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Written by

Dr. Saif Chatoo

May 10, 2023

What Causes Erectile Dysfunction & What Options are Available for Treatment?

Erectile dysfunction (ED) is a medical condition in which a man has difficulty achieving or maintaining an erection sufficient for satisfactory sexual intercourse. ED can be caused by many factors, including physical problems such as blood circulation problems, neurological or hormonal problems, side effects of medications, or psychological problems such as stress, anxiety or depression.

ED can be a temporary or persistent problem, and can have a significant impact on a man's quality of life and sexual relationship. There are several treatment options for ED, among which we find shock waves, which have a copious scientific literature to support them.

Erectile dysfunction affects about 40% of over 50s and half of over 70s, but it also affects younger men quite frequently, especially if exposed to cardiovascular risk factors.

A pathology, still often considered a taboo which in 75% of cases leads to the impossibility of having an erection and which is often the alarm bell also for atherosclerotic diseases.

Erectile dysfunction: not a disease but a symptom 

Erectile dysfunction is not a disease but it can be considered a symptom that the body is not well. It's not just about psychological problems - such as stress, couple tensions or work problems - but it's also due to numerous very common vascular risk factors, such as cardiovascular diseases such as heart attack and ischemic heart disease. High blood pressure problems, cholesterol problems, sedentary lifestyle, smoking, alcohol abuse, diabetes, expose you to a greater risk of developing atherosclerosis. Blood vessels tend to close and as less blood reaches the heart and brain, less blood flows for an erection and as a result, erectile dysfunction develops.

The drugs taken to facilitate an erection are not curative, but act on the symptom. Only by solving the problem upstream can the drug be discontinued.

In patients who have a sexual disorder, testosterone must be checked: it is a very simple test, a simple blood sample that is performed early in the morning on an empty stomach, together with blood sugar and cholesterol.

Who is most at risk of erectile dysfunction?

Erectile dysfunction affects about 13% of the population, but age is an independent risk factor: the more age increases, the greater the risk of having this problem. Almost 40% of patients around 50-55 years old and 50% of over 70s have erectile dysfunction problems. The reason is linked to the fact that starting from that age there is an increase in all cardiovascular risk factors and also in the use of drugs. For this reason, a healthy lifestyle is recommended, which also includes physical activity, mainly aerobic activity, which helps the metabolism, but which is regular and constant over time.

What treatments are available for erectile dysfunction?

Phosphodiesterase 5 (PDE5) inhibitors
(Sildenafil, Tadalafil, Vardenafil & Avanafil)

The administration of these drugs for the treatment of erectile dysfunction is indicated to enhance the effects of nitric oxide, a natural chemical substance produced by the body to relax the muscles of the penis. These drugs increase blood flow, facilitating the immediacy of response (erection) to sexual stimulus. The 5-phosphodiesterase inhibitors are the drugs most used in therapy for the treatment of erectile dysfunction: these active ingredients, by inhibiting the 5-phosphodiesterase enzyme, help obtain and maintain an erection.

Shockwave Therapy

Shock waves are the treatment that is currently the most popular even if it is effective only in cases of medium-light vascular disease. It is an absolutely painless methodology, without contraindications or side effects. It has a mechanism of action that tends to improve vascular activity, i.e. the circulation of blood in the penis, and therefore promotes an erection.

Smooth Muscle Relaxants

Papaverine (e.g. Antispasmin Colica): it is a vasodilatory substance capable of relaxing smooth muscles, useful for significantly increasing the vascular flow in the penile area: for this reason it is sometimes used for the treatment of erectile dysfunction.
Phentolamine (eg Regitine): is an alpha-adrenergic antagonist administered intramuscularly. However, the action of this drug is indicated when the patient suffering from erectile dysfunction does not benefit from the administration of papaverine.
Alprostadil or Prostaglandin PGE1 (eg Caverject): the drug (vasodilator) is administered intracavernous or intraurethral for the treatment of erectile dysfunction.

In any case, it is always better to be safe than sorry…

In addition to helping improve erectile dysfunction, the following tips may also improve overall health and help reduce the risk of cardiovascular disease (conditions that affect your heart and blood vessels).

Lose weight if you are overweight
Stop smoking
Reduce alcohol consumption
Do not take drugs of abuse
Engage in regular exercise
Reduce stress.


I. Introduction
A. Definition of erectile dysfunction (ED)
B. Importance of addressing ED
C. Brief overview of the blog post structure

II. Understanding Erectile Dysfunction
A. Definition and prevalence of ED
B. Common symptoms of ED
C. Psychological and physical causes of ED
1. Psychological causes
2. Physical causes

III. Psychological Causes of Erectile Dysfunction
A. Stress and anxiety
B. Depression
C. Relationship issues
D. Performance anxiety
E. Other psychological factors

IV. Physical Causes of Erectile Dysfunction
A. Cardiovascular diseases
B. Diabetes
C. Hormonal imbalances
D. Neurological disorders
E. Pelvic injuries or surgeries
F. Substance abuse
G. Other physical factors

V. Diagnosis of Erectile Dysfunction
A. Medical history and physical examination
B. Laboratory tests and diagnostic procedures
C. Psychological evaluation
D. Specialized testing (e.g., ultrasound, nocturnal penile tumescence test)

VI. Current Treatment Options for Erectile Dysfunction
A. Lifestyle modifications
1. Healthy diet and exercise
2. Stress reduction techniques
3. Smoking cessation and alcohol moderation
B. Oral medications
1. Phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis)
C. Other medication options
1. Alprostadil (injection, suppository, or cream)
2. Testosterone replacement therapy (for hormonal imbalances)
D. Vacuum erection devices
E. Penile implants
F. Psychotherapy and counseling
G. Alternative and complementary therapies

VII. Prevention of Erectile Dysfunction
A. Maintaining a healthy lifestyle
B. Regular medical check-ups
C. Open communication with your partner
D. Managing chronic health conditions

VIII. Conclusion
A. Recap of key points discussed in the blog post
B. Encouragement to seek professional help for ED
C. Message of hope and support for individuals with ED

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