Erectile dysfunction is diagnosed as a disorder when a man experiences difficulty or complete inability to obtain or keep an erection, with a three month period being the general medical basis for diagnosing the condition. It is most common in men over 40 years old, but can affect men of any age, especially those with certain risk factors relating to health and lifestyle.

 

ED can be caused by either physical or psychological factors – or sometimes both. Erectile function is a complex process that involves many parts of the body including the brain, so when something becomes unbalanced it can lead to partial or complete impotence. Sometimes, an unknown underlying health problem can be the cause of ED, but there are many reasons why you might start experiencing this very distressing problem. These include:

 

Mental stress

When you’re dealing with excessive life stress, whether it be work related, relationships, financial or anything else this will have a negative effect on the brain. The brain is a critical part of erectile function, therefore ongoing stress is a common cause of erectile dysfunction.

 

Cardiovascular

Heart disease, atherosclerosis, high blood pressure and high cholesterol are all risk factors for a man to get erectile dysfunction. Vascular related diseases or disorders can affect how much blood can get to the penis and how long it can stay there, which has a direct impact on erection quality. Some anabolic steroids pose a risk to increasing blood pressure, cholesterol or both. In these cases it is critical to monitor your levels regularly not only to help avoid ED, but for your general health.

 

Diabetes

Men with diabetes often have decreased levels of testosterone, but that is not the main driver of ED in diabetic men. People with this disease can have abnormal blood supply to the penis, resulting in an inability to gain or keep an erection. When blood sugar levels are not managed correctly by a male diabetic it results in less production of nitric oxide, contributing further to erectile dysfunction.

 

Obesity

Being very overweight brings with it a host of health problems, so ED can be either a direct or indirect consequence of obesity. Obese men are more likely to have diabetes, high blood pressure and other conditions which are known to cause erectile dysfunction. Being obese can cause blood vessels to become damaged, testosterone to lower, and the body to succumb to increased inflammation – all things which are linked to impotence.

 

Depression and anxiety

Normal functioning of the penis is as much psychological as it is physical, and men who are suffering from even mild to moderate depression, anxiety or stress can find themselves experiencing erectile dysfunction. Counseling and other psychological therapy can often assist with relieving ED that’s caused solely by anxiety and other mental health related conditions.

 

Drugs and medications

Many over the counter, prescription and recreational or illicit drugs are known to potentially cause ED. Many medications have side effects that can affect blood circulation, hormone function, the nervous system or mental health; all potentially leading to erectile difficulties. The list of drugs that could contribute to ED is extensive, but includes many blood pressure medications, diuretics, anti-anxiety and anti-depression medications, antihistamines, NSAID’s, and cancer treatment drugs.

 

Sleeping disorders

Problems with sleep quality can impact all parts of your life, including sexual function. Besides chronic tiredness from lack of sleep, sleep disorders like sleep apnea can negatively impact your testosterone levels and even your oxygen levels. Studies have shown that men with obstructive sleep apnea have a high tendency to report suffering from ED and males with this sleep condition are more likely to suffer from ED than men without sleep apnea.

 

Anabolic steroids

These can work in several ways to hamper erectile function. We know that some anabolic steroids can cause high blood pressure and high cholesterol, and those two factors can bring about ED, especially in men who might have already had cholesterol or hypertension but wasn’t aware of it.

 

Depending on the cause of your ED, there are steps every man can take to at least reduce the risk or severity of erectile dysfunction provided there’s not a serious health issue as the cause. Quitting smoking, getting regular exercise and living a healthy lifestyle all reduce the risk of ED, as does limiting alcohol intake and reducing stress. Keeping your blood pressure, blood sugar and cholesterol levels at a healthy level is perhaps the most critical part of avoiding ED for bodybuilders, as these are aspects which can be negatively affected by a number of the most popular steroids used.

 

The most obvious symptom of ED is of course the inability to get an erection. This can include not being able to get an erection at all, or not being able to sustain an erection for long enough. A decrease in sexual desire is another recognized symptom of impotence.

 

While any of these symptoms are not a cause of concern if they only happen every now and then, it’s when you are experiencing a persistent inability to get or keep an erection that ED becomes a medical concern. Medical professionals consider three months of erectile difficulty as a suitable time period to consider this to be diagnosed as a medical condition.

 

Some men with ED find that it happened literally overnight, while for others it can be a much more gradual process, with increased erection difficulty being noticed over time until it finally gets to a point where can no longer get an erection at all. When ED is being cause mostly for psychological reasons, such as stress or performance anxiety, you might find it comes and goes and may get better on its own.

