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Erectile dysfunction basics

Erectile dysfunction, commonly referred to as ED, or impotence, is the inability to achieve and sustain an erection sufficient for satisfactory sexual intercourse. This condition is not considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.

How common is ED?

According to the NHS, it is estimated that 50% of men between 40 and 70 years of age will experience ED at least once.

What causes ED?

In order to achieve an erection three conditions must occur. The nerves to the penis must be functioning properly; the blood circulation to the penis must be adequate; there must be a stimulus from the brain. If there is something interfering with any or all of these, a full erection will be prevented.

A common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection. This can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired.

Common causes of persistent ED include diseases that affect blood flow, such as atherosclerosis (narrowing of the arteries), nerve diseases, psychological factors, such as stress, depression and performance anxiety, and an injury to the penis. Chronic illness, certain prescription drugs and a condition called Peyronie’s disease (scar tissue in the penis) can also cause ED.
Side-effects of some medications can also contribute to ED.
 

Can cycling cause ED?

Bike riding, in moderation, does not affect erectile function. However, men should try to take breaks when cycling long distances.

Can tight underwear cause ED?

No. Causes of ED can be physical or psychological, but tight underwear is not among the causes of ED.

How is ED diagnosed?

A doctor will diagnose ED based on the reported symptoms, the man's medical history and may carry out a physical examination.
This may include checks for any penis anatomy problems, such as Peyronie's disease.

Blood tests may be arranged to check for any medical conditions that could be causing the symptoms.

Emotional issues will be discussed and explored.

A specific test for erection problems is monitoring erections that occur during sleep using a nocturnal penile tumescence test. This can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is more likely to have a physical rather than psychological cause.
 

Can ED be prevented?

For people who are at risk of developing ED due to personal behaviour, such as drinking too much alcohol, steps may be taken to prevent its occurrence. However, other causes of ED may not be preventable.

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