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Erectile Dysfunction (ED): Symptoms, Causes & Treatment

Erectile Dysfunction (ED): Symptoms, Causes & Treatment

Erectile Dysfunction

What is Erectile Dysfunction?

Erectile dysfunction (ED), also known as impotence, is a type of sexual problem that can affect males. Those Googling “erectile dysfunction” probably don’t need a description, but it simply refers to the inability to get or maintain an erection long enough to complete a satisfactory sex act (x).

What else is ED? Very common! Around 30 million men deal with it either temporarily or long term (x). It might have serious underlying physical causes or result from something as benign as a little performance anxiety.

Uncovering the cause of ED can help determine what steps to take to remedy it. And as awkward as it may be to discuss this issue with a healthcare professional, it may be well worth it for the sake of your health, relationships and well-being.

Erectile Dysfunction Symptoms

What causes an erection in the first place? A combination of mental and sensory stimuli cause the muscles of the penis to relax. The brain then sends signals to increase blood flow to the muscles of the penis, which makes it enlarge and stiffen. From there, a membrane helps keep the increased blood inside, sustaining the erection (x).

Ideally, one would like to get an erection on demand and have it last as long as necessary for successful completion of the sexual experience, whatever that may be. Most commonly, this just means sustaining it long enough to have sex (x). With impotence, a person may not be able to have an erection at all, as often as he’d like, or maintain it long enough. While advancing age isn’t a cause of impotence, it does happen to affect men more often as they get older (x).

Just a quick word on nocturnal penile tumescence, or “morning erection” — this occurs as a result of activity of the parasympathetic nervous system during sleep. A full bladder and dreams can also contribute to what is usually a sexually-neutral phenomenon. That said, morning erections offer clues as to underlying causes of impotence. If someone finds himself impotent in intimate situations but still gets morning erections, the issue is probably not due to problems within the vascular system (x).

Erectile Dysfunction Symptoms

Erectile Dysfunction Causes

While the symptoms of ED are pretty straight forward, the causes may not be. Several physiological and/or psychological factors can contribute to the condition. Some are easily fixed while others may take medical intervention or counseling.

Cardiovascular Issues

One of the major concerns about ED is that it may be caused by an underlying problem with the cardiovascular system such as atherosclerosis (plaque deposits on arteries). Not only can it be caused by impaired venous function, it can also be a predictor of whether or not someone will develop cardiovascular disease in the future (x).


Erectile dysfunction affects many men with type 1 and type 2 diabetes, possibly over 50 percent (x). This is due to complications of diabetes including nerve damage, vascular issues, oxidative stress and hormone disturbances (x).

Psychological Factors, Stress and Anxiety

ED is most often a function of some initial physiological factor. However, “accidental sexual failures” can often lead to anxiety about engaging future sexual activity (x).

In addition, general anxiety, depression, stressful life circumstances, poor self-esteem and feelings of guilt can contribute to ED (x).

Sleep Apnea

Men with sleep apnea are more likely to experience ED. Researchers believe this may be due to poor sleep quality and decreased intake of oxygen (important for erections) (x).


Several medications, some that are even used to address the above-mentioned medical conditions, can cause erectile dysfunction. They include (x):

  • Blood pressure medications
  • Antidepressants
  • Muscle relaxants
  • Cancer treatments
  • Hormone-altering drugs

General Health

Lifestyle factors like smoking, drinking alcohol in excess and taking recreational drugs can impact quality of erections. In addition, being overweight and sedentary also contributes to ED (x).

Erectile Dysfunction Remedies

Lifestyle Adjustments

The healthier you are, the healthier your sex life will likely be as well. While some things are out of our control, refraining from activities like smoking and alcohol abuse can go a long way. And not only does maintaining a healthy weight and engaging in exercise help prevent chronic conditions like heart disease and diabetes, these habits can also reduce sexual dysfunction.


Choosing foods that are rich in certain nutrients can help. For example, research found that men with ED were more likely to have low levels of the B vitamin folic acid (x). Foods highest in folate (the form of folic acid found in food) include beef liver, spinach, asparagus and black-eyed peas (x).

Zinc, a trace mineral found in food and water, also contributes to men’s sexual health by promoting adequate testosterone levels (x). This is one reason why oysters, a food very high in zinc, are considered aphrodisiacs! Some small studies suggest that an increase in zinc intake can improve erectile dysfunction in certain situations (x, x). Foods high in zinc include oysters, beef, fortified cereals, crab and lobster (x).

See Also
Night Terrors

What may be good news to some, a large population study uncovered a trend. Men with higher daily intakes of caffeine (85-303 mg/day) were less likely to experience erectile dysfunction. In other words, a cup of coffee or two per day can help prevent impotence (x).

Finally, the Mediterranean diet — a diet high in vegetables, fruit, olive oil and other healthy fats and moderate amounts of high-quality meat and dairy products — can reduce the risk of sexual dysfunction including ED. Researchers believe the antioxidants supplied through the diet help protect against cardiovascular disease and diabetes (x).

Supplements for Erectile Dysfunction

In addition to a well-rounded diet, certain dietary supplements can also help with ED.


L-arginine is an amino acid that produces nitric oxide (NO) in the body. NO is a vasodilator, meaning it relaxes blood vessels and allows blood to flow more efficiently to muscles and organs, including the penis (x). Studies show that low levels of this amino acid can contribute to ED and that supplementation can help (x, x).

Panax Ginseng Root Extract

Panax ginseng, also called Korean ginseng, has been a classic go-to for sexual health dating back thousands of years. Why? First, it increases nitric oxide in the body (like L-arginine). In addition, it can improve cardiovascular risk factors as well as exert an effect on the brain that increases sexual arousal (x, x).

Horny Goat Weed

As the name suggests, this botanical exerts a certain effect not just on goats, also humans. Horny goat weed helps with NO production and promotes healthy testosterone levels. Studies show it can help alleviate problems with erections (x).

Other Remedies

When diet, lifestyle, medical intervention, counseling and supplements don’t work, other solutions for ED exist. These include oral medications like Viagra and Cialis, and even ones that can be injected directly into the penis. Manual erection enhancers like vacuum pumps and penile implants can also help (x).

The Bottom Line

When things don’t work the way you need them to, it can be frustrating. For some, it’s devastating to their self-esteem, relationships and overall well-being. Impotence is not uncommon. Sometimes it has a temporary and transient nature while other times it persists. While its causes can be complicated and related to more serious health conditions, there are lots of remedies out there. Addressing any underlying medical problems, seeking psychological help if necessary and living the healthiest lifestyle possible are great first steps. Medications and dietary supplements can also help.

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