Erectile Dysfunction: Symptoms, Diagnosis, Treatments

General Information

The term ‘erectile dysfunction’, commonly abbreviated to ED, describes the condition when it is difficult or impossible for a man to keep an erection with the firmness sufficient for sex. Nowadays, more than 30 million americans suffer from ED.

Problems with erection occur in the majority of men. But the alarming sign is when this happens more often than half of the time. This can be due to health problems that disorder blood flow or when the penis’s nerves are damaged. Not infrequently, that marks the beginning of ED.

As often as not, a developing ED warns you of a more serious health problem approaching or of a protracted emotional crisis – that is, you have been stressed for too long.

ED also can stem from constant high levels of blood sugar, heart disease or abnormal blood pressure. It is critically important for your health that the cause(s) of your issues with erections are found and you receive an appropriate treatment.

How Erections Work

At moments when you do not experience sexual arousal, your penis is normally soft and limp. This changes abruptly when you are aroused, and blood flow to the penis is increased as the signals are sent to the nerves via neurotransmitter molecules.

Your penis has the so-called corpus cavernosum, which is sponge tissue arranged in two erection chambers that are filled with blood. The blood flow in the erection chambers are controlled by smooth muscles – those let blood into the chambers and ensure it stays there.

When the chambers are sufficiently pumped with blood, your penis becomes firmly erected. An orgasm triggers the inverse reaction,the blood leaves the chambers and,as the pressure drops, your penis again becomes soft.


What are the symptoms of erectile dysfunction? Just as any disease, it can occur in milder or more severe forms, up to not being able to have an erection at all.

Most often, you can say that you are experiencing erectile dysfunction if you go through any of the following:

  • it takes you a long time to get erected, even though your partner is sexually attractive and is stimulating you sexually;
  • after getting an erection you find it hard to keep it and lose it very quickly; after that, you have a hard time to gain one again;
  • you do not manage to get or maintain an erection at all, regardless of the stimuli you are getting and the level of your arousal;
  • you do not experience sexual desire, and as a result, an erection does not occur or is very weak.

It is important to note that these problems need to happen with some degree of frequency, otherwise it may not be an erectile dysfunction problem. Most men can have erection difficulties while being absolutely healthy.

This happens mostly because of stress at work, problems with their spouse or partner, or even mere physical exhaustion. In these cases, men typically have a morning erection and can masturbate without any inconveniences.

You will need to seek medical help if the problem is very frequent, or if you have any erection problems while not having other causes for its temporary halt as described above.


The reasons why men get an erectile dysfunction can roughly be divided into two categories – physical and psychological. Physical causes may be many, and they will include heart-related conditions, diabetes, excessive weight, diseases of the nervous system etc.

Impotence can also be caused on the physiological level by some medicines that you are taking. The psychological reasons, on the other hand, may be related to depression, anxiety or excessive stress. You can find out more about the possible causes of erectile dysfunction here.


The diagnosis of erectile dysfunction can take some time, depending on the reasons you have it in the first place. It is always wise to start with your physician who will take a look at your penis and ask you initial questions to find out about your problem.

At this stage, it is very important to give honest answers about your sexual life and health problems you are experiencing.

During a physical examination, the doctor will check the sensations in your penis and testicles to see if there is a problem with nerves. If there isn’t any, the reason for erectile difficulties may lie in your blood vessels.

If your doctor thinks so, he will order an ultrasound for you to see check the penis arteries and if the blood flows freely to your penis. Your doctor may also look at your chest and face to look for signs of the lack of testosterone because the cause of the ED can be hormonal.

The primary examination will also include a check of your psychological state to see if you have been exposed to any excessive stress or have been suffering from serious psychological problems.

It is possible that he will send you to see a psychiatrist to make sure that the erection problems are not related to depression, anxiety or other mental health conditions.

Depending on the result of the primary examination, your doctor may order other tests, like a blood test or urine test. This will happen if your doctor decides that your inability to get an erection is caused by another, more serious condition, such as diabetes or multiple sclerosis.

He will then redirect you to a specialist in that disease in order to confirm its diagnosis and get you the treatment you need.

ED Treatments

The treatment of erectile dysfunction will largely depend on its cause. This is why careful diagnosis is so important in this matter.

If the cause of the impotence was a condition that can be treated, such as hypertension, obesity or depression, your erectile dysfunction may go away with the effective treatment of the underlying cause.

For example, testosterone pills or injections can fix a hormonal imbalance, and the erection will come back on its own. In this case, you will not need to take any pills or other treatments that specifically target the erectile dysfunction.

If, however, the disease is incurable, such as diabetes, multiple sclerosis, or you simply have very advanced age, there is no chance that erectile dysfunction can be cured. The reason for this is that your nerves, muscles or blood vessels are not functioning properly, and the organism cannot perform a sexual act using only its own resources.

The good news is that, even if the erectile dysfunction is permanent and cannot be cured, there are remedies that can help get the necessary erected state on a temporary basis.

