Overview
The ability to achieve and maintain erections when aroused is a common health issue for many men.[1] While women don’t experience the phenomenon in the same way, inadequate blood flow to female genitalia is also common — and sometimes related to the same phenomena.
Aging is the biggest risk factor for ED, but there are a host of other contributing factors,[2] such as diabetes, vascular disease, low testosterone,[3] and hypothyroidism.[4]
The potential causes of ED generally revolve around vasodilation — the widening of blood vessels — which allows the penis to accommodate more fluid, thus allowing it to become erect. Nitric oxide is a chemical messenger that tells blood vessels to dilate; a breakdown in signaling is a common reason for ED and high blood pressure.
Nitric oxide precursors and substances that lead to greater nitric oxide synthesis are commonly found in drugs and supplements aiming to improve erections. Sex hormones are involved in nitric oxide synthesis, and men with low testosterone are more likely to have ED. Anything that leads to dysfunction in the walls of the blood vessels, such as smoking, inactivity, and excessive body fat, can increase ED risk as well.
Sometimes ED isn’t a breakdown in vasodilation or a hormonal problem but secondary to psychological issues of anxiety and anhedonia — a diminished ability to feel pleasure. In this case, while some libido-enhancing supplements may be useful, the answer may not be found in supplements or dietary modification.
How are erections assessed?
A urologist, who specializes in urinary and sexual issues, is best and can assess ED through a series of medical and sexual history questions. They may also perform a mental health screening and physical exam.
During the exam, your urologist may ask you some of the following questions.
- How would you rate your confidence that you can get and keep an erection?
- How often is your penis firm enough for intercourse?
- How often are you able to maintain an erection during sexual intercourse?
- Do you have an erection when you wake up in the morning?
- Do you use illegal drugs, drink alcohol, or smoke?
While it can be uncomfortable, the more accurate your answers, the better medical care your physician can provide.
What affects erections?
Examine Database: Erections
Research FeedRead all studies
Can adding garlic enhance erectile dysfunction treatment?
Are supplemental antioxidants safe and effective for treating erectile dysfunction?
Does aerobic exercise improve erectile function?
References
- ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
- ^Selvin E, Burnett AL, Platz EAPrevalence and risk factors for erectile dysfunction in the USAm J Med.(2007 Feb)
- ^Rastrelli G, Corona G, Maggi MTestosterone and sexual function in menMaturitas.(2018 Jun)
- ^Chen D, Yan Y, Huang H, Dong Q, Tian HThe association between subclinical hypothyroidism and erectile dysfunctionPak J Med Sci.(2018 May-Jun)
- ^J Cartledge, S Minhas, I EardleyThe role of nitric oxide in penile erectionExpert Opin Pharmacother.(2001 Jan)
- ^Biljana Musicki, Tongyun Liu, Gwen A Lagoda, Trinity J Bivalacqua, Travis D Strong, Arthur L BurnettEndothelial nitric oxide synthase regulation in female genital tract structuresJ Sex Med.(2009 Mar)
- ^V Dishy, G Sofowora, P A Harris, M Kandcer, F Zhan, A J Wood, C M SteinThe effect of sildenafil on nitric oxide-mediated vasodilation in healthy menClin Pharmacol Ther.(2001 Sep)
- ^Christoph A Schmitt, Verena M DirschModulation of endothelial nitric oxide by plant-derived productsNitric Oxide.(2009 Sep)
- ^Jackson J, Patterson AJ, MacDonald-Wicks L, McEvoy MThe role of inorganic nitrate and nitrite in CVDNutr Res Rev.(2017 Dec)
- ^Hord NG, Tang Y, Bryan NSFood sources of nitrates and nitrites: the physiologic context for potential health benefitsAm J Clin Nutr.(2009 Jul)
- ^Jones AMDietary nitrate supplementation and exercise performanceSports Med.(2014 May)
- ^Gilbert DG, Hagen RL, D'Agostino JAThe effects of cigarette smoking on human sexual potencyAddict Behav.(1986)
- ^Harte CB, Meston CMAcute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled trialJ Sex Med.(2008 Jan)
- ^Harte CB, Meston CMThe inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trialJ Sex Med.(2008 May)
- ^J Peugh, S BelenkoAlcohol, drugs and sexual function: a reviewJ Psychoactive Drugs.(Jul-Sep 2001)
- ^Mark G Biebel, Arthur L Burnett, Hossein Sadeghi-NejadMale Sexual Function and SmokingSex Med Rev.(2016 Oct)
- ^G Corona, A Sansone, F Pallotti, A Ferlin, R Pivonello, A M Isidori, M Maggi, E A JanniniPeople smoke for nicotine, but lose sexual and reproductive health for tar: a narrative review on the effect of cigarette smoking on male sexuality and reproductionJ Endocrinol Invest.(2020 Apr 22)
- ^Angela Castela, Pedro Vendeira, Carla CostaTestosterone, endothelial health, and erectile functionISRN Endocrinol.(2011)
- ^Fui MN, Dupuis P, Grossmann MLowered testosterone in male obesity: mechanisms, morbidity and managementAsian J Androl.(2014 Mar-Apr)
- ^Ückert S, Kuczyk MA, Oelke MPhosphodiesterase inhibitors in clinical urologyExpert Rev Clin Pharmacol.(2013 May)
- ^Friedman JM, Friedman AJDevelopment and therapeutic applications of nitric oxide-releasing materialsFuture Sci OA.(2015 Aug 1)
Examine Database References
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