For the majority of couples, sex is a choice

This has been reinforced by numerous social movements such as the emancipation of women, improved sex education and better information about the art of seduction. Therefore, sex has come to be enjoyed by men and women alike. It’s, therefore, becoming easier to consult a doctor about sexual problems. Going to the doctor to treat your erectile dysfunction is no longer a taboo, and there are more and more treatments available on the market to treat it.

What does erectile dysfunction mean?

Erectile dysfunction (also known as sexual impotence) is the inability to gain an erection that is firm enough to have sex. This is important for both the man and woman’s satisfaction.

Sexual impotence is different from the odd failure to gain an erection from time to time, as plenty of men experience now and again. This is often due to insomnia, tiredness, stress, alcohol consumption and drugs. Erectile dysfunction is permanent and must occur frequently over a period of six months or more to be counted as such.

If this ever happens to you, it’s important not to let it take over your whole relationship. Over the years, erectile dysfunction has become a recurrent problem for around 30% of men in their 40s or older. This percentage is constantly changing because of men now feeling like they can come out of their shell to ask for help.

A medical consultation is an important step in curing these issues, as your erectile dysfunction could be hiding a more serious illness like diabetes or heart problems.

The different types of erectile dysfunction

People often confuse impotence and erectile dysfunction. This is a mistake and it can mean that person who are trying to diagnose themselves get mixed up. It is therefore important to get to know what these terms really mean.

Erectile dysfunction is a term that is used to describe a number of male sexuality problems. Among these issues is impotence, which is actually just a part of erectile dysfunction.

Impotence is the inability to gain an erection good enough for satisfactory sex. Although it’s more common amongst men over 40, no man who is old enough to have sex is immune to suffering from it. There are a few causes of this problem, such as a bad lifestyle, drug use, alcohol consumption, certain medications, high-stress levels, or illnesses such as high blood pressure or diabetes. Lifestyle is most often the cause amongst younger people.

What leads to an erection?

  • As soon as the man is stimulated, nitric oxide is released into the corpora cavernosa of the penis
  • The nitric oxide then stimulates the guanylate cyclase enzyme, which causes the concentration of cyclic guanosine monophosphate (cGMP) to rise and hence allows the smooth muscle in the corpus cavernosum to relax. This means that more blood can flow to the penis, leading to an erection.
  • Then the cGMP’s rate of synthesis is regulated by guanylate cyclase and its percentage of degradation by PDE-5

The causes of sexual impotence

The causes of impotence are ordered according to whether they are physical or psychological.

The physical causes of Impotence can be

Atherosclerosis (cardiovascular disease)Tumours
High blood pressureParkinson’s disease
DiabetesAlzheimer’s disease
Pelvic traumaMultiple Sclerosis
Penile deformitySerious and frequent hormonal disorders

These diverse illnesses can cause various psychological symptoms and can eventually lead to sexual problems. If you do not take care of them they can lead to impotence. Among the more dangerous symptoms are narrowed arteries due to a build-up of fat and sclerosis in the small penile arteries. This can prevent nerve signals from reaching the penis which means that blood flow stops.

Psychological causes of impotence

If the man still gets erections in his sleep (that is to say, unconsciously), we can say that his erection problems are psychological. In this case, there are a number of factors that could be causing the problem, such as stress, tiredness or religious and cultural convictions. As long as the issues are not voluntary—i.e. it isn’t due to trauma or taking a certain treatment—it is safe to say the causes are psychological. The reason that you cannot get an erection is because of a lack of nerve stimulation; an unconscious emotional barrier.

What are the solutions if this is the case?

Apart from some isolated cases, it is almost always possible to treat sexual impotence. This is thanks to great advancements in treatments over the past few years. These treatments are not only increasing in variety but also in efficacy. The first stage towards curing your problem is, no doubt, to provoke desire with the help of a treatment. This way you can rule out psychological symptoms. There are numerous treatments available to this effect, which help you to gain a satisfying erection. These treatments are based on Sildenafil (Viagra), Vardenafil, Tadalafil or even the recently discovered Spedra.

