Erection Problems: Causes, Treatment, Complications

If you think that you are the only man experiencing penile erection issues, think twice. The sad truth is that men would rather keep silent about this issue than ask for help.

Unfortunately, erectile dysfunction and the need to stay silent about it seem to become a growing trend among men of all ages. Even teenagers seem to face this issue. Something must be done about it.

We recommend getting informed about the whole issue as the first step of action. If you happen to think the same, then the following article will come in handy.

Common causes of erection problems

For you to fully understand why erection problems occur, you first need to get familiar with how an erection develops. From experience, you probably know that an erection occurs whenever a man becomes sexually aroused. When that happens, the brain releases chemicals through the nerve that stimulate increased blood flow to the penis. 

The blood then flows inside two erection chambers inside the penis, both made out of spongy muscle tissue, otherwise known as the corpora cavernous.

For an erection to take place, these chambers need to relax and trap the blood inside of them. To relax the chambers, the blood is carrying nitric oxide within it, which is a chemical that helps the blood vessels to dilate and relax. The blood pressure inside these chambers maintains the penis in a fully erect, firm state. 

As soon as the man ejaculates, an opposite chain of events takes place. What happens is the chambers contracting, thus allowing the blood to return to the circulation. This will allow the erection to come down. 

Erectile dysfunction prevents a healthy erection from taking place. Despite being sexually aroused, the man cannot achieve and maintain a healthy erection during sexual intercourse. The truth is that most men will or have experienced erection problems at least once in their lifetime. Occasional erectile dysfunction is not considered to be a significant problem. Frequent erectile dysfunction, on the other hand, is and, as such, requires immediate treatment. 

The problem with frequent erectile dysfunction is the fact that it may indicate a more severe health issue. Leaving it untreated increases the risk of a long list of potential health problems and complications as well. 

But in order to treat it, doctors first need to know what it is that it has been causing it in the first place. This is where they face the first challenge. The problem with diagnosing erectile dysfunction lies in the variety of factors that may be causing it. In most cases, the issue is caused by a combination of both physical and psychological factors. 

Physical causes 

The physical causes of erection problems are more often seen in older men. In such a case, impotence is caused by a physical issue that disrupts the nerve innervation and/or blood flow in the penis.

Many health issues may be responsible for the development of erectile dysfunction. These are the most common ones:

Of all, the most common physical problem seems to be the natural decline in testosterone levels. Along with erectile dysfunction, low testosterone levels also cause a decline in sexual desire, loss of muscle mass, mood swings, hair loss, weight gain, etc. The use of tobacco and certain medications, such as beta-blockers and diuretics, may increase the risk of erectile dysfunction. 

Although prostate cancer is not a direct cause of erection problems, prostate cancer treatment often is. The treatment usually includes hormone therapy, radiation therapy, and even surgery. Radical prostatectomy involves the removal of the prostate gland and the surrounding tissues. This leads to erection problems. Hormone and radiation therapy also cause testosterone level changes, which reflect poorly on the overall testosterone production in the body.

Psychological causes

You would be surprised to learn how many erectile dysfunction cases have been caused due to psychological causes. Unlike the physical causes, a psychological cause can affect a man of any age. The most common psychological factors are:

  • Performance anxiety

  • Stress

  • Depression

  • Relationship problems, etc.

Erection problems in young men

Research shows that as much as 50% of the men in their 50s experience mild to moderate erectile dysfunction. Complete erectile dysfunction can be seen in about 20% of the men in their 70s. But scientists argue that erection problems begin long before that.

Doctors are reporting on meeting up with more and more young patients due to erectile dysfunction. A study published in The Journal of Sexual Medicine has shown that up to 26% of the menage 17 to 40 experience such issues. As much as one in four patients with erectile dysfunction are of a young age.

Researchers suspect that it has something to do with the increased use of tobacco, alcohol, and recreational drugs among young people. If you remember, we mentioned all of these factors as being common causes.

Diagnosing erection problems

After reporting the sexual issue to your primary physician, they will recommend talking to a urologist. A urologist is a doctor that specializes in treating the genitourinary tract, including the male reproductive system.