 

It’s important to be aware that ED symptoms can be different depending on what’s causing the problem. Chronic impotence – when it usually begins to happen gradually and gets worse over time without ever getting better – is almost always a sign that there’s a physical underlying cause such as diabetes or cardiovascular conditions.

 

Psychological related ED tends to be more sporadic, with periods of normal functioning combined with other times where you struggle to get an erection. In some men, it’s a combination of both and only your doctor can give you a proper diagnosis of the real cause of your erectile dysfunction.

 

When should you speak to your doctor about your ED concerns? This is a potentially embarrassing situation for men, but keep in mind that millions of men have spoken to a doctor about this very issue, and doctors will professionally evaluate your unique situation and medical history.

 

 

These drugs are a standard medical treatment for erectile dysfunction and include the famous drug Viagra, amongst others. PDE5 drugs causes dilatation of the blood vessels in the penis. They work by blocking the phosphodiesterase type 5 enzyme.

 

These drugs increase nitric oxide which brings about relaxation to the penis muscles so that blood is able to flow through the penis better and increase the chances of an erection being achieved.

 

Sexual stimulation is still needed when you use one of these medications. This is when the release of nitric oxide occurs. In healthy men, this results in an erection, but those needing a PDE5 inhibitor for ED will then rely on the drug to stimulate the release of nitric oxide after stimulation, so that blood can then flow to the penis and an erection can occur.

 

While they are now very well established, widely used and considered safe for the vast majority of men who are prescribed them, like most medications PDE5 inhibitors come with their potential side effects which you can find out more about below.

 

There are four commonly prescribed PDE5 inhibitor drugs, with Viagra no doubt being the most familiar. Here is the full list:

Vardenafil (Levitra)

Avanafil (Stendra)

 

All work in a similar core way to enhance nitric oxide so that blood flow to the penis is increased. Nitric oxide is critical in the process of causing the penile muscle to relax so that blood can flow and an erection can be both gained and maintained. Various health conditions (diabetes, high blood pressure) can cause natural nitric oxide function in the body to become impaired, which is then known to result in potential erectile dysfunction.

 

The main differences to look for with these drugs is their active life or half life (how long they provide the desired effects for). All of these medications are long proven to effectively treat erectile dysfunction and are considered safe for men who are not taking nitrate drugs, do not have heart disease and do not have hypotension (very low blood pressure).

 

 

The most famous of all ED drugs is Viagra. It is absorbed very quickly into the bloodstream and takes just one hour to reach its maximum level of concentration in the blood; meaning that Viagra starts working rapidly.

 

The duration of the effects of Viagra will depend on your dosage, but it’s possible that the drug’s effects are active for over five hours in some people. This allows a relatively wide period of time when you can take the drug and have it be effective; in other words, it can be taken anywhere from one to several hours before you plan to have sex with noticeable effects beginning between half an hour and one hour after taking a dose.

 

The majority of Viagra users experience no to only mild side effects and due to the drug’s short half life, side effects also disappear within three to five hours as the drug exits the body.

 

Cialis has the longest acting effects of all four PDE5 inhibitors (Viagra, Cialis, Levitra and Stendra) at up to 36 hours from a single dose. It also starts working faster than Viagra in most men with effects beginning in as little as 15 minutes after a dose, and before 45 minutes for most people.

 

Selecting Cialis over Viagra usually comes down to preference for the length of time you wish to enjoy the effects without resorting to multiple doses as would be required with Viagra. Besides ED, Cialis is also used to treat benign prostatic hyperplasia and pulmonary arterial hypertension.

 

Not everyone will experience side effects when using a phosphodiesterase type 5 (PDE5) inhibitor medication, but it’s wise to be aware of the potential negative effects that you could notice after you start taking one of these drugs to treat ED.

The main reported side effects of any of these medications can include:

 

Facial flushing/Nasal congestion/Headaches/Visual changes/Back pain/Dizziness/Sleep problems/Sore throat/Stomach upset/Decreased blood pressure/Abnormally long erections

 

Natural androgens produced in the body are responsible for all the characteristics that make a male a man. These are male sex hormones, including testosterone, that develop male traits as well as in reproduction. Androgen therapy for ED is essentially hormone replacement therapy with the focus on testosterone.

 

This treatment option is mostly considered for men who are suffering with low libido, depressed mood and other factors that are caused by low testosterone. 

