7 Common Questions About Erectile Dysfunction, Answered

1. What Causes Erectile Dysfunction (ED)?

ED is a common sexual health condition affecting men of all ages and demographics, whereby they experience difficulty in achieving and maintaining an erection during sex. This can occur either due to a restricted blood flow to the penis, or an early release of the enzyme PDE-5 that causes erections to subside.

These can be due to the below physical or psychological risk factors:

2. How Common is ED?

It may surprise you to know just how common erectile dysfunction really is. In a recent survey, a third of men claimed to have never told anyone about their ED, but experts estimate that up to half of men have experienced ED by the age of 40^[1]. This proportion increases incrementally in line with age past this point at the rate of roughly +10% per additional 10 years of age. ED cases are also on the rise amongst men under 40, with mental health, drug usage and the prevalence of pornography thought to be contributing factors^[2].

3. Is my ED due to physical or psychological factors?

It’s a common belief that erectile dysfunction is due predominantly to your mental approach to sex, with either anxiety, lack of self-confidence, overthinking or stress causing the issue. Whilst these are all very real contributing factors, it’s far more likely that your ED is related to something physical, such as one of the risk factors listed above. If you’re not sure whether your ED is predominantly psychological or physical, there are some simple tests you can do to establish if you’re able to achieve an erection. Firstly, if you take any other medication regularly, are these known to cause ED as a side effect? Secondly, monitor whether you are able to get an erection at other times of day, such as first thing in the morning or during the night. One method of figuring out if you are having erections whilst you sleep is to tape a thin and narrow piece of tissue paper around the shaft of the penis whilst flaccid, which should tear or show some damage if you have indeed had an erection. If you can have erections, then the cause of ED during sex is most likely psychological.

4. Is there a cure for ED?

Whilst there isn’t an easy method of curing ED for good, there are a number of lifestyle factors that may stop your ED once changed. Upping your exercise will improve your body’s blood flow, and pelvic floor exercises will strengthen the muscles in and around the penis^[3]. Making changes to improve the quality of your diet can also have a really positive impact, especially if you are diabetic or overweight. Additionally, drinking alcohol and smoking regularly have both been linked to erectile dysfunction, so cut down on these for best results. If the cause is more psychological, take time to identify any daily or major stressors in your life, or causes of anxiety or depression, and work openly with your partner to eliminate these as a team.

These changes can take time to enact, and even then you may still have trouble maintaining an erection, but thankfully there are numerous clinically proven medications that effectively and quickly help achieve an erection.

5. Which ED medication is the best?

PDE-5 inhibitors make up the majority of proven erectile dysfunction treatment, such as Sildenafil (Viagra / Kamagra) and Tadalafil (Cialis) amongst others. Sildenafil is the most popular and one of the most effective treatments for ED, and in generic form is far more affordable than the branded Viagra whilst being chemically equivalent.

ED medication doesn’t affect everyone in the same way, so trialling a few different treatments will be the best way to establish what works best for you. Additionally, the active ingredients in the different medications vary on activation time, duration and suitability.

6. Are there any side effects of ED medication?

Whilst the majority of men don’t experience side effects from erectile dysfunction treatment, some common side effects include:

• Headaches
• Dizziness
• Indigestion
• Body aches

Only 1 in 10 men experience side effects, but if you do, it’s worth switching to a different PDE-5 inhibitor to see if the change in active ingredient corrects the issue. It’s important to only take one PDE-5 inhibitor at a time, you shouldn’t combine different brands or varying active ingredients simultaneously.

7. Does watching too much porn cause ED?

There is evidence to suggest that watching a lot of porn can negatively impact your sex life and your ability to maintain an erection during sex. One study examining men, which classed heavy porn consumers as those spending over 300 minutes a week watching the content, found that they rated their sex life as lower quality on average, and that 45% of those under 35 years old had ED (above the national rate for this age group)^[4]. The main culprit here is the sexual desensitisation that overstimulating porn creates, increasing men’s required stimulation to achieve ejaculation, meaning that when they have sex with a partner they struggle to achieve that same level of stimulation easily. Although not always a cause of decreased libido, it’s also possible that the depleted dopamine reserves from regular porn watching may reduce appetite for sex. Bear in mind that research into this area has currently only focused on heavy porn watchers, and there’s no evidence to suggest an increased risk of ED with less frequent porn watching, although more research is needed on this topic.