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Jennifer Nelson

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About Author — Jennifer is a freelance writer in the Midwest who writes about a variety of topics but especially enjoys educating people about their health and the health of their pets.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog.

Every man experiences difficulty getting or keeping an erection from time to time, but when it becomes a regular problem, it’s referred to as erectile dysfunction (ED). As many as 30 million men suffer from erectile dysfunction, and it’s the most common sex problem men report to their doctors.

What are the causes and risk factors of erectile dysfunction? Are there any side effects? What are the various treatment options for ED? Can you buy ED drugs online? Let’s take an in-depth look at erectile dysfunction and ED drugs so you can find the answers you’re looking for and find treatment options.

Erectile Dysfunction Symptoms

Erectile dysfunction symptoms include persistent difficulty with:

  • Getting an erection
  • Maintaining an erection
  • Reduced sexual desire

How Erections Work

To understand how erectile dysfunction treatments help, you should understand how erections work.

When a man becomes aroused, nerves send signals to increase blood flow into spongy areas of the penis called the corpus cavernosum. The blood vessels in the penis relax, allowing blood to be trapped in the penis. The extra blood trapped in the penis is what causes an erection.

After an orgasm, different nerves send signals to increase the pressure in the blood vessels in the penis, which pushes the excess blood out of the penis and back into the rest of the bloodstream.

As you can imagine, any problems with the nerves or blood vessels in or around your penis can cause problems with the ability to get an erection or keep one long enough for sexual activity. That’s one reason there are so many different causes of erectile dysfunction.

Causes of Erectile Dysfunction

Erectile dysfunction can have physical causes, psychological causes, or both. For example, if high blood pressure causes a man to have erectile dysfunction, he may become anxious about it, and that anxiety can further contribute to ED.

It’s important to note that erectile dysfunction can be a symptom of many different health conditions. While you can just treat the symptom of ED, you should try to determine the cause of the ED and treat that cause. Many health conditions that can cause erectile dysfunction are very serious and may kill you in time without treatment.

Examples of physical causes of erectile dysfunction
Physical causes of erectile dysfunction may include:

  • Alcoholism or drug abuse
  • Blood vessel diseases
  • Clogged blood vessels (atherosclerosis)
  • Diabetes
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Hormone problems (such as low testosterone or thyroid hormone)
  • Kidney disease
  • Metabolic syndrome — a condition that includes increased blood pressure, high insulin levels, fat around the waist, as well as high cholesterol
  • Multiple sclerosis
  • Obesity
  • Parkinson’s disease
  • Peyronie’s disease (scar tissue inside the penis)
  • Prescription medications (more than 200 medications can cause ED)
  • Prostate enlargement
  • Radiation therapy to the pelvic region
  • Sleep disorders
  • Surgeries or injuries that affect the spinal cord or pelvic area
  • Tobacco use
  • Treatment for prostate cancer or an enlarged prostate
  • Venous leak (a leak from the big vein in your penis)

Psychological causes of ED may include:

  • Anxiety
  • Depression
  • Fear of intimacy
  • Guilt
  • Relationship troubles
  • Stress

Examples of Medications That Can Cause Erectile Dysfunction

There are more than 200 prescription medications that can cause erectile dysfunction. A few examples include:

  • Anticholinergics
  • Antidepressants, including monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants
  • Anxiety treatments
  • Drugs that work on the central nervous system, including some sleeping pills and amphetamines
  • Drugs that control high blood pressure
  • Heart medications like digoxin
  • Hormone drugs
  • Opioid painkillers
  • Prostate treatment drugs
  • Some cancer drugs, including chemotherapeutic agents
  • Some diuretics
  • The peptic ulcer medication cimetidine

Can Riding a Bicycle Cause ED?

There are rumors that men who frequently ride a bicycle are at a higher risk of developing erectile dysfunction, infertility, or prostate cancer. Research is limited and mixed in this area, but one study showed that, while bicycling does not increase the odds of developing ED or infertility, it may lead to an increased risk of prostate cancer.

