The All-inclusive Guide to Erectile Dysfunction: Symptoms, Causes, Diagnosis, Treatment methods, Prevention Measures, My Canadian Pharmacy Services and FAQ

The Table of Contents:

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Erectile dysfunction (commonly also referred as impotence/erectile disorder/ED) stands for the certain type of the sexual disorder as it’s hard to achieve or provide an erection which’s hard for performing great in a bed. ED impacts on as many as 30 million of males worldwide. The majority of males get issues with erections occasionally. But as such issue occurs more than in 50% of all you sexual intercourses and then such issue might be classified as ED.

Erectile dysfunction is already very widespread & becomes even more widespread as males become older. The latest survey showed – 1 male in 5 who is over 40 years old years has erectile issues & about 1 in 10 males are totally unable to get erections. Older males have even higher risks of having erectile issues.

The pursuing guide gives the whole picture of erectile dysfunction – how does ED start, how to manage it & treat such widespread sexual disorder which is relative to every 5th man in the world?

I. How to recognize Erectile Dysfunction?

When a person suffers from ED it is getting harder for him to cause and then keep an erection firm for having a sexual intercourse. Most males get trouble with erections from time to time, but in few males it’s the regular & more bothersome issue. But there’re certain signs which you’ve erectile dysfunction & not just temporary issues with weak erections:

symptoms of ED

1. You may not have it

Erectile dysfunction is recurrent inability to achieve & provide the penile erection good enough for sexual intercourses. Such thing denotes ED is not just about acquiring it up, but in addition about keeping it up. It in addition denotes which falling flat once in the while is not required reason for concern.

2. How can you evaluate yours erections?

  • Mild stage of ED – achieve the productive erection 7-8 times in 10 tries;
  • Moderate level of ED – achieve the productive erection 4-5 times in 10 tries;
  • Harsh ED stage – achieve the productive erection 0-2 times in 10 tries.

3. Not only you have this conditions

Statistics indicate more than 50% of males over 40 years old had episodes of ED – the issue can start at an even younger age.

4. As yours age increases, you need to test more often for ED.

testing for ED

The proven fact is that the likelihood of evolving ED enhances with age. In compliance with the American Urological Association 4 in 10 males at age 40 go through ED, 6 in 10 males have it at age 65 & 8 in 10 males at age 75.

1.1 Erection Hardness Score (EHS) is the best way to self-diagnose ED

Erection Hardness Score (EHS) as one of regular ED tests was offered by The National Institutes of Health in 1998. EHS might be the helpful test to evaluate ED – the man’s disability to get or provide an erection hard enough for having the sexual intercourse. According to EHS, there are five stages of erections the male can have:

  • 1 – Penis does not enlarge at all;
  • 2 – Penis is bigger, but not firm;
  • 3 – Penis is firm, but not hard enough for penetration;
  • 4 – Penis is hard enough to penetrate, however, not totally firm;
  • 5 – Penis is totally hard & fully rigid.

For many males, EHS test is attractive which is why it’s short & simple to apply. With just one question, males can easily assess their erection hardness & reveal back to their physician.

IIEF is another test considered as the standard for assessing the man’s erections. The IIEF is the 15-item self-showed questionnaire which evaluates 5 points: erectile option, orgasmic option, sexual desire, intercourse satisfaction & overall satisfaction from having sex. The IIEF lets clinicians to testing erectile dysfunction & determine how harsh the case may be.

II. How does the man get an erection?

To figure out the causes behind ED, it helps to understand how an erection happens corporeally. In the case you’re not aroused, the penis turns to be limp. While being aroused the nerve messages discharge the chemical enhancing blood flowing into the penis. The blood fills two chambers of spongy tissue (a.k.a. the corpus cavernosum) located right in the penis.

how does erection appear

The “smooth muscles” in these chambers then loosen and blood enters & stays in them. The blood pressure makes the penis firm, giving you an erection. After you’ve got an orgasm, the blood streams out of the chambers & the erections go away.

Essential substances great erections:

  1. Collagen is the major part in providing firm tissues in the body, including your genitalia;
  2. Oxygen-rich blood is the essential part for erectile health;
  3. Testosterone and various male hormones. The standard degrees of hormones, specifically testosterone, are essential for erectile option.

