If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Problems getting or maintaining an erection happen to all men occasionally. However, if these difficulties are getting in the way of your sex life, then you may have a medical condition called erectile dysfunction (ED). With ED, you cannot get an erection or stay firm enough to have satisfying sex. According to the National Institutes of Health (NIH), you may have ED if you experience any of the following (NIH, 2017):
- You can get an erection sometimes, but not each time you want to have sex.
- You get an erection during sex, but it does not last long enough for satisfactory sex.
- You are never able to get an erection.
You are not alone in dealing with this issue: ED is a common sexual dysfunction affecting over 30 million men (AUA, 2018). But there’s good news! Most men with ED find a treatment that works for them.
- Erectile dysfunction (ED) affects 30 million men—but it is treatable!
- Treating some of the underlying causes of ED (medication side effect, poor diet, stress, lack of exercise, smoking, etc.) may reverse your ED.
- Other treatable causes of ED include diabetes, heart disease, high blood pressure, high cholesterol, etc.
- The only FDA-approved oral medications for treating ED are the phosphodiesterase 5 (PDE5) inhibitors, like sildenafil (brand name Viagra), vardenafil (brand name Levitra), tadalafil (brand name Cialis), and avanafil (brand name Stendra).
- Other treatment options include injectable medications, medications that are inserted into the urethra, mental health therapy, natural supplements, and/or procedures.
Can ED be reversed?
Several factors can lead to ED—some are reversible, and others are treatable. Alternatively, a combination of reversible and treatable factors may be at the heart of the problem. Identifying the causes of ED will help you figure out how to reverse it.
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Reversible causes include stopping medications that may be affecting your erectile function, psychological factors, and poor lifestyle habits. By changing these underlying causes, you may be able to reverse ED. For example, some medications can contribute to ED, and stopping or adjusting the dose (under the guidance of a healthcare professional) may improve erectile function. These medications include (NIH, 2017):
- Blood pressure-lowering medications (e.g., beta-blockers, diuretics)
- Antiandrogens (medicines used for prostate cancer therapy)
- Antidepressants (e.g., selective serotonin reuptake inhibitors or SSRIs)
- Prescription sedatives (medicines that help you calm down or sleep better)
- Medications to treat acid reflux or stomach ulcers
Alternatively, certain reversible lifestyle habits can also lead to ED:
- Poor diet
- Alcohol overuse or abuse
- Illegal drug use
- Being overweight or obese
- Lack of physical activity
By addressing these issues and engaging in healthier habits, you may be able to reverse your ED. Not to mention that quitting smoking, eating healthy food, exercising, losing weight, and avoiding excessive drug and alcohol use are all key to healthier living in general.
Lastly, psychological factors may play a role independently or in combination with any of the factors already mentioned. Performance anxiety, life or relationship stressors, and self-esteem issues have all been linked to ED.
ED may be an early warning sign of more serious underlying conditions that, while not reversible, are often treatable. ED can act as a “check engine light” indicating that you need to talk to your healthcare provider about other underlying medical issues, especially those that affect the blood vessels and blood flow to the penis. Some health conditions that are related to ED include:
- Type 2 diabetes: Men with diabetes are more than three times as likely to have ED and may develop it 10–15 years earlier than men without diabetes (Kouidrat, 2017)
- Heart disease
- Low testosterone levels
- High cholesterol
- High blood pressure (hypertension)
- Atherosclerosis (hardening of arteries due to cholesterol plaques)
- Chronic kidney disease
- Multiple sclerosis (MS)
- Peyronie’s disease (scar tissue in the penis)
- History of surgery, injury, or nerve damage to the penis, spinal cord, prostate, bladder, or pelvis
Depending on the cause of your ED, you may be able to reverse your ED with lifestyle changes like eating a healthy diet, losing weight, smoking cessation, and stress management. Or your healthcare provider may recommend a modification in your medication regimen if one of your prescriptions is contributing to your ED. Alternatively (or in combination with lifestyle changes), you can treat some of the non-reversible causes of ED with medications, natural remedies, and/or procedures.
The only oral prescription medications FDA-approved for treating ED are the phosphodiesterase-5 (PDE5) inhibitors, including:
- Sildenafil (brand name Viagra)
- Vardenafil (brand name Levitra)
- Tadalafil (brand name Cialis)
- Avanafil (brand name Stendra)
The American Urology Academy reports that 70% of men will have better erections after using PDE5 inhibitors (AUA, 2018). If you have low testosterone levels in your blood, your healthcare provider may recommend testosterone therapy. Other medical treatments include drugs like alprostadil, either alone or in combination with other medications.
These combinations (called “Bimix” or “Trimix”) may be injected into the penis or inserted into the urethra (AUA, 2018). Some herbal supplements, like ginseng, show potential as possible treatments, but results are preliminary and more research is needed in these areas (Borrelli, 2018). Surgery involving the placement of a bendable or inflatable implant in the penis (penile implant) is an option for some men.
Don’t neglect your mental health. Anxiety about sexual performance, general anxiety, depression, self-esteem issues, and life stressors can all interfere with a man’s ability to get an erection. Talk to your partner about your personal and/or relationship problems that may be linked to your ED. It’s important to be open and honest and have your partner involved in the treatment plan.
ED may not always be reversible, but it is often treatable. Sometimes ED can be a sign of an underlying medical issue—talk to your healthcare provider about your symptoms and possible treatment options. Together, you can identify potential causes and start down the path to improved sexual health and satisfaction.