Does Erectile Dysfunction Last Forever?

What is erectile dysfunction?

Erectile dysfunction is defined as the inability to achieve and/or maintain a firm erection in order to perform sexual activity. 

The penis contains two chambers called the corpora cavernosa, which run the length of the organ. Upon sexual stimulation, impulses from the brain and local nerves cause the muscles of the corpus cavernosa to relax, allowing blood to flow in and fill the chambers. The influx of blood makes the penis expand, causing an erection. 

When muscles in the penis contract to stop the inflow of blood and open outflow channels, the erection effect is reversed, and the penis returns to a flaccid state.

The process of male sexual arousal is complex, involving the brain, hormones, emotions, nerves, blood vessels and muscles. ED happens when there is limited blood supply to the penis, upon sexual stimulation. This can result from an issue with any one of these aspects of the body, making identification of the root cause, an important part of treatment. 

What causes erectile dysfunction?

While having occasional difficulty with an erection isn’t a cause for concern, the persistence of an unfirm erection can cause significant stress and psychological triggers related to feelings of inadequacy or failure.

The ensuing anxiety can compound the physical effects related to your erectile dysfunction.

Physical causes of ED:

• Age and hormone levels. Men typically experience the effects of ED at increasing rates as they naturally age. 42% of men will experience some form of ED once they reach the age of 60. Hormone levels, including testosterone, decrease as men age. Testosterone is the primary hormone associated with the male libido, and a low testosterone level can have a significant impact on a man’s sex drive.
• Smoking. The act of smoking affects blood flow in the veins and arteries, which may reduce the blood flow necessary to achieve an erection.
• Venous leak. Erectile muscular tissue is required to relax and expand to trap blood in your penis in order to facilitate the erection itself. When this muscle is stiff and can’t trap blood in the penis, the leak of venous blood results in a failed erection.
• Diabetes. The nerve and artery damage caused by diabetes can make achieving an erection difficult. According to research published by the Cleveland Clinic, between 35% and 75% of men with diabetes experience some form of ED. 
• Kidney or heart disease. Chemical changes caused by kidney disease can affect the hormones, circulation and nerve functions necessary to achieve an erection. ED caused by heart disease is attributed to the build up of plaque in the arteries, reducing blood flow to the penis.  
• Nerve damage or neurological disease. Damage to the nerves of the brain or spinal cord, or peripheral nerves such as those surrounding the pelvis, can result in ED symptoms. Any interruption of nerve signals to the penis can affect the ability to achieve an erection. Individuals suffering from multiple sclerosis (MS), Alzheimer’s disease or Parkinson’s disease commonly experience ED due to an interruption in the transmission of nerve signals between the brain and penis.
• Peyronie’s disease. A disease where scar tissue in your penis causes it to bend, curve or lose length or girth. This can be painful and cause erectile dysfunction.

Compounding the physical causes of ED, stress, and mental health concerns, can exacerbate symptoms. This is defined as psychogenic erectile dysfunction, or the presence of a mental state where stressors or thought patterns can contribute to the inability to achieve or maintain an erection. While this may be circumstantial or situational, it is important to recognise how overall mental health can affect ED.

Psychological causes of ED:

• Stress. The presence of external factors – financial worry, thoughts regarding the status of work assignments or various other elements unrelated to sexual activity can greatly inform one’s difficulties maintaining an erection. Many experts believe that during times of stress, activity in the less essential sections of the brain – including the receptors responsible for managing arousal – start to decrease.
• Performance anxiety. Generally believed to be amongst the most common psychological causes of ED, sexual performance anxiety is a major component in persistent psychogenic ED. The desire to please a new partner during sexual intercourse can cause performance anxiety in men of any age. Not performing on the odd occasion can also have a negative effect the next time you try, and this can have a negative impact on your confidence. In most cases, anxiety induced ED is temporary, but may require therapy.
• Depression. Whether exacerbated by loss of self-esteem or overfatigue, a depressed mental state can significantly impact the body’s ability to trigger sexual arousal. ED itself can exacerbate the symptoms of depression, and vice versa. 
• Loss of interest. A reduction in libido may cause ED. Symptoms stemming from a lack of interest in sex may have as much to do with partner familiarity as they do a lack of testosterone, and relationship issues can trigger an onset of ED symptoms.