To help diagnose the erection problem, the doctor will need to perform a couple of tests. He will proceed to evaluate your mental and physical health and recommend proper treatment accordingly. The following tests may take place:

  • Physical exam – The doctor will perform a complete examination of the penis and the testicles. He may also test the bulbocavernosus reflex, which will allow an evaluation of the nerve sensation in the penis. 

  • Blood tests – Doing a complete blood work will help the doctor rule out possible causes. Using blood tests, the doctor will check against signs of erections problems such as diabetes, low testosterone, heart disease, etc. 

  • Urine tests – Similar to the blood tests, the urine tests can also help rule out specific potential causes such as diabetes or some other health problem.

  • Ultrasound – For the doctor to check the blood flow to the penis, he will need to perform an ultrasound. Using a transductor, the doctor will examine each blood vessel that supplies the penis with blood and the nutrients required. This is an invasive diagnostic method that provides quite helpful information regarding erectile dysfunction. 

  • Psychological tests – If there is no apparent physical cause, the urologist may recommend that you consult a psychologist. Because stress and depression can be common causes of sexual disfunction, the psychologist will use questions to screen for depression and/or anxiety. It is important to remember that you are in a safe space where you can share all your worries and anxieties that can help diagnose the problem’s root. 

Other tests may be performed as well. It all depends on the results provided with the initial examination. Your doctor can answer all questions that you may have on the topic. 

Treating erection problems

Let’s say that your doctor has identified the root of the problem. Now what? The good news is that erectile dysfunction is a highly treatable issue. These are the available treatment options:

Erectile dysfunction medication

Talking about medication, there are quite a few different approaches. One of the most popular options is Viagra. Viagra belongs to the group of drugs called PDE-5 inhibitors. It is taken 30-60 minutes before sex to help achieve and maintain a healthy erection. Other than oral medications, some medications are injected into the penis or the urethra, although these are less commonly used. 


Like drug therapy options, many surgical procedures can help improve erectile dysfunction. The usual approach is vascular surgery to help improve the blood flow in patients with erectile dysfunction. A penile implant exists as an option, as well. However, this is only recommended for patients with no success using drug therapy and other non-invasive treatment options. It allows the patient to achieve an erection by having a discreet device inside the penis.

Vacuum devices

Another option for those who have no success during drug therapy is the penile vacuum pump. A penile vacuum pump is sealed around the penis. It helps draw up blood to achieve an erection. A band is also used to prevent the blood from leaving the penis. 

Talk therapy

If the doctor identifies a psychological factor as the root of the problem, he will recommend talk therapy. Together with your therapist, you can discuss the reasons that have led to erection problems. Whether it is gathered up stress, depression, or relationship problems, you can discuss everything with your therapist. 

Lifestyle changes

Because of the proximity between the physical causes and the unhealthy lifestyle, doctors often advise their patients to pursue serious lifestyle changes. In cases of mild erectile dysfunction, lifestyle changes are often the first treatment method.

If no success has been achieved, it is only then that the other treatment methods are explored. Most often, the following lifestyle changes take place:

  • Daily exercise

  • Healthy diet

  • Quitting smoking

  • Reduced alcohol intake

  • Getting enough sleep

  • Trying relaxation methods

  • Using herbal remedies, such as l-citrulline

  • Relying on supplements

  • Trying out massage and acupuncture, etc

Potential complications

The potential complications of untreated erection problems are quite significant. They should, under no condition, be ignored.

Explaining the possible complications is not a strategy to scare you. It is a strategy to inform you why you should never ignore something as serious as erectile dysfunction. Here is a list of the potential complications linked to an untreated erectile dysfunction.

One of the greatest complications that can occur is progressing the health issue that has been causing the erection problems in the first place.

For example, if high blood pressure has been causing erectile difficulty, leaving the issue, untreated can potentially lead to greater consequences. Untreated high blood pressure is a risk factor for stroke, heart attack, heart disease, and metabolic syndrome leading to diabetes, etc. 

When to call a doctor?

It is not uncommon for men to keep to themselves about experiencing erectile dysfunction. The erectile problem is often the cause of feelings of shame and guilt. Men must ask for help as soon as possible.

