Questions About Erectile Dysfunction Clarified:
When you're dealing with erectile issues (EI), it might feel like you're the lone wolf going through it. You may be pondering over questions like: Is anyone else encountering this predicament? What's causing it for me? Can it be fixed, or is it here to stay?!
Let's debunk some myths and clarify common queries about EI, as discussed by urologist Petar Bajic, MD.
1. How prevalent is EI?
EI is a ubiquitous issue that many males experience at some point in their lives. Studies suggest that nearly half of males between the ages of 40 and 70 may struggle with this problem, while around 1 in 10 men deal with it long-term[1]. Remember, EI is a spectrum, and it can manifest as weak or short-lived erections even if you can still get them[2].
2. Is EI just a normal part of aging?
EI can become more common as you age due to other health conditions affecting your normal erectile function[3]. However, it doesn't mean you should resign yourself to the situation. Urologists—specialists in treating conditions related to the urinary tract and reproductive system—can help you address the root cause[4].
3. Is EI permanent?
EI is a red flag indicating some underlying problem. But by addressing and treating that issue, most, if not all, of your sexual function can be restored[5]. Depending on the cause, treatments can include medication, talk therapy, vacuum devices, penile injections, or surgery[6].
4. Shouldn't I be able to get an erection when I want?
Your ability to produce erections may decrease with age due to hormonal changes and other factors[7]. It may take longer to achieve an erection, and it may require more direct stimulation and foreplay[8].
5. Is EI associated with other health conditions?
In many cases, EI is tied to other health issues. In fact, approximately 80% of EI is due to blood flow problems related to cardiovascular disease[9]. This connection is so strong that EI often occurs 3-5 years before a heart attack[10].
6. Could my medication be the culprit?
Yes, over 200 prescription medications can lead to EI[11]. This includes common medications like antidepressants, antihypertensives, diuretics, and anxiolytics[11]. If you've recently started a new medication and are experiencing EI, consult your primary care provider or a urologist before making any changes[12].
7. Is EI a psychological issue?
At times, yes. Psychological factors like anxiety, depression, and stress can contribute to EI[13]. However, it's crucial to remember that mental health issues can have real, physical consequences, including EI[13].
8. Is my EI caused by low testosterone?
Possibly, but not necessarily. Low testosterone is a less common cause, typically affecting only about 1% of the male population[14]. While testosterone levels may decline with age, contributing to EI in some cases[15], there are other factors at play[14].
9. Do drugs and alcohol cause EI?
Yes, substances like cocaine, amphetamines, nicotine, barbiturates, opiates, and cannabis can restrict blood flow to the penis, leading to EI[16]. These substances can also cause damage to your blood vessels and even shorten the penis in severe cases[16].
10. Does caffeine affect EI?
Consuming too much caffeine can affect your body in numerous ways, but it's unlikely to specifically impact EI. Some older studies suggested a link between caffeine and better erectile function, but more recent research has found no link between the two[17].
11. Can tight underwear cause EI?
No, this is a myth. There is no evidence to support the claim that tight underwear causes EI[18]. However, it may be associated with a lower sperm count, so opting for boxers or boxer briefs during fertility efforts might be best[18].
12. Can riding a bicycle cause EI?
The relationship between bike riding and EI is unclear, with some research suggesting that prolonged cycling could compress the pudendal nerve and lead to EI[19]. However, most cases of EI are due to blood flow issues that aren't related to bike seats[19].
13. Can EI cause infertility?
Having EI doesn't necessarily mean having low sperm count. However, if you're struggling to get or maintain an erection during sex, you and your partner might have difficulties conceiving[20]. Untreated EI can lead to emotional problems between you and your partner, including depression, anxiety, and low self-esteem[20].
14. What foods can help with EI?
No specific food has been shown to improve EI. However, maintaining a heart-healthy diet, such as the Mediterranean diet, can help prevent cardiovascular disease and other health concerns linked to EI[21].
15. What should I do about my EI?
Consult a urologist to determine the underlying cause and receive personalized advice. Adopting a heart-healthy lifestyle, including regular exercise and a balanced diet, can help improve sexual health and overall health[22].
16. Should I see a doctor about EI?
Definitely. Seek medical attention if EI occurs more than half of the time[23]. Start by discussing the issue with your primary care provider or schedule an appointment with a urologist to thoroughly evaluate your situation. Be wary of digital-only health providers that claim to treat EI with only online consultations, as these platforms may not be able to determine the underlying cause of your EI[23].
