Facing issues in keeping penis erect and firm enough to sexually satisfy one’s partner? Don’t fret, it’s treatable!
Most men at some point in their lives have their penis behaving not right, indicating a sexual health concern- erectile dysfunction. Some men may not be facing any issues currently but have possible problems lurking beneath the surface. The good news is that there are remedies available to restore sexual function to virtually all men and a vast majority of men do respond to such therapies. But, the foremost thing that men must keep in mind is to not feel embarrassed about their penile or sexual problems and hide from the urologist. In any case, any kind of problem with the penis must not be ignored. It’s recommended to consult a certified urologist who could help properly diagnose the penile condition, find out its causes, and accordingly provide a treatment plan. [1, 2]
What is Erectile Dysfunction?
Erectile dysfunction (ED), also referred to as impotency, is the persistent inability of males to get or keep up a sufficient penile erection for up-to-the-mark sexual performance. Researchers predict that by 2025, the prevalence of erectile dysfunction in men aged 40-70 years would be approximately 322 million throughout the world.
If men are having trouble keeping their penis erect for sex from time to time, it’s not necessarily a concern. However, if they are experiencing erectile dysfunction as an ongoing problem, they can feel stressed, have lower self-confidence, and also face relationship issues. [3, 4]
Causes of Erectile Dysfunction
For sexual arousal in males, many factors play a role including their emotions, brain, nerves, hormones, blood vessels, and muscles. Erectile dysfunction can happen as a result of any of these. Mental health issues and stress can even lead to or worsen erectile dysfunction.
Earlier, it was commonly believed that erectile dysfunction is caused by psychological issues. It is now known that for most men physical problems like limited blood supply to the penis or damage to nerves can result in erectile dysfunction. Sometimes, men may have a combination of psychological and physical issues. For instance, a minor physical issue that could affect the sexual response might cause anxiety about maintaining an erection. The resulting anxiety could in turn worsen or lead to erectile dysfunction.[3, 4]
Common Physical Causes/Risk Factors of ED:
- Not enough blood flows into the penis as a result of health issues like Atherosclerosis (blocked arteries due to high cholesterol), heart disease, diabetes, or even smoking
- The penis is not able to trap blood to keep itself erect
- Certain injuries, diseases, or surgeries that affect the spinal cord or pelvic area that harm nerves leading to the penis, which is why nerve signals from the brain or spinal cord are not able to reach the penis for sexual arousal
- Type-2 diabetes leads to nerve damage to the penis or small vessel disease
- Certain prescription medications (e.g. Blood pressure lowering drugs and antidepressants)
- Peyronie’s disease- scarring inside the penis
- Use of tobacco, alcoholism, or other forms of substance abuse like recreational drugs (heroin and nicotine)
- Old age
- Lack of exercise
- Parkinson’s disease
- Multiple sclerosis
- Metabolic syndrome
- Sleep disorders
- Low testosterone
- Thyroid problems
- Lower urinary tract symptoms
- Blood clotting problems 
Common Psychological Causes/Risk Factors of ED:
The brain also has a role in proper erectile functioning, starting with feelings of sexual excitement. Many psychological concerns that can interfere with sexual feelings or cause/worsen erectile dysfunction include:
- Personal or professional stress or stress stemming from cultural, social, or religious conflicts
- Constant worry about sex performance
- Anxiety, depression, or other mental health issues.
- Relationship conflicts because of poor communication between the partners, stress, or other concerns. 
Signs of Erectile Dysfunction To Watch Out for:
The symptoms of erectile dysfunction can’t be missed out. Generally, it includes persistent:
- Difficulty in getting or keeping hard enough for sex: problems in achieving erections or staying that way for long until the woman gets satisfied
- Lower sexual drive
- Lack of self-esteem
- Guilt or embarrassed feeling of not being able to sexually satisfy a partner
- It’s been a while without the experience of morning wood: All men usually experience night or morning erection which doesn’t mean that they feel aroused. It happens due to the release of less noradrenaline- a hormone that prevents non-stop erection of the penis during sleep. It’s a good indication of having healthy blood flow to the penis if the morning woods are frequent but not so otherwise. It could mean that anything impeding the morning wood might eventually cause erectile dysfunction.
- No thoughts about sex as much as there used to be: Testosterone is the male sex hormone associated with sexual drive. Low testosterone can be a culprit of erectile dysfunction. The signs of low testosterone and ED include lack of sexy thoughts, trouble in muscle building or developing a gut, and mood changes or fatigue. [1,4]
Treatment Options For Erectile Dysfunction
The highly customized, safe, and effective medical treatments for erectile dysfunction include:
- Prescribed oral medications to cause erections in men when sexually transmitted
- Use of vacuum devices to draw and collect blood in the penis for erection
- Use of penile injections to directly administer medications into the side of the penis for creating an erection or use of intraurethral suppositories to deliver medication
- Hormonal replacement therapy to restore the deficient levels of testosterone
- Penile implants are placed surgically inside the penis to mimic the erection process (in case all other treatments fail) 
Prevention of Erectile Dysfunction
By making small and impactful lifestyle changes, men can prevent or resolve ongoing ED. The healthy measures to improve erectile dysfunction include:
- Stress management
- Regular exercising
- No smoking
- Eating a balanced diet
- No excessive alcohol intake or use of recreational drugs
- Maintaining a healthy body weight
- Reviewing medications with the doctor and knowing about medications that have a chance of causing ED
- Managing serious health conditions
- Couple counseling if there is trouble in communication between sex partners.