Whether it is plain old stress or a much more serious issue such as heart disease, high blood pressure, or diabetes that has been causing it, it is up to you to call your doctor.

Please do not hesitate to call a doctor if you notice erection problems that become worse over time. It is highly important to contact your physician if you experience issues with your erectile function surgery/injury to the prostate gland. Another case scenario in which you need to contact your doctor is experiencing sexual performance changes after being prescribed a new medication. 

Proper treatment can help eliminate the cause, thus eliminating the symptoms as well. It is never an option to keep silent about such serious issues, especially not when it can lead to various potential complications that we have discussed. 

Preventing erection problems

The good news about erectile dysfunction is that it can be easily prevented. We mentioned erectile dysfunction being caused by problems with your blood flow. This means that focusing on your cardiovascular health is key. 

If you were to incorporate more of the lifestyle changes that we discussed earlier, you would see a great improvement in your overall quality of life. In addition, you would be prevented, not only erection problems, but also heart problems, obesity, high cholesterol, and many other health issues.

One of the best ways to boost your blood flow is through regular exercise. Daily exercise is also a great way to increase your testosterone levels and slow down the natural decline in testosterone production. The best choice would be a combination of weight-lifting and cardio exercises. Think about trying out running, cycling, swimming, going to the gym, or even doing a simple home workout. 

Contrary to what many people believe, cycling will not increase your risk of erection problems. Science has proven that there is no link between long hours of cycling and erectile dysfunction. On the other hand, cyclists were prone to developing prostate cancer, knowing that we would recommend avoiding long hours of cycling for the sake of keeping your prostate healthy and happy.

But exercise is not the only aspect that you should be focusing on. Diet plays a huge role, as well. Many chronic diseases, including erection problems, can be prevented by following a healthy, nutrient-rich diet. For starters, try to eliminate processed food, unhealthy fats, sugars, and excess salt. Rethink your drinking habits and limit your daily alcohol intake to a minimum. And do not even think about smoking. That is a big no-no.

And since stress is such a valuable risk factor for erection problems, do take the time of the day to take a breath and relax. Whether it is a long walk, hot bath, or a quick meditation session, use whatever you have to lower your anxiety levels.

Talk to a professional or simply talk to your partner and ask for help. Talking about the problem is very important, especially in the case where the relationship problems are the root of the issue in the first place.


Great levels of satisfaction come from one’s sexual activity. Now imagine not being able to be fully intimate with your partner. And all because of a persistent health issue such as erectile dysfunction.

Erectile dysfunction seems to affect a growing number of men worldwide. What is even more unfortunate is the fact that this issue seems to no longer pick its victims according to age. Whether tobacco use, stress, or natural testosterone decline, erection problems will find their way into your life.

The big question is – What is there to be done about it? The good news is that there are plenty of options to be explored. Depending on the cause, your doctor can help you solve this issue and return to enjoying your bedroom time. Do not hesitate to ask for help. Consult your doctor today.


  1. Pastuszak, A. W. (2014). Current Diagnosis and Management of Erectile Dysfunction. Current Sexual Health Reports, 6(3), 164-176. doi:10.1007/s11930-014-0023-9
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  3. Capogrosso, P., Colicchia, M., Ventimiglia, E., Castagna, G., Clementi, M. C., Suardi, N., . . . Salonia, A. (2013). One Patient Out of Four with Newly Diagnosed Erectile Dysfunction Is a Young Man—Worrisome Picture from the Everyday Clinical Practice. The Journal of Sexual Medicine, 10(7), 1833-1841. doi:10.1111/jsm.12179
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  4. Hayes, L. D., Herbert, P., Sculthorpe, N. F., & Grace, F. M. (2017). Exercise training improves free testosterone in lifelong sedentary aging men. Endocrine Connections, 6(5), 306-310. doi:10.1530/ec-17-0082
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  5. Hollingworth, M., Harper, A., & Hamer, M. (2014). An Observational Study of Erectile Dysfunction, Infertility, and Prostate Cancer in Regular Cyclists: Cycling for Health UK Study. Journal of Men’s Health, 11(2), 75-79. doi:10.1089/jomh.2014.0012
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