Erectile Dysfunction

Erectile dysfunction is when a man is unable to achieve an erection, or sustain an erection resulting in being unable to undertake sexual activity with penetration.

It is not a disease in and of itself, but usually a symptom of a different problem, either physical, psychological, or both.

Erectile dysfunction is a very common symptom that men face, and becomes increasingly common as men age.

It has been shown that at least one in five men over the age of 40 years has erectile problems, and one in ten are completely unable to have erections.

The process of achieving an erection

When we’re younger it often feels like there’s no process at all, however the inverse is actually true. It’s quite a complicated process with many points at which erectile dysfunction can manifest itself.

The corpus cavernosum is a sponge like tissue, of which there are two tubes that run along the length of the penis. This is held together with a tough, elastic and fibrous casing.

When stimulated by the nerve, this spongy tissue moves to accommodate more blood within it. As this tissue expands, it blocks off the veins which usually act to drain blood from the penis, and with more blood going in and less going out, the penis increases is size and stiffness and an erection is acheived.

Both the spongy tissue and the blood vessels react to a variety of chemicals in the body, to either make an erection happen or to make the penis flaccid. The balance determines the outcome.

So what causes erectile dysfunction?

It’s very seldom a single cause. A few factors are usually present at the same time, and adding another can then lead to erectile dysfunction. Sometimes it’s a sign of another more serious health problem which affects the nerves or blood vessels like diabetes or cardiovascular disease. Sometimes there is no obvious cause identifiable. The following is a non-exhaustive list of known causes;

Psychological issues
  • Performance anxiety
  • Sexual attitudes and upbringing
  • Relationship issues
  • Employment and financial pressures
  • Depression
  • Psychiatric disorders
Nerve issues
  • Spinal cord trauma
  • Multiple sclerosis
  • Diabetic neuropathy
  • Pelvic surgery (prostate/bowel)
  • Parkinson’s disease
  • Alzheimer’s disease
Reduced blood flow
  • Atherosclerosis (narrowing of arteries)
Drugs, alcohol, medicines
  • Alcohol and drug usage
  • Smoking
  • Medicines used for
  • Blood pressure
  • Cholesterol
  • Depression
  • Prostate cancer
Metabolic issues that interfere with blood vessel function
  • Diabetes
  • Hypertension (high blood pressure)
  • Obesity
  • High cholesterol
  • Sleep apnoea
Urological problems
  • Peyronie’s disease
  • Pelvic trauma
Endocrine problems
  • Thyroid disease
  • Acromegaly
  • Cortisone excess
  • Hypogonadism

Should I expect erectile dysfunction as I get older?

As the body begins to age, the muscles and nerves in the penis also become less responsive which interferes with getting and keeping erections. This can mean that it takes longer for someone to get aroused, and it may also take longer to have a second erection compared to when you were younger.

How can I tell what my cause of erectile dysfunction is?

It’s best to come and chat to your doctor at GS Health if you’re having erectile problems, or whether or not you want to have sex. Have confidence that you can talk to your doctor openly and freely about any concerns that you have.

How is erectile dysfunction treated?

For most men there isn’t a cure per se, but improvements can be made by treating the underlying cause. This is why it’s important to have a thorough assessment instead of just taking pills.

Once the process of improving and exploring any underlying causes is underway, other more immediate treatments can take place to allow you to achieve an erection easier.


Made famous by movies like Love and Other drugs, PDE5 inhibitors are commonly used for the treatment of erectile dysfunction. Initially developed for the treatment of pulmonary hypertension (and still used for this), the side effect of improving erections was quickly discovered.

These tablets are generally safe and helps most men reach an erection.


If tablets can’t be used, or haven’t worked, an injection into the spongy tissue of the penis can help increase blood flow.


Penis vacuum devices (penis pumps) are placed over the penis and air is pumped out of the cylinder. The negative pressure helps to draw blood into the penis achieving an erection. Following this a rubber ring is placed on the base of the penis to maintain the erection.


A penile prosthesis can be implanted in men to allow erections when squeezing certain parts of the prosthesis. This is generally reserved for people who have tried and failed with other treatments.

While it seems simple there can be many causes for the development of erectile dysfunction, and these need to be considered before treatment begins. Your doctor at GS Health is the best person to speak to if you have any concerns.

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