These treatments all work using phosphodiesterase type 5 inhibitors, which is why their instructions of use are very similar.


Viagra was the first treatment created for erectile dysfunction. It was discovered by Pfizer laboratories. The pill works within 30 minutes after taking it and it lasts for up to 4 hours. It is made using Sildenafil, which is its active ingredient. Side effects include headaches, flushing, dizziness, dyspepsia, nasal congestion and impaired colour vision.


Cialis is made by Eli Lilly laboratories and is one of the best known erectile dysfunction treatments. Like Viagra, it starts working 30 minutes after you take a pill, but it lasts for much longer. Cialis works for up to 36 hours. Its side effects include headaches, dyspepsia, dizziness, flushing, nasal congestion and back pain.

5mg Cialis Daily

Cialis Daily is the only treatment for erectile dysfunction that you can take once a day. It is a permanent solution as it allows the man to be ready at any moment. After you take it, it can last between 3 and 5 days. Based on Tadalafil, Cialis Daily is made in the same way as the classic pill and is made by Eli Lilly. Its side effects include headaches, dyspepsia, dizziness, flushing, nasal congestion and back pain.


Levitra is better adapted for older men and those suffering from diabetes, high cholesterol and high blood pressure. It works 20 minutes after you take it and works for the next 5 hours. Manufactured by Bayer laboratories, Levitra uses Vardenafil as its active ingredient. Its side effects include headaches, flushing, dyspepsia, nausea, dizziness and rhinitis.

Orodispersible Levitra

Manufactured by Bayer laboratories, Orodispersible Levitra is for men who have trouble taking tablets. It works in the same way as classical Levitra and it has the same side effects.


Spedra is manufactured by Berlin-Chemie AG and it entered the European market in April 2014. This recent addition to the market is a sexual stimulant for adult men. It works 15 minutes after you take the pill and it works for 6 hours, thanks to its active ingredient Avanafil. Its side effects include headaches, flushing, nasal congestion, dizziness and back pain.

We would like to note that prescription treatments are usually guaranteed to be effective, however, there are several other impotence treatments on the market.

7 things you can do to prevent erectile dysfunction

Here are 7 ways to reduce the risks of sexual impotence:

  1. Controlling your blood pressure, even if this is just once a year
  2. Controlling your blood sugar levels constantly if you are a diabetic
  3. Regularly controlling your cholesterol levels
  4. Practising regular physical activity (for at least half an hour a day)
  5. Not consuming an excessive amount of alcohol and drugs, as these are often factors
  6. Quitting smoking if this is a habit of yours. Your erectile dysfunction could be totally cured within six months by stopping smoking.
  7. Following a healthy and varied diet that avoids junk food

It is obvious that leading a healthy lifestyle can help you avoid erectile dysfunction. However, it will sometimes be necessary to resort to treatment and do not hesitate to consult your doctor if you notice even the slightest problem.

Talking with your partner can help

Erectile dysfunction is no longer a taboo subject. As soon as you realise a problem you should talk to your partner about it. Not only is this helpful, but it can also help to reassure you and help you regain your confidence.

Supplementary information about erectile dysfunction

Venogeneic erectile dysfunction and male impotence

Venogeneic erectile dysfunction—also known as venous leak and penile venous insufficiency—often concerns young men, unlike other natural causes of sexual impotence.

Directly linked to impotence, this involves a permanent inability to gain an erection. The venous leak happens when the veins in the penis are not able to properly circulate the blood, which usually creates an erection. The veins cannot then ensure that the blood will reach the penis. Venous leak can also be linked to a vascular illness.

Little is known about this illness as it is still controversial in the medical community. There are numerous causes that can be directly linked to psychology or even other illnesses. But there are solutions and treatments that can help you deal with it. You should seek a doctor’s advice as soon as you notice symptoms.

A bit of anatomy

The penis is composed of three cylinders: two corpora cavernosa and a spongiosa that surrounds the urethra.

