Content Approved by Dr Fotinos | Male Excel Blog Sep 21, 2020 8:15:23 AM 28 min read

What is Erectile Dysfunction?

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A diagnosis of erectile dysfunction (E.D.) may sound like the end of the world. It may challenge a man's perception of his masculinity. The definition of E.D. is when a man is unable to get an erection or maintain an erection to have sex. The common term used for E.D. is impotence.

It isn't uncommon for a man to have an erection problem from time to time. However, when the condition persists with no other apparent cause, there is a chance that he has E.D.

E.D. is not something men easily discuss as it is a source of embarrassment. The strange thing is that if they did open up to others, they'd be surprised to find out how many others have the same problem. The reason is that E.D. studies indicate that up to 52% of men experience E.D. While it is more common in older men, younger men can face E.D as well.

Fortunately, E.D. is no longer as much of a taboo as it used to be. Men are freer to speak about it than they've ever been before. Mainly because, in recent years, effective treatments for E.D. have become available.

How Does a Penis Get Erect?

Getting an erection can happen within seconds, but it is a complex physiological process:

A man experiences sexual arousal from sensory or mental stimulation. Immediately, the brain communicates with the penis, sending it nerve messages.

These messages contain an impulse which makes the muscles of the corpora cavernosa to relax. The penis contains two corpora cavernosa chambers, which are fed by a vast network of blood vessels.

Nitric oxide in the blood instructs the arteries and blood vessels to dilate to facilitate blood flow. Blood is redirected to the corpora cavernosa to fill the chambers. The increased presence of blood causes the penis to become erect.

Membranes around the corpora cavernosa called the tunica albuginea assist by trapping the blood in the chambers, which is what sustains an erection.

How Erectile Dysfunction Affects and Erection

An inability for the body to perform the steps in the process results in E.D. Examples of an interruption to the erection process include:

  • A problem with the blood supply to the penis.
  • An issue with the neurological system which sends the impulse to trigger the erection.
  • Psychological causes which interfere with the brain's reaction to a sexual stimulus.
  • Injury to the penis which affects the physical capacity to get an erection.

Common Causes of E.D.

The leading causes of problems with the blood supply to the penis that could cause E.D. are physical conditions. They include, but are not limited to:


A buildup of plaque in the arteries is called atherosclerosis. The plaque contains fat, cholesterol, and calcium. The plaque clogs and blocks the arteries, thereby restricting blood flow to the heart. An interruption of the blood flow to the heart can cause a heart attack. Plaque deposits can also cause clots, which have life-threatening implications.

The same blood flow problems to the heart that atherosclerosis causes can also impact a man's ability to get and maintain an erection. Arteries that are compromised cannot feed the blood vessels that flow into the penis to make it erect.


As oxygen-rich blood flows around the body, it places pressure on the artery walls. The higher the amount of pressure on the artery walls, the higher your blood pressure. Over an extended period, this constant stress on the arteries causes damage to the artery walls. It results in the narrowing of the arteries, which restricts blood flow to and from the heart.

Photo by Tim van der Kuip on Unsplash

High blood pressure is one of the leading causes of E.D. It prevents the arteries that supply blood to the penis from opening up as they should. Hypertension also stops the muscles of the penis from relaxing to allow blood flow into the corpora cavernosa chambers. Insufficient blood flow to the penis results in a partial erection or no erection at all.


Men with type 2 diabetes are more likely to experience E.D. than their non-diabetic counterparts. Diabetes causes restricted blood flow in the body, leading to a loss of sensation in the feet and hands. The blood vessels and nerves are damaged, which causes circulatory problems. The same blood flow problems may cause E.D. as insufficient blood is reaching the penis.

Another problem affecting diabetic men is nitric oxide levels in the blood. Nitric oxide is essential for getting and maintaining an erection because it instructs the muscles of the penis to relax. The arteries also dilate, which allows for more blood flow into the penis. When blood sugar levels are high, such as in diabetics, there is less nitric oxide in the blood.


