Understanding Erectile Dysfunction: symptoms and causes

Questions about ED? Explore the causes and solutions in this article.

What are the symptoms of erectile dysfunction? 

Erectile dysfunction (ED) is defined as not being able to achieve an erection, or to maintain it long enough to reach a climax. The main symptoms are:

• Inconsistent ability to achieve an erection.
• Achieving an erection alone, but not with a partner.
• Maintaining an erection for too short a time to have sex.
• Never being able to get an erection.
• Reduced sexual desire.

Learn more about Erectile Dysfunction Treatment and Diagnosis.

What causes erectile dysfunction?

Erectile dysfunction is very common in men, especially over the age of 40. The most common causes include:

• Psychological problems like stress, anxiety or depression. 
• Being inactive, or not getting enough sleep.
• Drinking too much alcohol, or eating an unhealthy diet.
• High cholesterol, diabetes, or heart disease.
• Low testosterone levels (read more about testosterone)
• Side effects of medication. 
• Prostate or bladder surgery.

There are several different treatments, depending on what’s causing the dysfunction. Most treatments are highly effective. 

Can erectile dysfunction be psychological?

Your mental state can have a powerful effect on your sexual response. Psychological factors that might impact your ability to achieve an erection include: 

• Stress.
• Anxiety.
• Depression.
• Relationship problems.
• Losing confidence in your ability to satisfy your partner.
• Worries that prevent you getting adequate (between 6-9 hours) sleep.
  

If you’re struggling with psychological factors, talking to a counsellor may help (learn more about the psychological impact of ED).

Are erectile dysfunction and premature ejaculation related?

Erectile Dysfunction (ED) and Premature Ejaculation (PE) can be related if they are both caused by performance anxiety, stress or relationship problems. But they can also create a vicious circle: a man suffering from ED might rush through sex because he’s scared of losing his erection, which can lead to him ejaculating too fast everytime. 

Can erectile dysfunction be permanent?

Some physical problems can cause long-term (also known as end-stage) erectile dysfunction. These include: · 

• Spinal damage.
• Diabetes.
  
• Multiple Sclerosis (MS).
• Treatment for bladder or prostate cancer.

If psychological factors or medications are causing ED, treatment or lifestyle adjustments can often reverse the symptoms. Read more about natural treatments for ED.

Can you get erectile dysfunction treatment over the counter?

 In Ireland, ED medications (like the classic little blue pill) are available only by prescription. You can access our discreet online service to order ED medication. The request is reviewed by an Irish GP, and upon approval, medication is delivered to your home.  Other methods of treating erectile dysfunction – like penis pumps, penis rings, and counselling– are available without prescription. 

Does cholesterol medicine cause erectile dysfunction?

Any medical condition that restricts blood flow around the body – like high cholesterol or heart disease – could cause erectile dysfunction. Read more about high cholesterol here.

Statins (the most common form of treatment for high cholesterol) have actually been found to improve erectile dysfunction. A meta-analysis of randomised trials, published in the Journal of Sexual Medicine in 2014, revealed that statins improved erectile function in most men, as measured on the International Inventory of Erectile Function.

Can erectile dysfunction be a sign of prostate cancer? 

Prostate Cancer is when a malignant tumour grows on the prostate gland, situated near the rectum in men. Symptoms usually appear only when the cancer is advanced, which is why prostate screening is recommended for men over 50. Erectile dysfunction can be a symptom of prostate cancer, so it’s always a good idea to talk to a doctor if you develop ED, especially if it starts suddenly.

Other symptoms of prostate cancer include:

• Blood in the urine or semen.
• Pain when you ejaculate or pass urine.
• Back ache.
• Bone pain (if the cancer has spread). 

If you are concerned about prostate cancer, you can talk to a doctor online.

Does anxiety cause erectile dysfunction?

Yes, anxiety can contribute to sexual problems. According to a 2022 study published in the International Journal of Impotence Research, men with anxiety disorders are more likely to experience erectile dysfunction, especially if they suffer from PTSD, panic disorder or social anxiety. If you suffer from anxiety, talking to a counsellor can help. 

Erectile dysfunction can also be a side effect of anxiety medication or anti-depressants. 

Does masturbation cause erectile dysfunction? 

No. There’s no evidence to suggest that masturbation causes erectile dysfunction. However, a link has been suggested between erectile dysfunction and excessive use of pornography. If you find it harder to get an erection with a partner than you do when watching pornography, you could try avoiding pornography for a set period (like 90 days) to see if your symptoms improve.  

This blog was written by Kate Taylor, a Sex Expert, Sex and Dating Features Writer, columnist and author of five books, for HealthHero.ie.