What is erectile dysfunction?

The term means an inability to achieve or maintain sufficient erection in order to carry out an intercourse with triggering. The symptom should occur in at least 25% of the situations where erection is desired before it is defined as a medical problem. In many, the state leads to significant negative effects in terms of self-esteem and relationship with the partner.

The most common reason is psychological

Previously negative sexual experience.
Performance anxiety.
The morning effect is intact and the patient usually gets erection and orgasm through masturbation. This is an important sign that distinguishes psychological causes from some bodily disease changes.

The condition affects 5% of all 40-year-olds, 10% of 50-year-olds and 20-25% of men over 65 years. There are studies that show a much higher incidence of the problem. In men with diabetes, between 30% and 50% have erection problems.

Previously, it was thought that impaired sexual function was a natural part of aging. Changed views in the population and modern medicine have now rejected this myth. Nowadays, men and their doctors feel more comfortable talking about sexual problems and as new treatments appear, men can often remain sexually active up to the age of 70 and later.


Being able to receive and maintain an erection is dependent on several factors.

Psychological conditions mentioned above.
Nerve impulses.
Male sex hormone, testosterone, is needed for sex drive.

Blood flow in the penis must also be intact so that there may be an accumulation of blood in the swelling bodies of the penis.

Defects in these systems reduce the potency. In addition, different medicines, especially medicines for severe mental disorders, may have an adverse effect on sex drive and erectile ability.


The diagnosis is made after examination and conversation. As mentioned above, the psychological factors are the most common cause of erectile dysfunction. The doctor also takes different blood samples, but the benefit of these is limited.

Factors that indicate mental cause:

Sudden debut of the problem.
Short-term erection.
Good quality or better experience in spontaneous action, self-stimulated erection or morning reaction.
Early or no trigger.
Problems or changes in relationship with the partner.
Important life events or psychological problems.

Factors that may indicate cause:

Gradually debut of the problem.
Absence of nightly erections.
Normal trigger.
Normal sex drive.
Bodily diseases such as diabetes, neurological disease or cardiovascular disease.
Operations, radiation or injuries in the abdomen.
Smoking, high alcohol consumption, use of dop preparations.

In exceptional cases, it may be appropriate to do an intravenous injection test with a specialist. The investigation means that a vasodilator is injected into the penile swelling bodies. This usually causes blood supply in the area to increase so that erection occurs. If successful, this can also be a possible form of treatment.


There are several things you can do yourself to improve the situation.

If you reduce your consumption of tobacco and alcohol, this can have a big effect.

Many may also benefit from information about the permit.
Call therapy, possibly with the partner, may be good for psychological reasons.

Drug treatment

The most commonly used preparations contain sildenafil, tadalafil or vardenafil. These means help both for mental and physical reasons. The risk of heart and blood vessel side effects is not higher in heart disease or patients receiving blood pressure treatment, except for those treated with nitrate-containing medicines. The most common side effects are headache, redness, discomfort in the upper abdomen, nasal congestion and dizziness. A few may experience visual disturbances.

Sildenafil is available in several strengths and is locally effective. The recommended dose is 50 mg taken as needed approximately one hour before sexual activity. The dose may be increased to 100 mg or reduced to 25 mg. For effect, sexual stimulation requires sexual stimulation for about three to six hours. Therefore, the preparation should not be used by patients who use nitrates or have an unstable coronary disease. It has also been shown to be effective in the treatment of erectile dysfunction due to the use of drugs for mental illness.

For tadalafil, the recommended dose is 10 mg taken 30 minutes to twelve hours prior to sexual activity. The dose may be increased to 20 mg if the effect is insufficient, but not in patients with impaired liver or renal function. The effect of the preparation may be for up to 24 hours. One advises more than one dose a day.

For vardenafil, the recommended dose is 10 mg taken 25-60 minutes before sexual activity. The dose can be adjusted down to 5 mg or up to 20 mg.

Alprostadil is a medicine used for local treatment. The preparation is placed in the urethra using a special applicator. The effect occurs relatively quickly and there is less risk of side effects than with sildenafil. Side effects are pain in the penis of every third patient and a burning pain in the urethra of about 10%.

Self-injection with vasodilators is also used by a few. The injection must be done before intercourse and the effect lasts for 30-60 minutes. Side effects in the form of long and painful erection may occur.

Testosterone is only relevant in cases where low testosterone levels have been detected in the body.


In some cases, it may be advisable to straighten out any incision in the penis through surgery.

Operation to improve blood flow in the penis can have effect, but is rarely done. In some cases a penile prosthesis can be operated. Other possible treatment methods are the use of pubic ring and / or vacuum pump. The pubic ring should be placed around the penis root after erection and then sitting during the intercourse.

This inhibits the backflow of blood from the penis, and the erection can be retained throughout the intercourse. The vacuum pump makes the penis rigid enough for intercourse. These actions are often combined. First, the vacuum pump is used for erection and then the pubis ring is pressed to maintain the erection. The problem with these measures is that they are often dense and unpleasant.


As already mentioned, there are many different treatment options for erectile dysfunction problems. Most patients experience better erectile dysfunction after different treatment options.

In the long term, the forecast depends on what caused the inconvenience.