Being obese can result in lowered testosterone levels. Low testosterone levels alone are seldom the cause of E.D. However, combined with high blood pressure, atherosclerosis, and diabetes, which are conditions associated with obesity, they can add to the problem.

Smoking and Alcohol Use

Nicotine raises both blood pressure and heart rate. Smoking damages the body's blood vessels, which can directly affect the blood supply to the penis. Studies suggest that smoking is a significant contributor to E.D., especially in younger men.

Alcohol affects your brain. The brain is an essential part of the erection process as it triggers the body's physical response. Too much alcohol can result in the brain being unable to instruct the blood vessels to channel blood flow to the penis.

Neurological Conditions that Can Cause E.D. Include:

  • Parkinson's disease
  • Alzheimer's disease
  • Multiple Sclerosis (M.S.)
  • Brain tumors

Psychological conditions like anxiety, stress, or depression can cause E.D. Low self-esteem because of previous E.D. episodes can lead to 'performance anxiety,' which is a fear of sexual failure. This performance anxiety can result in further episodes of E.D.

When To Get Help for E.D.

It's normal for most men to occasionally not get or sustain an erection at some point in their lives. There's no real cause for concern. However, if it starts happening more frequently and gets worse, there's likely to be a problem causing it.

A physical problem predominantly causes E.D. Finding out what it is will not only be a solution for E.D., but it could also save your life. E.D. is a warning sign that something is wrong in the body, often with the heart. Reduced blood flow to the penis causes E.D. A struggling circulatory system damages the heart in the long-term.

If you suspect you have E.D., it's advisable to get help as soon as possible. E.D. can affect your self-confidence and cause conditions like depression. Many antidepressants also cause episodes of E.D.; ignoring E.D. can make the problem more complicated.

Common Erectile Dysfunction Treatments

There have never been more treatment options for E.D. than there are today. Each man's E.D. problems are different, so the same treatment may not work for everyone.

As part of their treatment, men with E.D. should make some lifestyle changes:

  • Quitting smoking.
  • Reducing alcohol intake and avoiding binge drinking.
  • Getting more exercise to stimulate the heart and circulatory system.
  • Following a healthy diet to lose weight.
  • Cut out fatty and processed foods, which decrease blood circulation.

A doctor might suggest a medical intervention to help a man experiencing E.D. The most common treatment is an oral medication with Viagra® (Sildenafil) and Cialis® (Tadalafil) being the most popular.

There are four main medications used for the treatment of E.D.:

  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

Each medication works in basically the same way. They relax the muscles and improve the blood flow to the penis. Each contains nitric oxide, which is essential for blood flow to the penis. As a result, the man can get and maintain an erection.

Viagra is by far the most well-known E.D. medication. While it doesn't work for everyone, most men who have used it have found it very effective. Its active ingredient is sildenafil. Today, a generic version of Viagra, which includes sildenafil, is made under license by Pfizer.

There are alternative treatments for E.D. as well. Taking zinc supplements and Ginkgo Biloba is a common alternative treatment. However, their benefits are limited, and few men find them to be useful on their own. Not all alternative therapies are FDA approved and could be potentially harmful. Users are encouraged to consult their doctor before using any of them.

Buying E.D. Medication Online

There's no need to go for an awkward face-to-face doctor's appointment to discuss your E.D. problems and get a prescription. If you feel that you'd prefer to handle the whole process online, there are convenient options for you to explore. The sites work as platforms for the customer to access the services of the medical providers who issue prescriptions.

The process starts with a free online consultation with a U.S.-licensed doctor. Completing a medical survey is the first step. It is essential to provide all the necessary information so that the doctor can decide on your treatment options. Including your symptoms as well as any other medications you use. The data is confidential to encourage, and users are encouraged to provide honest, accurate information.

One of the things doctors insist on is that customers have seen their doctor for a medical exam within the last three years before consulting with them. The doctor may send a message requesting further clarification before coming up with a practical, detailed treatment plan.

The doctor reviews the initial treatment request within two hours of receiving it during business hours. Outside of business hours, customers should expect to have their treatment request reviewed within 24 hours.