III. Causes of Erectile Dysfunction

3.1 Vascular reasons of ED

1) Atherosclerosis
ED might be triggered by atherosclerosis – the thickened walls of the arteries which trigger them to narrow & lose elasticity, restricting the regular blood stream. The tinier arteries located in the penis are commonly impacted by atherosclerosis – damage to the lining of the arteries – as even the tiny number of narrowing in such arteries can impact on blood’s circulation.

2) Hypertension

ED can in addition be triggered by the most common cardiovascular factor – hypertension. The AHA (The American Heart Association) gives a detailed explanation which hypertension can provoke ED which is why it damages arteries, impairing the blood stream essential for achieving an erection.

3.2 Physical triggers of ED

It’s always worth consulting the physician about persistent erection issues as the reason of ED ought to be any one of the number of critical medical conditions:

  • Obesity & metabolic syndrome;
  • Any complications after prostate disorder;
  • Parkinson’s disorder;
  • Diabetes provokes neuropathy being the widespread neurological cause of ED;
  • Injuries in the pelvic location/spinal cord;
  • Multiple sclerosis;
  • Heart disorder & narrowing of arteries;
  • Increased cholesterol level;
  • Hormonal disorders featuring thyroid conditions & testosterone deficiency;
  • Hypertension;
  • Smoking, alcohol & substance abuse, featuring cocaine and heroin use;
  • Peyronie’s disorder;
  • Surgical complications (radical prostatectomy, cystectomy, rectal cancer surgery);
  • Radiation therapy to the pelvic regions.

physical causes

3.3 Drug-triggered Erectile Dysfunction

Numerous RX medical preparations are in addition to organic causes of ED, can make your sexual disorder really bad. The list of orally taken pills that can cause or worsen ED include:

  • Anticholinergics – medical preparations with the wide range of uses which block the neurotransmitter impacting on muscle tones;
  • Some diuretics (“water pills”);
  • Some cancer medical preparations;
  • Heart medical preparations like Digoxin;
  • Prostate therapies;
  • Opioid painkillers;
  • Medical preparations acting on your CNS, featuring few sleeping pills & amphetamines;
  • Hormone meds, featuring estrogens & meds acting on luteinizing hormone-releasing hormone;
  • Medical preparations assigned to manage hypertension (beta-blockers & Clonidine);
  • Antidepressants, featuring MAOIs, SSRIs & tricyclic antidepressants;
  • The peptic ulcer meds like Cimetidine;
  • Anxiolytics for curing anxiety.

3.4 Mental reasons of ED

In rare cases, Erectile Dysfunction can be caused exclusively by psychological triggers like:

  • Fear of intimacy;
  • Harsh anxiety;
  • Guilt;
  • No emotional connection with a sex partner;
  • Depressive condition;
  • Social phobia and/or functionality anxiety – repeated feelings of doubt & failure in what worrying about acquiring an erection can trigger severe episodes of ED;
  • Stress caused by work, financial, & emotional issues.

However, psychological reasons can’t explain an inability to achieve erections for long time.

3.5 Prostate disorder & Erectile Dysfunction

Therapy of prostate cancer may trigger ED, although the cancer itself never causes the issue. Prostate surgery to delete cancer can outcome in ED, as well as radiation therapy inclined to cure prostate cancer.

The trauma of the delicate nerves & arteries essential for erections can trigger permanent ED, so be careful during treatment of prostate cancer. For many males, the power to get erections returns inward the primary few months after therapy, as the nerves & arteries can heal.

Therapy of non-cancerous, benign prostate disorder can in addition trigger ED. Medical preparations – 5α-reductase inhibitors – can also trigger ED.

3.6 Other widespread reasons of Erectile Dysfunction:

  • Smoking usually causes the vascular disorder—many people suffer & die from the vascular consequences of cigarettes than from the cancers that it reasons;
  • Radical prostatectomy, being also the surgery for prostate cancer, frequently provokes ED, which is why the nerves & arteries which stock the penis are very close to the prostate.
  • Radiation therapy for prostate cancer frequently provokes ED. Such effect may occur after either external beam radiation or radioactive seed implantation;
  • Alcoholic beverages inhibit erections directly, but as applied to excess it in addition reasons long-term damage which significantly worsens the quality of erections.