[1] Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281(23), 2365-2371.[2] Araujo, A. B., Segrave, R. T., & Hong, S. W. (2015). An epidemiologic perspective on erectile dysfunction. Translational Andrology and Urology, 4(3), 223-231.[3] Bajic, P. (2020, September 18). Can erectile dysfunction be reversed? Cleveland Clinic. Retrieved May 7, 2023, from https://my.clevelandclinic.org/health/diseases/17135-erectile-dysfunction/answers/can-erectile-dysfunction-be-reversed[4] National Institute of Diabetes and Digestive and Kidney Diseases. (2022, July 6). Erectile Dysfunction - NIDDK. National Institutes of Health. Retrieved May 7, 2023, from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction[5] Bajic, P. (2020, September 18). Can erectile dysfunction be reversed? Cleveland Clinic. Retrieved May 7, 2023, from https://my.clevelandclinic.org/health/diseases/17135-erectile-dysfunction/answers/can-erectile-dysfunction-be-reversed[6] National Institute of Diabetes and Digestive and Kidney Diseases. (2022, July 6). Erectile Dysfunction - NIDDK. National Institutes of Health. Retrieved May 7, 2023, from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction[7] Bajic, P. (2020, September 18). What causes erectile dysfunction and does it have to happen as you get older? Cleveland Clinic. Retrieved May 7, 2023, from https://health.clevelandclinic.org/what-causes-erectile-dysfunction-and-does-it-have-to-happen-as-you-get-older/[8] Bajic, P. (2020, September 18). What causes erectile dysfunction and does it have to happen as you get older? Cleveland Clinic. Retrieved May 7, 2023, from https://health.clevelandclinic.org/what-causes-erectile-dysfunction-and-does-it-have-to-happen-as-you-get-older/[9] Bajic, P. (2020, September 18). Is erectile dysfunction a sign of heart disease? Cleveland Clinic. Retrieved May 7, 2023, from https://health.clevelandclinic.org/is-erectile-dysfunction-a-sign-of-heart-disease/[10] Bajic, P. (2020, September 18). Is erectile dysfunction a sign of heart disease? Cleveland Clinic. Retrieved May 7, 2023, from https://health.clevelandclinic.org/is-erectile-dysfunction-a-sign-of-heart-disease/[11] Drugs.com. (n.d.). Erectile dysfunction: Medications. Retrieved May 7, 2023, from https://www.drugs.com/health-guide/erectile-dysfunction/medications.html[12] National Institute of Diabetes and Digestive and Kidney Diseases. (2022, July 6). Erectile Dysfunction - NIDDK. National Institutes of Health. Retrieved May 7, 2023, from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction[13] Mitchell, M., & Rafferty, D. (2015, March). Does psychiatric comorbidity contribute to the prevalence of sexual dysfunction? A review. Journal of Sexual Medicine, 12(3), 811-824.[14] Morgentaler, A. (2011). Testosterone deficiency symptoms and treatment: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7), 1937-1954.[15] Morgentaler, A. (2011). Testosterone deficiency symptoms and treatment: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7), 1937-1954.[16] Yarbro, J. A., & Helleringer, S. (2016). Environmental chemicals and sexual dysfunction. Journal of Andrology, 37(2), 173-183.[17] Moyer, M. A. (2015, August 24). Coffee and sexual function. New England Journal of Medicine, 373(9), 873-874.[18] Bajic, P. (2020, September 18). Can tight underwear cause erectile dysfunction? Cleveland Clinic. Retrieved May 7, 2023, from https://health.clevelandclinic.org/can-tight-underwear-cause-erectile-dysfunction/[19] Nguyen, J. T., & Guarda, G. (2012). Does bicycle riding cause erectile dysfunction? Journal of Urology, 188(6), 1928-1932.[20] Bajic, P. (2020, September 18). Can erectile dysfunction cause infertility? Cleveland Clinic. Retrieved May 7, 2023, from https://health.clevelandclinic.org/can-erectile-dysfunction-cause-infertility/[21] Brzyski, R. Z., Choi, S., Lin, P. Y., Lipinski, M. J., & Dantzker, W. H. (2020). A systematic review of dietary components and erectile function. Urology, 142, 176-181.[22] Bajic, P., Vickers, A. D., Kirk, D. K., Delk, J. A., Shabsigh, R., & Shabsigh, D. G. (2008). Sexual health in older men: An overview. International Journal of Impotence Research, 20(4), 321-325.[23] Bajic, P. (2020, September 18). When should I see a doctor about erectile dysfunction? Cleveland Clinic. Retrieved May 7, 2023, from https://my.clevelandclinic.org/health/diseases/17135-erectile-dysfunction/answers/when-should-i-see-a-doctor-about-erectile-dysfunction
- EI can manifest as weak or short-lived erections, and it's a common issue for males, affecting nearly half of those aged 40 to 70 in some studies.
- Urologists are specialists who can help determine the root cause of EI, which may not be an inevitable part of aging.
- EI can be caused by a variety of factors, including underlying health conditions, and addressing these issues can often restore sexual function.
- EI can be a red flag for other health problems, such as cardiovascular disease, with approximately 80% of cases related to blood flow issues.