 

When androgens are used to treat erectile dysfunction caused by low testosterone, these drugs can come in different forms including oral medication, gels, injectable and even transdermal application. Some men take a combination of testosterone and PDE5 inhibitors as it is possible that this combo gives some men better results.

 

This is a treatment option that most men are likely to be very hesitant to consider, for good reason. Penile injections are a daunting thought, but it’s worth looking into what this particular treatment is beneficial for. By injecting a vasodilator like a prostaglandin directly into the penis, a doctor is able to very quickly determine whether the blood vessels are functional and able to dilate. This in fact makes this method a very good diagnostic tool as well as a treatment.

 

Men who undertake this type of therapy for ED can be taught by their doctor how to self-inject the formula into the penis. Because the erection develops so quickly after injecting PGE1, this is the only option for men who want to make practical use of the treatment in their sex lives – for some men though the prospect of regularly injecting into the penis is not something they wish to consider, and if you’re one of those men then you’re likely to look into other treatment options such as oral medications.

 

Studies show that the longer and more frequently that anabolic steroids are used, the higher the chance of a man experiencing ED. But importantly, the study also found that men who make use of anti-estrogen drugs were able to more successful maintain normal erectile function after using anabolic steroids, indicating the critical important of post cycle therapy(PCT).

 

There are two reasons that men will choose to take Viagra while using anabolic steroids: one is to take advantage of the way this drug dilates the arteries for improved blood flow which is not only beneficial for performance enhancement, but can also get the steroids moving through the body more efficiently.

 

The second reason for Viagra being used with steroids is to treat potential erectile dysfunction as a side effects of the steroids, which is of course the main purpose of Viagra.

 

 

Yes and no. Using some anabolic steroids can give you a higher risk of ED, but many steroid users will make use of a testosterone source during a steroid cycle as well and this has shown in studies to reduce the occurrence of erectile dysfunction, however if testosterone is stopped then ED and other problems like decreased libido are likely without proper PCT(Post Cycle Therapy).

 

When using anabolic steroids, taking an exogenous testosterone ester can help to prevent ED. But for men who do not use steroids and are suffering from erectile dysfunction for any other reason, testosterone is very unlikely to help with the problem when the man has normal testosterone levels, or even those who have low T but have no other symptoms like low libido and fatigue.

 

Even though men will see their levels of serum testosterone decrease as they age, this is rarely low enough to cause ED. The cause of impotence is usually related to other problems.

 

There is no known benefit for combining these two for men with low testosterone levels, when it comes to treating ED. But when it comes to steroid users who might be using testosterone in a cycle, there is no known danger in using Viagra as well and this is sometimes done to reverse the ED side effects of some steroids.

 

Viagra and other PDE-5 inhibitor drugs have not been formulated to affect testosterone, but instead to encourage blood supply and muscle relaxation in the penis. However studies have shown that an unexpected effect of Viagra when taken by men with both ED and low testosterone is that it resulted in an increase in serum total and free testosterone, with researchers being confident that Viagra has a direct effect on the testicles which can benefit men with existing low testosterone.

 

Most of the side effects from Viagra are mild, like headaches and facial flushing. But we know for a small percentage of men, the adverse effects can be much more serious. In the first nine years of Viagra’s existence starting in 1998, a study found that over 1800 men who were using the drug died, with most of them being heart attacks.

 

The main culprit is believed to be when men with existing heart problems combined Viagra with angina medications called nitroglycerin, their blood pressure dropped to dangerous levels. Now doctors never prescribe Viagra to men who are taking nitrate medications for angina.

 

The better drug is the one that works for you. Both are PDE5 inhibitors but one of the major differences is the length of time each one is effective: Viagra lasts for up to 12 hours while the effects of Cialis last much longer: up to 36 hours. Another consideration is that Viagra works best when taken on an empty stomach, while Cialis is not affected by food. When it comes to treating ED, both drugs have shown to have a very similar rate of successful results.

A possible side effect of Winstrol (Stanozolol) is actually the opposite to ED: some men can experience prolonged or frequent erections.

 

If you’re embarrassed about seeing a doctor about your ED you might have thought about trying any available over the counter (OTC) treatment options. Potential options include the natural hormone Dehydroepiandrosterone (DHEA), the amino acid L-arginine, and herbs like yohimbine and ginseng. There is no scientific proof that any of these natural ED treatments are effective, especially in men who have serious underlying causes of ED like diabetes and high blood pressure.