IV. Are you at risk of having Erectile Dysfunction?

Give the truthful answers to the pursuing questions to self-evaluate the risks of having ED:

1. Do you go through diabetes or similar endocrine disorders?
Diabetes or the testosterone deficiency is the reason of ED in 36% of all diagnosed cases.

2. Do you’ve heart disorder, high cholesterol hypertension? Are you a smoker?
Disorders of such sort cause narrow arteries or drop blood stream. They affect males in 40% of all ED cases.

3. Do you go through anxiety or stress?
Frequently ED is triggered by the combination of corporeal & emotional factors. Stress, guilt, anxiety, depressive condition & low self-esteem get all linked to ED & in about in one of 10 cases, an emotional issue is the only reason to this disorder.

risk factors - aging

4. Suffer from nerve damages inflicted by surgeries, injuries or radiation therapy?
Damage to any nerves leading to or from the penis is the contributive factor in 24% of ED cases.

5. Do you apply sleeping pills, antidepressants or medical preparation for hypertension?

ED can be adverse reaction of many widespread medical preparations.

6. Do you apply recreational medical preparations or binge drink?
Medical preparations & alcoholic beverages are recognized to sap the sex drive and trigger ED.

7. Are you obese?
According to the official research, every 9 kg of excessive weight trigger 3% decline in erectile functionality.

V. Tests & diagnosis for ED by My Canadian Pharmacy

Nevertheless, self diagnosis gets to be proven by the acclaimed medical tests & the professional diagnosis. Here is what you ought to expect from an urologist who will examine you at the hospital. Before considering the diagnosis of ED which seeks therapy, the therapist will look for signs which get persisted for at least 3 last months. Prepare for the small interview with personal issues and the following tests:

5.1 Physical examination

A corporeal exam checks overall health. Such may involve checking yours blood pressure, penis & testicles. You may get the rectal exam to check prostate. Such tests are not painful & may give meaningful information about the trigger of yours ED. Physical tests include:

  • Pulse examination;
  • Neurological examination;
  • Rectal exam ;
  • Abdominal examination.

5.2. Lab tests

To test for disorders which trigger ED, yours healthcare supervisor may order blood tests & collect the urine samples. Some simple laboratory tests may be performed:

  • Liver & kidney work;
  • Testosterone deficiency test;
  • Thyroid functioning;.
  • Blood tests;
  • Urinalysis;
  • Lipid profiles & triglyceride degrees, possibly indicating arteriosclerosis;
  • Blood sugar degrees in order to reveal diabetes.

Yours health care provider will test to see how the arteries, nerves, muscles & tissues of yours penis are working. Normal nocturnal penile tumescence (NPT) tested during sleep shows which yours nerves & blood stock are working properly.

5.3. Vascular testing

  • Duplex ultrasound – it’s the form of ultrasound which lets physicians to see the structure & blood stream through arteries;
  • Injection testing – agents which trigger enhanced blood stream are injected into the erectile chamber of the penis to trigger an erection and check its condition;
  • Dynamic infusion cavernosometry – the sophisticated penile blood stream test conducted in few males having ED & penile abnormalities.

To sum up, the therapist must do the pursuing tests & steps to testing ED correctly:

  1. He may ask about yours sex life, disorders you’ve had & medical preparations assigned to you;
  2. A complete corporeal exam (featuring the abdomen, penis, prostate, rectum, & testicles);
  3. Routine lab tests featuring urine analysis, blood counts, lipid profile & evaluation of liver enzymes;
  4. Nocturnal penile tumescence testing that monitors in the case you’ve erections while asleep;
  5. Tests for measuring penile arteries;
  6. Prolonged nervous system’s tests;
  7. Mental tests for measuring your psychic condition and the level of stress.

You and the therapist will use the outcomes of the examination & tests to evolve the therapy plan which may include medical preparations, non-surgical therapy or surgery.

VI. Erectile Dysfunction can be treated: learn how to do this

In such section we apply the look at the accessible therapy settings for ED, from medical preparations to vacuum devices, surgery therapies & dietary supplements.

6.1 Oral drugs for ED

The primary setting for the therapy of ED – once the condition’s been established as the persistent issue – is the group of medical preparations titled as PDE-5 (phosphodiesterase-5) inhibitors.