What You Need to Know About Buying E.D. Medication Online

Once the doctor has determined what treatment is needed and discussed it with the patient, they write out a prescription. U.S-based pharmacy packages the medication discreetly and ships it to the patient's preferred address. Most medical providers prescribe 12 doses a month at a rate of $65. The first two weeks' treatment is free.

Men who feel they need more than 12 tablets a month are free to discuss this with the doctor. Insurance does not cover the prescriptions; however, the medication is priced lower than most insurance plan options.

Users of such sites must be over 18 years of age. Underage users will have their information deleted. Anyone who suspects that a minor is using the site's services must report it immediately for investigation. Users can access the site and undergo an online consultation.

Before we write any prescriptions, the doctor will insist on a video call or that a customer upload a current picture of themselves. An uploaded image of government-issued identification is also required to authenticate the patient.

Customers are not guaranteed a prescription. We reserve the right to decline a prescription request if they feel health risks are associated with it. There are also states that, by law, do not allow the use of such sites. 

Side Effects of Erectile Dysfunction Medication

Like any medication, E.D. may have certain side effects; they can also react badly to other medication types that your doctor will check before prescribing.

There are some mild side-effects users can expect. They include:

  • An upset stomach including diarrhea
  • Sleep cycle disruptions
  • Dizziness, nosebleeds, and flushes
  • Headaches and pain in the muscles and back
  • A tingling sensation or complete numbness in the limbs and extremities

Serious side-effects of E.D. medication include:

  • Priapism is a medical emergency, an erection that won't go away and lasts for more than four hours.
  • Sharp chest pains and shortness of breath.
  • Changes in vision, from blurring to total vision loss
  • Severe headaches
  • Fainting

If a user suspects they are experiencing side-effects from their E.D. medication, they should stop taking them and speak to a doctor immediately. In the case of severe side-effects, the user should go to their nearest emergency room for assistance.

Who Should Not Take E.D. Medication?

Men with these health conditions should not take E.D. medications:

  • A heart attack or stroke within the last six months
  • An irregular heartbeat with life-threatening potential within the last six months
  • Uncontrolled blood pressure, whether high or low
  • Chest pains experienced during sex

Medications Not to Use with E.D. Medication

There are also certain medications with which E.D. medications do not interact well. These include:

  • Nitrates prescribed for the treatment of heart conditions
  • Medication for pulmonary hypertension
  • Alpha-blockers
  • Beta-blockers
  • Blood thinners
  • Certain seizure medications

To avoid a dangerous interaction, it is always preferable to share a full list of medication taken for any medical condition with the doctor. This knowledge helps the doctor make an informed decision about a treatment plan and whether E.D. medications are suitable.

How to Take Erectile Dysfunction Medication

Any E.D. medication comes with instructions for its use. A user should adhere to them strictly. Using more or less of the medicine than prescribed can render it less effective. An overdose is dangerous, and the user should report to an emergency room immediately.

How to Talk to Your Partner about Erectile Dysfunction

E.D. can cause a lot of tensions between couples. When a man has E.D., his partner may assume that it's their fault. The partner feels unattractive and unable to arouse their significant other sexually.

It can cause a lot of insecurity in the relationship on both sides. It is incorrect to assume that E.D. affects the self-esteem of the man experiencing it alone. E.D. can have a considerable impact on their partner as well.

Open lines of communication are essential when a man is diagnosed with E.D. Discussing the causes will show his partner it has nothing to do with them. A frank conversation about treatment options is also necessary. The dosage and potential side-effects are essential information that a partner would want to know.

E.D. is a medical condition like many others, and treatment is available

What To Do If You Have Erectile Dysfunction

Don't let an E.D. diagnosis make you define yourself as less of a man. Your masculinity has nothing to do with E.D. Explore the possible causes.

Identifying the reason that you have E.D. is the first step in finding the solution. You're not alone. Many men experience E.D. It's helpful to talk to other men who are in similar circumstances. You can support each other during this challenging time.

Please don't keep it a secret from your partner. E.D. is a sensitive subject, but your partner deserves to know so that they can support you. E.D. is not the end of your sex life. The condition is treatable, and you have several options available to explore.