The spongiosa regulates the diameter of the urethra in order to let urine pass during urination and sperm pass during sex. The corpora cavernosa are like sponges that contract to prevent blood from flowing into the penis to allow it to “rest” when it is flaccid. As soon as the corpora cavernosa relaxes, blood is allowed to flow through and fill the penis until it is rigid (tumescence), which is what we call an erection. These sponges are made up of muscular fibres and connective tissue that form the frame and the vascular reservoirs. These three cylindrical bodies are surrounded by a fibroelastic tunic albuginea.

When these tissues are damaged or do not react normally to the brain’s commands, we call it venous leak.

Causes of venous leak

The venous leak is, therefore, a problem with the smooth muscle’s ability to relax, or it can also be an anatomical abnormality.

There are numerous causes of a venous leak; notably due to structural changes in the corpora cavernosa or low testosterone levels. In some cases, it is due to other illnesses such as diabetes or even fibrosis.

As for psychological reasons, these causes are linked to the sympathetic nervous system and adrenaline secretion. This contracts the arteries and tissues, which in turn affects the central nervous system and stops the veins from closing. This inevitably leads to a venous leak.

Symptoms of venous leak

Most men who suffer from venous leak start experiencing erectile problems from adolescence. In order to diagnose the venous leak, doctors look for a sign that suggests your erectile dysfunction symptoms are organic rather than psychological.

These signs include
Erectile dysfunction that is persistent and unrelenting, which means that it is impossible to gain an erection whether with a partner or without (during masturbation).
Loss of morning erections
Loss of spontaneous erections and resistance to impotence treatments such as sildenafil and injections into the corpus cavernosum

Thus, if it is difficult for you to maintain a natural erection, there is a reason to worry. Especially if, after taking a vasodilator or injection, it is still not possible to maintain an erection or if the pressure drops quickly, it is probably venous leak. In order to verify that this is a problem, you must have a cartography to identify the leaking vein.

Treatment for venous leak

There are numerous treatments for this type of problem. Whether they are oral medications or surgical treatment, it is necessary to always take psychology into account. This is because it is both necessary to support the patient and also to help them find their confidence again. Among the possible treatments for the venous leak are Sildenafil (which you take orally), and also intra-cavernous injections. Some types of surgery may also be proposed to patients suffering from venous leak: arterial or venous surgery, or even a prosthetic penis. There are other techniques such as vacuum systems that can help.

Infertility and men impotence

Many people confuse erectile dysfunction and infertility and these terms are often wrongly interchanged. However, in reality, they are two totally different and distinct situations.

It is, therefore, important for all adult males who worry about their health, and in particular, their sexual health, to learn and understand the fundamental differences between these two problems that can have a profound psychological effect on the individual.

What’s more, there is a notable difference between infertility and sterility. Sterility is a definitive state, which means that you cannot conceive. On the other hand, infertility is only temporary. This means that it is simply difficult to have a child.

Erectile dysfunction, sterility and infertility

Doctors know that sterility has nothing whatsoever to do with a man’s sex life. In fact, sterility comes from a problem with a man’s sperm. This could be to do with their number, size or mobility. On the other hand, erection problems are linked to a lack of blood pressure in the penile corpora cavernosa.

Impotence and infertility therefore have no relation to one another in terms of cause and effect and are two distinctly different phenomena.

Thus, a man suffering from impotence can be completely fertile and have no problem having children. The production of sperm is independent of the capacity to gain an erection long enough to have sex.

Can erectile dysfunction endanger infertility?

Although it can prevent an erection, erectile dysfunction has no influence over the quality of sperm and hence fertility.

If erectile dysfunction is only occasional and the man can ejaculate normally, as is the case for the majority of men suffering from impotence, we can talk about infertility as this is just a temporary state. Therefore, even if these recurrent dry patches prevent sex from happening, they are in no way linked to the man’s fertility.

However, impotence can cause occasional infertility, which is possible to treat with medication for erectile dysfunction in conjunction with a healthy lifestyle. A hormonal treatment, IVF or artificial insemination can also be used as a last resort if medication or surgery do not work.

Medical review on 7 August 2021 by Dr. Martin Trudeau


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