The best recognized therapies for ED are sildenafil (Viagra), Vardenafil (Levitra) & Tadalafil (Cialis).

More info about Sildenafil (Viagra):

Here is you can see how PDE5 inhibitors work:

the work of PDE5 inhibitors

Commonly these particular drugs are applied 30-60 mins before sex. PDE-5 inhibitors get to be assigned by the therapist, who may check for heart conditions & usage of medical preparations. For instance, the cardiologist may get to advice on the best timing for the usage of ED drugs in males who keep nitrate medical preparations for rare occasions of angina chest pain triggered by coronary artery disorder.

6.2 Dietary supplements

There are few safe dietary supplements that can prevent ED:

  • Chlorophytum Arundinaceum;
  • Dehydroepiandrosterone (DHEA);
  • Tribulus Terrestris;
  • Korean red ginseng (Panax ginseng);
  • Mucuna prurins;
  • Withania Somnifera;
  • Asparagus Aacemosus.

Never take these dietary supplements since they may trigger severe side effects:

  • Yohimbe;
  • Ginkgo biloba;
  • Horny goat weed;
  • L-arginine.

6.3 Injections of drugs straight to penis

If other oral medical preparations don’t work, the medical preparation called as Alprostadil. This medication was confirmed for use in males suffering from ED. Such medical preparation comes in 2 forms, depending on how it’s to be used:


1) Transurethral Therapy for impotence

The medical preparation is injected into the side of penis. The success level for acquiring an erection firm enough to get sex is 86%. The tiny medicated pellet of the medical preparation is placed in the urethra. Applying the medical preparation in such way averts having to give you the shot, but makes it less probably to work. The most widespread side consequences of Alprostadil are the burning feeling in the penis, as well as priapism.

2) MUSE Local ED Therapy
While there’re few therapy settings for ED, few of them are more effectual or tolerable than other pills. MUSE (a.k.a. Medicated Urethral System for Erection) assisted many males who never responded well to oral medical preparations.

6.4 Surgical therapy

When other therapies do not improve ED, yours healthcare supervisor may offer you surgery.

1) Vacuum erection device a.k.a. vacuum pumps
A vacuum erection device stands for the plastic tube slipping over the penis, making the sort of the seal with the body. An elastic ring after this is slipped onto the penile basis. Such device holds the blood in genitalia (and keeps your penis firm) for 30 mins.

2) Penile implants


Penile implants are devices which are placed totally inward yours body. Such devices give stiff penis which lets you experience normal sex. Penile implants can be the great therapy choice for men who never responded to other ways of treatment. There’re 2 kinds of such implants:

• Bendable implant – consists of 2 rods made of silicone and inserted to your penis to provide firm erections;
• Inflatable implant –these are more fluid-filled cylinders located during the full length of penis.

3) Vascular surgery

The American Urological Association presents it as the setting only for healthy males who get lately acquired ED triggered by the focal arterial occlusion.

4) Penile Arterial Revascularization
Young males (who are under 45 years old) who had injuries to the pelvis or penis are most probably to be assisted by such therapy. Such surgery fixes issues with blocked or injured arteries in the penis.

6.5 Seed Brachytherapy

Prostate or seed Brachytherapy is a special type of radiation treatment involving spreading mild radiation rays to the prostate cancer cells. Such therapy can be provided in 2 rather painful ways:

• temporary – through wires;
• permanent – or with radioactive seeds remaining in the prostate.

Brachytherapy is recommended as a single method or in conjunction other ED therapy methods. Side consequences of such procedure usually feature blood in stool or urine, issues with urination & diarrhea.

6.6 Acupuncture

This method has in addition been suggested as the replacement therapy for ED, but there’s currently insufficient evidence accessible to decide the benefits or risks of such interference. the systematic review of trials looking at the safety & efficacy of acupuncture for ED is underway & is expected to be publicized in the British Medical Journal in 2016.

VII. What are the most associated issues with Erectile Dysfunction?

1. Premature ejaculation (know more how treat PE)
It is the most common associated disorder that comes along with permanent or regular episodes of ED. According to the clinical trials, most 60% of males suffering from ED also have one or another form of premature ejaculation (PE).

following diseases

2. Infertility
About 15% of all U.S get difficulties with conceiving a babe. This disorder (infertility) affects approximately 3.5 million people in the U.S. ED can significantly decreases the chances to conceive.

