Erectile dysfunction symptoms

Erectile dysfunction (ED), also known as impotence, is the inability to get or maintain an erection long enough to have sex. Occasional difficulty with erections is relatively common, however, you might be diagnosed with ED if you have consistent difficulty with erections and if it starts to cause you distress.

ED becomes more common as those with a penis age, affecting 52% of people aged 40–70.The ability to get and keep an erection isn’t always age-related, and people across the age spectrum can be affected by ED.However, this doesn’t mean that ED is an inevitability of getting older. In fact, a large survey found that the prevalence of ED increased from 2.3% at 30 to 53.4% at 80 years old.

So, what are the erectile dysfunction symptoms in men to look out for, what causes these symptoms and what is the relationship between age and erectile dysfunction symptoms? Let’s find out together.

How do erections work?

Sexual arousal that involves a penis depends on a sequence of events occurring inside the body. If something disrupts this sequence, it can affect the ability to get or maintain an erection.

The sequence starts when the brain activates the nerves in the penis. This triggers the smooth muscle in the penis to relax so that blood can flow into the area. This increase in blood pressure causes the penis to become bigger and more erect. It then compresses the veins which have been preventing blood flow from leaving the area to help sustain the erection. The penis should stay erect until you ejaculate or stop feeling aroused.

Symptoms of erectile dysfunction

The main symptoms of ED are:

• having difficulty getting an erection
• being unable to maintain an erection
• needing a lot of stimulation to maintain an erection
• having a low sex drive

You may only experience ED in certain situations, such as when you are with a sexual partner.This means, depending on the cause of your ED, you may still be able to get an erection at other times, for example, when you wake up or during masturbation.

Importantly, ED should not be confused with premature ejaculation (when you get aroused, orgasm and ejaculate too quickly).

When to see a GP or go to a sexual health clinic

If you keep having difficulty getting or maintaining an erection, you should go to see your GP or visit a sexual health clinic. You will be able to explore the treatment options available, such as lifestyle changes and ED pills.

In addition, ED can sometimes be the first symptom of heart disease. So, it’s important to speak to a healthcare provider if you start noticing symptoms.

Early signs and symptoms of erectile dysfunction

The symptoms of erectile dysfunction can often appear suddenly. However, there may be some subtle signs in advance of a failed erection that indicate you may be at risk:

• a noticeable decrease in sexual desire (libido)
• having fewer erections, or less firm erections, when you wake up in the morning
• feeling persistently tired or stressed

Causes of erectile dysfunction symptoms

There are three main causes of ED symptoms:

1. physical health conditions
2. psychological issues
3. medications

Alternatively, having suffered injury to the penis or undergone surgery in that area can sometimes lead to ED.

Physical health conditions

There are four main types of health conditions that can interrupt the physical processes required to develop and maintain an erection. These are:

• vasculogenic conditions – heart disease, high blood pressure and diabetes. These conditions all affect the flow of blood to your penis
• neurogenic conditions – multiple sclerosis, Parkinson’s disease, spinal injuries or disorders and stroke. These conditions all affect your nervous system (brain, nerves and spinal cord), which is responsible for sending messages from the brain to the penis
• hormonal conditions – hypogonadism, hyperthyroidism, hypothyroidism, Cushing’s syndrome. These conditions all affect your hormone levels
• anatomical conditions – such as Peyronie’s disease, which causes the penis to bend, get shorter and causes pain during an erection

In addition, a common vitamin B12 deficiency symptom is erectile dysfunction. Obesity is also positively correlated with ED, meaning the higher your BMI the higher your risk of ED.

Psychological causes

About 40% of cases of ED are considered psychogenic (caused by psychological issues). These can interrupt your sex drive and prevent you from getting an erection. 

Psychological issues that can contribute to ED include:

• stress and anxiety
• performance anxiety
• depression
• relationship problems
• trauma
• low self-esteem
• cultural or religious beliefs

Medications

Certain medications can cause erectile dysfunction, such as:

• diuretics
• antihypertensives (e.g. beta-blockers)
• fibrates
• antipsychotics 
• antidepressants 
• corticosteroids (steroids) 
• H2-antagonists 
• anticonvulsants 
• antihistamines
• anti-androgens 
• cytotoxics 

The link between erectile dysfunction symptoms and age

Age is the main risk factor for ED.However, ageing does not directly cause ED.Rather, as people get older, they become more likely to develop a health condition or take a medication that causes ED. In addition, your testosterone levels can decrease with age, which can contribute to the development of ED.

However, psychological issues are the main cause of ED in younger men. Unfortunately, this can become a vicious cycle. For example, if you struggle to get an erection occasionally, due to stress or low mood, this can lead to performance anxiety which increases the frequency of the problem.

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