Vascular Diseases: Arteriosclerosis, heart disease or stroke, high blood pressure and high cholesterol

Metabolic disorders: Characterized by excessive urine discharge and constant thirst, especially the two types of Diabetes

Nerve Disease: Spinal cord injury, multiple sclerosis, pelvic fractures and nerve degeneration

Cancer treatment: Surgery performed for colon, rectal or prostate cancer and even radiation therapy in the pelvic area

Hormonal Problems: Low levels of the male hormone testosterone affect the desire for sex

Side Effects of Medications: Medications including anti-hypertensives (blood pressure medications) or medications
prescribed for depression or mood disorders

Alcohol: Long-term, excessive drinking can cause nerve and liver damage and hormone imbalances

Smoking: Studies suggest that men who smoke have a greater chance of developing ED than men who don’t use tobacco

Sedentary Lifestyle: Lack of exercise may lead to ED.


Physical Factors (80% cases of ED)

Anxiety: Anxiety about sexual performance

Stress: Stress at home, work or in general

Depression: Depression can lead to some degree of ED, and vice versa

Relationship Problems: Tensions between sexual partners, whether related to sexual issues or others

Psychosocial causes can occur alone or in combination with one or more of the physical causes of ED.


Erectile Dysfunction Diagnosis

A preliminary investigation is conducted to determine the origin of the erectile dysfunction. Your physician will ask you a
series of questions related to your medical history, lifestyle and even emotional wellbeing. It is important that you answer
these questions carefully and without being embarrassed about them.

Blood tests: Male hormone levels are measured and tests are conducted to eliminate diseases such as diabetes from the
list of potential causes.

Penile nerve function: Physical tests are performed to determine sufficient nerve sensation in the penis.

Ultrasonography: Duplex ultrasound is used to assess the adequacy of arterial circulation in the genital area.

Nocturnal Penile Tumescence (NPT): Various methods are used to measure changes in penile rigidity and girth
during nocturnal erections.

Cavernosometry: This test measures vascular pressure in the penis.

Treatment and care

Your doctor or other healthcare professional will suggest several treatment options for your problem, depending on its severity.

Oral Medication (prescription): Oral medications such as Viagra, Cialis and Levitra are used in the treatment of ED.
The currently available oral medications are called PDE5 inhibitors, which work to restore a normal system of blood flow in
the penis so that an erection can be achieved upon stimulation. However, these are usually accompanied by long lists of
possible nasty side effects.

Oral Medication (herbal remedies): These are supplements that might be taken before sexual activity to improve
erectile function. Usually, herbal supplements like ProCalisX are a combination of herbs, vitamins and minerals that are
risk-free and do not involve any side effects.

Sex Counseling: Consulting a trained counselor, psychologist or psychiatrist may help you identify, understand and deal
with your sexual distress.

Penile Injection Therapy: Shortly before sexual activity, the patient injects a medication that increases blood flow to the
penis.

Intraurethral Therapy: Pellets of a medication that increases blood flow are inserted into the urethra (through which
urine flows out).

Vacuum Therapy: A vacuum device is used to cause blood to flow into the penis and a constriction ring is placed at its
base to maintain the erection.

Penile Implant Surgery: This is a device that is surgically inserted into the penis and used when there is a desire for
sexual intercourse.

Before starting any medication for ED, it may be advisable to make some simple changes to your daily routine. Your doctor or healthcare professional may recommend and help you follow a few of these:

• Exercise
• Diet
• Stress management
• Quit smoking
• Reduce alcohol intake