3. Priapism
It is the persistent & frequently painful erection which lasts for few hours. The erection is not necessarily connected to sexual stimulation or excitement & never subsides after ejaculation (when sperm is spread from your penis). Priapism has to be treated immediately with the medical assistance – you ought to seek immediate professional help in the case your erections are very painful and prolong more than 4 hrs without getting soft at all.

4. Prostate issues
They are widespread in men, notably in those over 50 years of age. These issues include:

  • prostatitis (inflammation of the prostate);
  • prostate enlargement;
  • prostate cancer.

5. Low libido

Low libido is usually recognized is nothing else than the lack of interest in any sexual acts. Many factors of the biological nature build the person’s libido. It level is quite different for everyone & may drastically change depending on certain life changes. Low libido is commonly caused by stress or certain disorders like diabetes and if it is complicated by ED you should definitely visit your healthcare supervisor.

VIII. Can I do anything to avert Erectile Dysfunction?

ED becomes more widespread as males age. But it’s not necessarily the normal part of aging. How can you avert ED?

1. Drink alcoholic beverages in moderation or not at all.
No more than 2 glasses of wine per 24 hrs will make you feel better and improve your erections.

2. You are what you eat.
The latest studies show which ED is relatively non-widespread among males who follow the major principles of the Mediterranean diet, what includes vegetables, fruits, whole grains and healthy fats like olive oil, nuts, fish and red wine.

There are certain foods that can significantly boost libido:

3. Try to keep the healthy weight.
Being obese provokes a lot of problems with health, featuring diabetes type II, that in its turn can trigger nerve damaging throughout the body and lead to ED.

4. Avert high blood pressure & increased cholesterol levels
These conditions can damage arteries, featuring those which lead blood to your penile area. Gradually, such effect may provoke permanent ED. Make sure yours therapist checks blood pressure and cholesterol levels.

5. Exercise regularly
Running, swimming and aerobic exercise can significantly improve your health condition. One form of exercise which doesn’t seem helpful is Kegel exercises, what involve repeatedly contracting & loosening the muscles in the pelvis. Kegels might be helpful for males & women suffering from incontinence. But there’s no evidence on their positive effect on ED.

6. Avert using anabolic steroids
Such medical preparations, what are frequently abused by athletes & bodybuilders, can shrink the testicles & sap their power to make testosterone.

7. Keep tabs on your testosterone levels
Even in healthy men, testosterone degrees frequently begin falling sharply near the age of 50. Every year after the age of 40, the man’s testosterone level typically falls about 2%. Signs like the low sex drive, moodiness, lack of stamina, or trouble making decisions suggest the testosterone deficiency, as do lackluster erections. Yours therapist can check on which.

8. in the case you smoke, try to drop this habit.
Smoking cigarettes can harm arteries & curb blood stream to the penis. & nicotine makes arterys contract, what can hamper blood stream to the penis.

9. Curb stress.
Mental stress boosts degrees of the hormone adrenaline, what makes arterys contract. which might be bad news for an erection. Anything the man can do to ease tension & feel better emotionally is probably to give his sex life the big boost.

IX. Fast facts about Erectile Dysfunction

  • The most widespread ways of therapies include counseling, oral medical preparations, vacuum devices, penile injections & implants;
  • ED is the barometer of cardiovascular health.
  • Typical primary-line therapy of ED involves the usage of medical preparations called PDE-5 inhibitors – Levitra, Cialis and Viagra;
  • ED causes are usually physical ones but can in addition be mental;
  • Men having diabetes are at the greater risk of ED than males without diabetes;
  • ED is defined as persistent difficulty achieving & providing an erection sufficient to get sex;
  • Men having bad teeth are more probably to go through ED. The periodontal disorder or chronic gum disorder with the condition can trigger ED;
  • It’s normal for the man to get occasional cases of ED, perhaps from tiredness or drinking too many alcoholic beverages;
  • Drinking just two cups of coffee the day ought to perk up the man’s abilities and improve erections;
  • Half of all males between the ages of 40 & 70 go through ED in certain degrees;
  • ED is not an over-treated condition, despite media representations. On the contrary, studies get showed which 90% of those suffering from ED, never go for therapy;
  • Ongoing ED ought to be investigated by the therapist or it can become the chronic one;
  • Professional diagnosis is necessary.

