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Erectile dysfunction

The symptoms of erectile dysfunction are characterised by the difficulty of getting an erection or maintaining it long enough to have sex. As this illness can strongly influence the self-confidence and well-being of affected people the topic is seldom discussed openly. Many men keep their sense of shame and related problems to themselves.

We offer treatments for Erectile dysfunсtion:


ED - Erectile Dysfunction

The inability to get or keep an erection is called Erectile Dysfunction (ED), we know this condition usually as impotence.ED is a common type of male sexual dysfunction, usually when the man gets older. According to some estimates, 50% of all men, ages from 40 to 70, will have it in some level.           

Erection: How it happens?

The penis starts to become larger and harder when the nerves increase the blood flow to the penis. This is a consequence of the brain sending signals to the nerves in his penis, after the man starts to feel aroused (sexually excited). ED can happen in any situation which interferes in the blood circulation or in the nervous system. ED can also happen when something affects the libido (level of sexual appetite). When the libido is reduced, it is harder for the brain to send signals to get the erection. There are several reasons to explain the decreased of the libido, psychological conditions, for example depression, as well as changes in the hormone levels in the body.

Erectile dysfunction: Causes

ED can have several causes as psychological and physical disorders. If you can have erection, for example, during a masturbation or when you wake up, but you can´t get an erection with a sexual partner, probably the cause of the ED is psychological (stress, for example). However, if you never can get an erection, probably the cause is physical. There are also some medicines, which your side-effect can be an erectile dysfunction.

Psychological causes

As follow, there are two possible causes to lead an erectile dysfunction:

  1. Depression – mental illness of deep sadness that happens for a long time;

  2. Anxiety – a feeling characterized by an unpleasant state of inner turmoil, for example fear or worry;

There are more emotions that can affect your ability to have and keep an erection, for example:

  • starting a new relationship;
  • sexual problems in the past;
  • historical of sexual abuse;
  • no sexual experience;
  • relationship issues;

You can have an ED also with both disorders: psychological and physical.  The combination of diabetes (physical cause) and anxiety (psychological cause) can lead to an episode of erectile dysfunction – for example, a man has diabetes and can have difficult to get an erection, this situation can lead him to be anxious, causing erectile dysfunction.

Physical causes

The four main physical causes to lead an erectile dysfunction are mentioned below.

These health conditions affect:

  1. The blood flow to the penis (vasculogenic);
  2. The nervous system (made up of the nerves, brain and spinal cord) (neurogenic);
  3. The hormone levels (hormonal);
  4. The physical structure of the penis (anatomical);

Risks factors and other causes:

Various risk factors can contribute to ED, including:

  • Illegal drugs (cannabis, heroin and cocaine) and alcohol use;
  • being overweight, especially if you are obese;
  • lack of exercise or physical activity;
  • high cholesterol;

These risk factors are very similar to cardiovascular disease. If you have an erectile dysfunction, this can be also a sign of cardiovascular disease.

When to see a doctor and diagnosis:

If you have, erectile dysfunction for more than some weeks is good to see a doctor. This lake of erection can be the first sign of some serious health conditions, for example heart disease. It is important to get a diagnosis and identify the cause, even may be embarrassed. Your doctor will do some simple tests, and will ask you some questions about your symptoms, as well as a physical examination.


The treatment you need depends on what is causing it, if this is physical or psychological causes. One cause very  common  is Atherosclerosis (the narrowing of the arteries). The doctor, in this situation, to reduce the risk of cardiovascular disease, may suggest simple lifestyle changes like losing weight.  This suggestion can improve your health in general and relieve the symptoms.

The doctor can give you medicines to decrease the pressure of your blood and cholesterol-lowering statins to treat atherosclerosis.  The doctor can include sex therapy and CBT (cognitive behavioral therapy) for psychological treatments.

Medications: Phosphodiesterase-5 (PDE-5) inhibitors

For the treating of ED, there is one type of medication very used in the entire world and the most effective: Phosphodiesterase-5 (PDE-5).

There are four PDE-5 inhibitors available to treat ED in England.

  1. Sildenafil (Brand Viagra)
  2. Vardenafil (Brand Levitra)
  3. Avanafil (Brand Spedra)
  4. Tadalafil (Brand Cialis)

The medicines that can take around eight hours to work are avanafil, vardenafil and sildenafil. All of them work on demand. The medicine that can last more than 36 hours and this treatment it is better for a long period, more than a weekend for example, is tadalafil.  Using avanafil, sildenafil and vardenafil, the man probably is able to have sex between one to 10 hours after taking the medication. Using tadalafil, the effects will last more than 36 hours.

It should take about 30-60 minutes before the medication starts to work, it will depend on the type of the PDE-5 and the dose. 

Your doctor will consider your particular situation to determine which medication might work best. You might need to work with your doctor to find the right medication and dosage for you, which depends on how often you are sexually active and if you already tried any other medications before.

For all types of PDE-5, you only take one tablet within a 24-hour period and to have the effects faster it is better to take the medication on an empty stomach. You can eat after one hour without affecting the results of the medicine. After taking one type of PDE-5, two-thirds of men improved your erections according to some studies to prove the effectiveness of this kind of medication.

It is important to know that this medication is a trigger for sexual stimulation, will not cause excitement, you need to feel sexually excited to get an erection.

There are some causes if the PDE-5 inhibitors will not be effective:

  • You maybe need a dose higher;
  • You maybe need to wait longer after taking the dose;
  • You have waited longer after taking the dose;
  • You maybe do have the necessary sexual stimulation;


Men who have some diseases or problems should use the medicine (PDE-5 inhibitors) with caution, as follow:

  • Cardiovascular disease (for example, coronary heart disease). You should discuss with your doctor the risks and benefits because sexual activity can be also beneficial for cardiovascular health;
  • Anatomical problems in his penis (for example Peyronie´s disease – disease that affects the tissue of the penis);
  • Men with risk of priapism (an erection with pain that can take many hours);
  • Men with also taking long lasting alpha-blockers (medication used to treat a lot of conditions, for example high blood pressure – hypertension);

PDE-5 inhibitors can also warned not to take, if you have:

  • Low blood pressure (hypotension);
  • Had a stroke recently (the blood supply to the brain is blocked);
  • Unstable angina (Symptoms as chest pain which is a cause of an underlying heart condition);
  • Had a heart attack (the blood supply to the heart is blocked);
  • Eye condition than can lose your vision suddenly (non-arteritic anterior ischaemic optic neuropathy)
  • If your doctor said to not have sexual activity or activities that widen your blood vessels;

If you taking some medicines (for example organic nitrates to treat angina) or recreational drugs (butyl nitrate – common known as poppers), which contain nitrates is dangerous the combination with PDE-5 inhibitors. It can be very dangerous effects in your heart.

Side effects

There are some side effects of using the PDE-5.

There are:

  • Disturbances in the vision;
  • Migraines and headaches;
  • Flushing (redness);
  • Nausea (being sick);
  • Runny nose or a blocked;
  • Pain in the back;
  • Vomiting (feeling sick);
  • Muscle pain;

There are many studies, in recent years, showing that treatments for erectile dysfunction have increased and becoming better significantly.

It would be possible for the most men to return their sexual life.


  • Erectile dysfunction (impotence) - Causes: website:, last check 09. September 2017.
  • Everything you need to know about erectile dysfunction: website:, last check 09. September 2017.