A man's sexual life can be disrupted by the appearance and development of certain ailments, including erectile dysfunction. Affecting the lives of one in three men after the age of forty, this set of disorders, sometimes referred to as "breakdowns", is one of the greatest concerns of men in the field of sexual health. Because it has long been considered shameful, erectile dysfunction is still poorly understood. Here's what you need to know about male erectile dysfunction.

What is erectile dysfunction?

Erectile dysfunction is a sexual dysfunction that affects men exclusively. The term refers to a group of disorders that have long been pejoratively referred to as "impotence". Also known as "erectile dysfunction", erectile dysfunction refers to the inability or difficulty in maintaining an erection sufficient for sustained penetration.

Erectile dysfunction can occur over the short or long term and involves repeated "breakdowns" that prevent engagement in sexual intercourse. Generally, a recurrence of erectile instability or absence of erections for at least three months is necessary for a diagnosis of erectile dysfunction. Depending on the case and the patient's daily life, erectile dysfunction or ED can be categorized as organic, psychological or mixed.

Is it common?

Although it is still taboo, erectile dysfunction affects more men than it seems. In fact, this sexual problem is highly prevalent among men, especially as they get older. According to the MMAS study, 40% of men who have reached the age of 40 have erectile dysfunction that affects their sex life.

According to the same study, each additional decade past the age of 40 increases the prevalence of erectile dysfunction by 10%. Unfortunately, despite this high prevalence of the disease, only 25% of the men concerned consult a doctor.

The IFOP survey Men and erectile problems: the great taboo? reveals that 61% of men admit to having experienced erectile problems at least once. Nine percent of these men say that they have had an erection, 18 percent say that they do not have enough desire and 24 percent say that their erection is not firm enough.

Premature ejaculation, which is sometimes associated with erectile dysfunction, affects 30% of men according to the CSF survey.

The causes of erectile dysfunction

Erectile dysfunction can affect men at any age. However, there are a few recurring causes that are at the root of the occurrence of this disease in men. These are mainly organic or psychological causes.

  • Psychological disorders

    Psychological disorders can be the cause of erectile dysfunction in men. According to sexologists, intense stress can create a psychological block that results in difficulty for the penis to become erect. Other psychological disorders such as anxiety and depression can also be the cause of erectile problems.

  • Vascular problems

    High cholesterol, high blood pressure and diabetes are all causes of erectile dysfunction.

    Poor blood flow to the sexual organ sometimes results in a decrease in the quality of a man's erections. It is the blood flow in the penis that allows it to swell and create an erection.

  • Neurological problems

    The neurological system is partly involved in the erection of the male sexual organ. In this way, neurodegenerative diseases such as multiple sclerosis or Parkinson's disease can have erectile dysfunction as a symptom. Diabetes and other diseases that affect the nerve endings can also be implicated.

    After certain surgical procedures on the penis, testicles or corpora cavernosa, erectile dysfunction is one of the possible sequelae. In the case of surgery for prostate cancer, the nerves responsible for erection may also be affected.

  • Hormonal disorders

    Because of the involvement of hormones in the erection process, hormonal problems can inhibit erection. Insufficient production of testosterone, especially in cases of andropause, is a common cause of erectile dysfunction.

  • Legal and illegal drugs

    The use of chemical substances sometimes creates erectile dysfunction in patients. Smoking and the use of certain drugs can therefore have a negative impact on daily sexual life by affecting sexual performance.

    Some medications taken as part of a treatment for certain diseases such as antihypertensive drugs and drugs for depression also have the side effect of reducing the quality of the erection.

The symptoms

Depending on the patient, sexual impotence problems can present with a variety of symptoms. Depending on the treatment recommended by the doctor, these symptoms may change over time. Generally, the most common symptom of erectile dysfunction is the inability to get an erect penis, even after sexual foreplay.

Sometimes the problem manifests itself by a loss of erection during intercourse and before the man reaches orgasm. The quality of the erection achieved is sometimes insufficient and prevents the penetration of the partner during sexual intercourse.

The diagnosis

The first step towards a cure for erectile dysfunction is for the patient to consult a general practitioner or a urologist. Before the doctor can diagnose the condition, he or she uses certain tests to assess the severity of the situation.

The quality of the erection is first evaluated by using an HES which allows to put a score on a scale from 1 to 4. It is done before and several times during the treatment, to allow the doctor to do a complete follow-up.

To determine the risk factors and causes of the patient's erectile dysfunction, the physician may order blood tests and other tests to identify potential diseases. An online pre-treatment questionnaire can be completed to provide a brief overview of the patient's sexual status and the effects of the problem on the patient.

How to prevent erectile dysfunction?

To minimize the risk of developing disorders, there are a few habits to adopt to prevent the effects of impotence in men. Sexual desire can be more easily aroused by creating a healthier lifestyle.

Depending on the case, it is important to control or prevent the risk of diabetes. Diabetes treatments must therefore be carefully followed by patients suffering from erectile dysfunction.

Uncontrolled weight gain should also be avoided by regular exercise. In order to considerably reduce the risks related to drug use, stopping smoking and moderate alcohol consumption are mandatory.

It is also necessary for the patient to consult with his or her physician to identify medications that may be causing sexual dysfunction.

Possible treatments

Depending on the causes and factors inhibiting erection identified by the doctor, the treatment of erectile dysfunction differs.

  • Oral PDE-5 treatments

    For first-line treatment of erectile dysfunction, drugs called phosphodiesterase type 5 (PDE-5) inhibitors. These include viagra or sildenafil, and another drug called tadalafil. This type of medication helps to improve blood flow to promote sexual erection and ejaculation.

  • Intra-urethral suppositories

    When tablets are ineffective, intra-urethral suppositories are a simple alternative. They are introduced into the urethra a few minutes before the sexual act.

  • Intracavernous injections of vasodilators

    In order to improve the quality of erections, intra-cavernous injections of vasodilators into the corpora cavernosa are practical. On the other hand, they can have priapism as a side effect which is quite disturbing. This is a prolonged, irreducible and painful erection that occurs without sexual stimulation.

  • Plasma injection

    The blood circulation of the penis can be improved by the injection of platelet-rich plasma. It is painless and effective, and can improve sexual performance without any absolute contraindications.

  • The shock wave

    For the painless treatment of erectile dysfunction, shock wave therapy is the perfect choice. It allows a progressive vascular regeneration of the sexual apparatus.

  • Penile implants

    For long-term treatment, penile implants are an ideal solution for men with neurological problems. The implant can be inflatable or malleable, but requires a fairly substantial budget.

  • Hormone therapy

    Bioidentical hormone replacement therapy is available to patients with hormone-related erectile dysfunction. It is a fully customized therapy based on the patient's needs.


Canadian Urological Association Practice Guide: Erectile Dysfunction. Trustin Domes, Borna Tadayon Najafabadi, Matthew Roberts, Jeffrey Campbell, Ryan Flannigan, Phil Bach, Premal Patel, Gavin Langille, Yonah Krakowsky, Philippe D. Violette.

Erectile Dysfunction. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, Gerald Brock, William Harper. Erectile dysfunction.

Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study. Henry A. Feldman, Irwin Goldstein, Dimitrios G. Hatzichristou, Robert J. Krane and John B. McKinlay.