If you have any questions left about ED, watch educational level with the key facts about this disorder:

X. My Canadian Pharmacy services for treating Erectile Dysfunction

treatment of ED

Therapy of occasional ED episodes is the crucial thing unless you want to get the permanent & chronic erectile disorder a.k.a. impotence for lifetime. While the surgery may seem the radical way of therapy (which is mostly applied in the harshest cases of refined impotence) the usage of medically confirmed & tested oral medical preparations can the primary-line choice. As it was mentioned above, there’re basically three substances (all belong to the class of PDE5 inhibitors) which in one way or another assist to cope with ED in 98% of all cases. Such are Sildenafil/Viagra, Tadalafil/Cialis & Vardenafil/Levitra.

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How can the My Canadian Pharmacy services assist you? First of all, you might benefit from its online catalogue with detailed descriptions of generic pills like Canadian Viagra & generic Cialis, Kamagra & original Levitra, etc. The safety guides, tips & expert advices will assist you to pick up the right medical preparation for ED therapy. Secondly, the MCP service lets comparing the real prices for such medical preparations in regular & online Canadian pharmacies so you could find the cheapest offer. And at last with the My Online Canadian Pharmacy it’s easy to make an order with the delivery of yours ED pills straight to the home in Canada & the U.S.

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XI. Frequently Asked Questions about Erectile Dysfunction

ED faq

1. Can I combine therapy settings for curing my ED problem?
Such combinatory method is usually the best choice. But which is why erections can last too long with medical preparation therapy, combining therapy ought to only be done after talking with yours health care provider. Ask yours therapist for proper guidelines.

2. Can young males get ED?
Yes, but it appears much more frequently in older men. Current statistics are not accessible for South Africa, but in America about 10% of males are presumed to be affected. The frequency rises with age: about 5% of males at the age of 40 & between 15 & 25% of males at the age of 65 go through ED. As males age, they typically reveal few loss of sexual desire as well.

3. Is it normal to get ED?
Yes, it’s, in the sense which many males get erectile issues, specifically at times of great changes in their lives. In fact it’s probably more widespread than people realize, as proven by anti-impotence medical preparations. It’s estimated which males having erectile issues wait an average of 5 years before going to the specialist. It ought to not be ignored, as erectile issues frequently point to other corporeal issues, like diabetes.

4. Does riding the bicycle trigger ED?
Some research has raised concerns which males who regularly cycle for long hours ought to get the greater risk of ED, in addition to other men’s health issues like infertility & prostate cancer.
The latest trial to investigate such established which there was no connection between riding the bike & ED, but it did find an association between longer hours of cycling & the risk of prostate cancer. However, in the case you ride the bike more than 3 hrs per day you should occasionally check your prostate.

5. Can ED be averted?
Many erection issues might be averted if you decide to change your lifestyle for better – like losing weight, ceasing smoking and drinking, having healthy and supportive sexual relationships. In the case you & yours partner will discuss the issues you will immediately notice that yours stress & anxiety decrease and you become more comfortable during sexual intercourses. Many people avert talking about problems in sex life. But such therapy can be very useful for both partners. Nevertheless, foreplay and self-confidence can enhance the chances for normal erections, regardless of the male’s age.

6. Is there any good home therapy for ED?
In the case you only practice occasional episodes of ED, you may be able to cure it at home beyond the therapist’s help. Some of the reasons of erection failure are inward yours control, like smoking, stress and drinking a lot of alcoholic beverages. Special pelvic-floor exercises may become extremely helpful for most males having erection issues. Such exercises do not involve any risks. Don’t be embarrassed about seeking professional assist in the case home strategies don’t assist & erection issues are persistent & troublesome.

7. Is impotence the same as ED?
Yes. Though another sexual disorder – premature ejaculation – is frequently confused with ED. Premature ejaculation occurs when the entire process of arousal, erection, ejaculation & climax happens rapidly, frequently in just the few minutes, and the man can’t make it last longer. Premature ejaculation may affirm an erection issue like ED but is, as the rule, cured differently.

This Online Guide is created by the research group of  My Canadian Pharmacy and is strictly informative. Best Regards, My Canadian Pharmacy RX Team.