These include pills which inhibit certain chemical substances in the penis that relax its muscles and ensure that the blood leaves the pelvis. As a result, the penis can maintain muscle tension, get a stronger blood flow to it, and maintain the blood in it.

Thus, getting and maintaining an erection becomes possible, which, in turn, enables normal sexual relationships.

Commonly Used ED Drugs

The list of frequently prescribed ED medications includes Viagra (Sildenafil), Staxyn (Vardenafil), Cialis (Tadalafil), Stendra (Avanafil), and Levitra (Vardenafil). These drugs fall into the category of phosphodiesterase-5 (PDE-5) inhibitors. The mechanism of all these medications lies in improving the blood supply to the penis.

Those drugs, however, differ slightly inthe duration and other specifics of action. Levitra, for instance, is very similar to Viagra. They both kick into action in about half an hour, but Viagra provides you with the effect for four hours, while Levitra works for five hours. Staxyn and Stendra actin around 15 minutes with the effect lasting for about six hours. Cialis is known as a long runner: the drug sets in actionin 15 minutes, maintaining the effect for a total of 36 hours.

How the Pills Work: Mechanism of Action (MA)

All ED drugs feature a quite similar MA. As long as the whole scheme is about controlling blood flow, these medications promote the effects of nitrous oxide on your organism, allowing for the erection chamber muscles to relax and draw blood in.

However interchangeably they can be referred to in the day-to-day lexicon, these pills differ in the nuances of action and, consequently, indications. The duration of their effect decides more than simply the probable length of an intercourse.

Viagra and Levitra allow you to get ready for sex in 30 to 60 minutes and do not stay long in your body. One of the newer pills, Avanafil (Stendra), has been designed to be a more immediate aid and cuts the “before sex” time down to 15 to 30 minutes. Depending on the patient’s condition, it can last up to 12 hours.

Acting with a minimum delay (15 minutes), Cialis is a real standout when it comes to a prolonged benefit. It could be especially handy if you often find yourself in a situation where you do not know the exact time you might need it.

A normal practice is to take it daily, as thedrug constantly keeps you at the ready. Cialis (brand for Tadalafil) pills are also FDA-approved to be used by men in the treatment of benign prostatic hyperplasia (BPH), which is a condition manifested by an enlarged prostate and problematic urination.

How precisely ED medications affect the body is measured through a range of factors, such as direct effects, the average onset of action, side effects, and half-life.

Numerous studies conducted for the above drugs have made them the most well-understood ones. Below is provided more expanded reviews for these medications.The information specified in the following section should not be used as an exclusive reference.

Always talk to your doctor before starting an ED treatment course.

Specifics Of Action Of ED Medications

Cialis, Levitra, and Viagra are the most common ED drugs kept by pharmacies in their stocks. All the three drugs are nearly similar in cost. Generally, the majority of health insurance companies do not cover these medications.

Whether your experience from the use of one of these ED drugs will be a satisfactory one is dictated by your individual needs. In general, careful time consideration is necessary before you can engage in sexual activity.

The best thing to do is to get prepared ahead of time –take your ED medication in strict accordance to your physician’s recommendation(which is somewhere between 30 to 60 minutes before intercourse, depending on your particular medication).

Another important thing to keep in mind is that the absorption of your ED drug too needs to be optimized. Specifically, a high-fat, abundant meal is likely to delay the onset of action. That is exactly the reason why the manufacturers of most ED drugs recommend taking such medications as vardenafil, tadalafil and sildenafil with plenty of water after a light meal or no meal at all.

Half-Lives of ED Medications

One more essential aspect of a drug’s mechanism of action is its half-life. If we take the peak concentration of a drug as 100%, the half-life will be the amount of time that is needed for the medication’s concentration to decrease to 50%.

For instance, a 50 mg dose of sildenafil (generic for Viagra) reduces down to 25 mg after one half-life is passed.

Primarily, the half-life of a drug is a parameter that shows how long the medication remains in the bloodstream.

As its half-lives pass, the ED drug provides less and less effect until finally it is totally eliminated from the bloodstream and excreted.

As for the three popular ED medications described above, the half-lives and action duration are as follows:

Vardenafil, or Levitra, is designed with a half-life 5 hours and provides its effect for a maximum of 6 hours after it’s taken.

Tadalafil, or Cialis, is designed with a half-life of 17.5 hours and provides its effect for a maximum of 36 hours after it’s taken.

Sildenafil, or Viagra, is designed with a half-life of 4 hours and provides its effect for a maximum of 5 hours after it’s taken.

In summary, of the three currently most widely marketed ED drugs tadalafil provides a significantly longer lasting action.

This turns it into the best option for aconsistent treatment of ED for periods strictly defined by your doctor, whereas vardenafil and sildenafil are offered with a design for somewhat more incidental use.

Also, in case of Cilais, the possibility of management of benign prostatic hyperplasia (BPH) comprises an added benefit.

Please bear in mind that using any of these medications without previously consulting your doctor is not advised.