical but there are also emotional issues that may be responsible.

Physical causes

Physical causes of erection problems include the following:

  • Diabetes
  • Heart disease
  • Atherosclerosis, also known as hardening of the arteries
  • Hypertension of high blood pressure
  • High levels of cholesterol
  • Obesity
  • Liver disease
  • Kidney disease
  • Parkinson’s disease
  • Multiple sclerosis
  • Peyronie's disease can cause scarring and can result in the penis becoming curved
  • Prostate problems and their treatment
  • Abuse of recreational drugs
  • Long term smoking
  • Trauma or injury to the genital area
  • Trauma or injury to the spinal cord
  • Congenital problems if the genital organs
  • Some medications prescribed for other conditions such as antidepressants, beta-blockers, diuretics and muscle relaxers
  • Alcoholism

Psychological causes

Emotional issues can affect men of any age and their ability to have a healthy erection. Issues that may prevent a man from becoming aroused include:

  • Anxiety around the issue of being unable to achieve or maintain an erection
  • Long term stress may be caused by financial issues, family problems and work stress
  • Depression
  • Relationship problems

Are erection problems age related?

It may be worth noting at this stage that erection problems are not solely suffered by older men as may be the widely held belief. The problem may be far more common in young men than was previously realised and is thought to be seen by doctors less often as younger men are embarrassed by the issue, seeing it as an affront to their masculinity.

However, it is believed that physical problems are less likely to cause erection problems in younger men and it may have more to do with lifestyle and mental health. It has been noted that younger men are more likely to abuse tobacco, alcohol and recreational drugs than their older counterparts.

When to consult your GP?

If you are suffering from erection problems and it is beginning to have a significant impact on your life it is worth visiting the doctor because much can be done.

The doctor will need to carry out tests in order to diagnose if you have a problem and what is the likely cause. Investigations that they may want to carry out initially will include a physical examination, blood tests and taking a full medical history from you including your sexual history.

When a doctor has determined that you are suffering from erectile dysfunction they will be able to diagnose the treatment which is most appropriate in your particular case.

It is worth mentioning at this point that erection problems can be caused by underlying conditions that can be serious such as diabetes and heart disease. Erectile problems can be seen as an early warning system for more serious issues and so it is important that you do not ignore the problem, thinking it will go away.

Treatment for erection problems

There are a number of different treatment options now available in respect of treating erection problems.

Oral medication

Phosphodiesterase 5 inhibitors are the first-line therapy for erectile dysfunction. They include sildenafil (Viagra, Revatio), Tadalafil (Cialis, Adcirca), Vardenafil (Levitra, Staxyn) and Avanafil (Stendra). These drugs work by facilitating an erection by allowing blood to flow into the penis in order to achieve an erection. However, if a man is not sexually aroused they do not work which is contrary to popular belief!

There are a number of side effects which are associated with this class of drugs and they include:

  • Headaches
  • Flushing
  • Backache
  • Lightheadedness
  • Nasal congestion
  • Visual changes
  • Upset stomach

Penile injections may sound a little barbaric but they can have fewer side effects and are as effective as oral therapy. The side effects which may occur include:

  • Discomfort around the injection site
  • Prolonged erection

Alprostadil suppositories or cream may be an option. The suppository is placed in the tip of the penis and the cream is applied to the same area. The benefit of alprostadil as a treatment is that unless it is given via injection, it is non-invasive.

Testosterone replacement therapy

If you have low levels of testosterone and this is the cause of your erectile dysfunction, testosterone replacement therapy can be very effective in treating the problem.

Penis pump

A penis pump is a tube that is placed over the penis; the air is then pumped out of the tube which creates a vacuum which in turn encourages blood to flow around the penis. A ring is placed around the base of the penis to stop the blood from draining away and so the erection can be maintained.

The disadvantage of this is that spontaneous sexual intercourse is not going to be very spontaneous!


There are few surgical procedures which may be options to consider if all else fails:

  • If there has been damage to the blood vessels which supply the penis, maybe as a result of previous surgery or physical trauma, a surgeon may be able to repair the vessels and so a better blood supply could be established
  • An inflatable implant may be implanted in the penis. When an erection is required, the implant can be inflated.
  • Malleable implants can also be inserted. These can be adjusted manually to give the desired shape and effect.

Psychological treatment

If your erection problems stem from an emotional or psychological cause, sexual counselling, relationships counselling or other specific types of counselling such as cognitive behaviour counselling may be considered. They can be useful in treating issues such as:

  • Depression
  • Anxiety
  • Stress
  • Relationship problems

Complications of erection problems

Problems with getting or achieving an erection can have a profound effect on your life and relationship and can lead to:

  • An unsatisfactory sex life
  • Embarrassment and low self-esteem
  • Relationship problems
  • Stress and anxiety
  • The inability to impregnate your partner

Preventing erection problems

Lifestyle can play a major part when it comes to erection problems and there are things you can change which will help alleviate matters. They include:

  • Managing your weight. Obesity can be a major factor when it comes to erectile dysfunction
  • Take regular exercise and improve your overall fitness levels. This will help improve your vascular health which is directly involved in achieving healthy erections
  • Eating a healthy diet
  • Limiting the amount of alcohol you consume
  • Give up smoking. This is important as it is a major factor when it comes to erectile dysfunction as it has such a detrimental effect on a person's vascular system


Erectile dysfunction was a problem that was never spoken about and suffered by many men. In the last couple of decades, treatment for the problem has come a very long way and research continues so that better and safer treatments can be found.

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