Other studies have shown that frequent cycling may injure the perineum, the area between your penis and your anus. This area is filled with veins and arteries that provide blood to the penis. Having a sore or injured perineum may lead to ED.

Luckily, there are things you can do to reduce your risk such as wearing padded bike shorts and getting a wider bicycle seat.

Risk Factors for ED

As men age, they become more likely to develop ED. Other than age, additional risk factors for erectile dysfunction include:

  • Being overweight (obesity is even worse)
  • Certain medical treatments like prostate surgery or radiation treatment for cancer
  • Drug and alcohol abuse
  • Injuries, especially if they damage the nerves or arteries responsible for erections
  • Medical conditions like heart disease or diabetes
  • Medications, including antidepressants, antihistamines, and medications to treat high blood pressure, pain, or prostate conditions
  • Psychological conditions like anxiety, depression, or stress
  • Tobacco use

Prostate Disease and Erectile Dysfunction

Prostate disease and prostate cancer generally do not contribute to erectile dysfunction by themselves. However, treating these problems, especially with things like radiation or prostate surgery, can lead to erectile dysfunction.

Complications of Erectile Dysfunction

Naturally, there are many complications related to dealing with erectile dysfunction, including:

  • An unsatisfactory sex life
  • Embarrassment or low self esteem
  • Inability to conceive
  • Relationship problems
  • Stress or anxiety

Preventing ED

Luckily, there are some things you can do to help prevent the chances of developing erectile dysfunction. Ways to prevent ED include:

  • Exercise regularly
  • Get help for anxiety, depression, or other mental health concerns
  • Reduce stress
  • See your doctor for regular checkups and medical screening tests
  • Stop smoking, limit or avoid alcohol, and don’t use hard drugs
  • Work with your doctor to manage diabetes, heart disease, or other chronic health conditions

Diagnosing Erectile Dysfunction

As long as your doctor doesn’t suspect that an underlying health condition is the cause of your ED, talking to your doctor about your symptoms and medical history may be enough for them to diagnose you with erectile dysfunction. If your doctor believes you may have an underlying condition that’s causing your symptoms, they may run tests like these to determine what condition you may have:

  • Blood tests to check for things like diabetes, heart disease, low testosterone, or other health conditions.
  • Physical exam to check the condition of your penis and testicles, including checking your nerves for sensation.
  • Psychological exam to screen for things like anxiety or depression.
  • Ultrasound to check for blood flow problems.
  • Urine tests to check for diabetes or other health concerns.

ED Treatments

The first key to treating erectile dysfunction is to manage any underlying health conditions that may be causing it. Beyond that, there are a wide variety of treatments that may help, including:

  • Oral medications like Viagra and Cialis
  • Topical or injected medications such as testosterone replacement or Alprostadil suppository or injection
  • Penis pumps
  • Penile implants
  • Exercise
  • Counseling
  • Quitting smoking
  • Losing weight
  • Treating drug or alcohol problems
  • Working through relationship issues

Erectile Dysfunction Drugs

Oral ED medications enhance the effects of nitric oxide, which relaxes the muscles in the penis, allowing more blood to enter and produce an erection. The pills don’t cause an immediate erection – sexual stimulation is still required to get an erection. Some erectile dysfunction drugs (like Viagra) have a short-term effect and are taken 30 minutes to 4 hours before sexual activity, while others (like Cialis) are taken daily to be able to get an erection whenever the mood is right.

The most popular erectile dysfunction drugs include Cialis and Viagra.

  • Avanafil (Stendra)
  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)

These medications can cause side effects, some of which may be serious, including:

  • Allergic reaction
  • An erection that’s painful or lasts longer than 4 hours
  • Backache
  • Burning or itching while urinating
  • Diarrhea
  • Dizziness
  • Feeling like you might pass out
  • Flushing (reddening of the face)
  • Headache
  • Hearing problems
  • Heart attack
  • Heartburn
  • Insomnia
  • Irregular heartbeat
  • Muscle or back pain
  • Nasal congestion
  • Numbness or tingling in hands or feet
  • Rash
  • Ringing in the ears or sudden hearing loss
  • Seizures
  • Sensitivity to light
  • Shortness of breath
  • Swelling in hands, feet, or ankles
  • Upset stomach
  • Visual changes

ED drugs can be very dangerous if taken with certain other medications or medical conditions like:

  • Heart disease or failure
  • Low blood pressure
  • Nitrate drugs like nitroglycerin

Topical or Injectable Medications

While oral medications are the most popular options for treating ED, they aren’t the only medications available for treating erectile dysfunction. Other medications include:

  • Alprostadil self-injection involves using a fine needle to inject a drug directly into the side or base of the penis that will create an erection that lasts for up to an hour. Side effects may include prolonged erection (priapism), mild bleeding from the injection, or the formation of fibrous tissue at the injection site.
  • Alprostadil urethral suppository is a tiny suppository that you place inside your urethra with a special applicator. It can help create an erection within around 10 minutes that may last from 30 to 60 minutes. Side effects may include minor bleeding in the urethra, pain, and formation of fibrous tissue inside your penis.
  • Testosterone replacement therapy may help treat ED caused by low levels of testosterone.

Penis Pumps or Implants

When medication isn’t enough, penis pumps or implants may help.

  • A penis pump uses suction to pull blood into the penis. A tension ring is placed around the base of the penis to keep the blood in there during intercourse. The ring is removed after sex. Side effects of penis pumps and tension rings may include bruising and a penis that is cold to the touch.
  • Penile implants are a last resort option when nothing else works. Inflatable or bendable rods are inserted into the sides of the penis to manually create an erection.

Kegel Exercises for ED

While Kegel exercises are often associated with women who struggle with incontinence or who are recovering from childbirth, men can benefit from Kegel exercises, too. These exercises strengthen the pelvic floor and can help treat erectile dysfunction. To do Kegel exercises:

  • Identify your pelvic floor muscles by stopping your urine mid-stream. These are the muscles you will use during your Kegel exercises.
  • You can do Kegel exercises while sitting or standing. Tighten and hold your pelvic floor muscles for 5 seconds, then relax.
  • Aim to do 10 to 20 repetitions every day.
  • You should notice an improvement in your symptoms within about 6 weeks.

Supplements and Alternative Treatments for ED

There are a massive amount of products on the market that promise to treat erectile dysfunction, often with herbs or other “natural remedies.” The Food and Drug Administration (FDA) warns against any ED treatment that doesn’t come from a doctor since they don’t regulate any supplements or other products. These alternative treatments may be ineffective at best and dangerous at worst.

It isn’t worth your health to try unproven treatments that may contain dangerous or contaminated ingredients. Stick with treatments that are prescribed by a doctor.

Buying Erectile Dysfunction Drugs Online

While there are plenty of websites purporting to sell ED drugs online, many of them are not reputable. If a deal seems too good to be true, it probably is. In order to get safe and reliable ED medication, you need a prescription from a doctor. Any site claiming to sell ED medication that does not require a prescription is a scam.

Luckily, you can make an appointment with an online doctor and have a phone or video appointment. If the doctor deems it appropriate for your treatment, they can send an electronic prescription to your pharmacy so you can pick up real, trusted ED drugs.

Contact PlushCare Today to get ED Drugs Online

With PlushCare, there’s no need to go into your doctor’s office to get ED drugs. Simply make an appointment with our trusted online doctors by clicking here or calling (888) 608-5845. After discussing your symptoms, medical history, and other medications, the doctor can electronically send a prescription for erectile dysfunction drugs to the pharmacy of your choice. Don’t get scammed buying ED drugs online when you can get the real thing by talking to one of our experienced doctors today. It’s fast, easy, and discreet.

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