Does erectile dysfunction last forever?

In most cases, men who were able to previously achieve and maintain an erection may well find that there is a good chance of reversing ED. This is largely cause-dependent, although maintaining a healthy, active lifestyle greatly improves one’s chances of achieving a full recovery from ED symptoms.

ED caused by uncontrolled long-term conditions like diabetes, high blood pressure and high cholesterol, a full recovery may be impeded by the long-term damage that has been caused. Early onset of such long-term conditions makes it easier to cure ED by reversing the effects of these conditions. A healthy lifestyle has a large part to play in this.

Where long-term conditions are not controlled, or where they have caused long term damage, the chances of reversing ED become slim. Hardening and thickening of arteries caused by high blood pressure and cholesterol reduce blood flow to the penis. Nerve damage caused by uncontrolled diabetes over a long period of time can also cause ED.

Can erectile dysfunction be cured?

While there is no simple cure for ED, engaging in the following healthy lifestyle practices can limit your risk of suffering from erectile dysfunction. 

• Lifestyle changes. Meditation, exercise, and increased sleep can have profound effects on your body’s ability to ward off the effects of ED and maintain a prolonged erection. The increased brain activity, uptick in chemical processes and heightened mental state achieved by regular maintenance and resting activities is linked to a sustained ability to engage in healthy sexual function.
• Counselling or therapy. Seeking the help of a medical or mental health practitioner can go a long way towards combating the negative self-image, depression and other psychological factors often associated with, or characterised by, erectile dysfunction. Understanding that millions of men around the world share the symptoms of ED can reduce the anxiety of feeling embarrassed by an inability to achieve an erection. In this situation, ED is likely to be temporary.
• Medication. There are a number of medications available that specifically combat the symptoms of erectile dysfunction. From popular brands like Viagra and Cialis to non-branded cheaper alternatives such as sildenafil tablets and tadalafil tablets. These treatments work by helping to increase blood flow to the penis. For those who don’t like the idea of taking a tablet before sex, there is the option of taking tadalafil daily, a low dose tablet that is taken every day to help you achieve and erection spontaneously.
• Alternative medicine. Many men aren’t aware that treatments such as acupuncture can help treat ED. It is thought that by stimulating the nerve pathways of the body and increasing blood circulation, the body’s ability to achieve an erection is enhanced.
• Medication changes. Some medications, such as beta blockers and antidepressants can potentially cause ED. In the event of an increased or decreased dose – or the introduction of a new treatment protocol – it is wise to observe even perceived changes in sexual desire and arousal. The faster you take note of a decrease in the ability to maintain an erection upon starting a new medication, the more likely a medical professional can potentially alter your treatment protocols.

How long does erectile dysfunction last after steroids? 

The use of anabolic steroids can cause ED. Steroids are synthetically produced drugs which mimic the action of testosterone. Men looking to build muscle will take steroids in an bid to gain more muscle, as more testosterone can help to build muscle and lose fat. The use of steroids, also referred to as “roids”, can increase blood pressure and cholesterol, causing ED. By taking steroids, you are confusing the body as it thinks that it does not need to produce its own testosterone. This can shrink the testicles, reducing libido and making it difficult to get an erection. It can take around 3-12 months for testosterone levels to return to normal after steroid use. Maintaining a healthy lifestyle during this time can help to speed up this process.

How long does erectile dysfunction last after prostate surgery?

ED after prostate surgery is something most men will experience after the procedure. This is due to nerve damage as a result of surgery. Depending on the nature of surgery and how possible it was to spare the nerves, ED is likely. ED can last up to 3 years after surgery; however, around 40-50% of men will recover within one year, with 30-60% of men taking 2 years to recover.

ED following radiation therapy has a worse outcome, with up to 50% of men experiencing erectile dysfunction following the procedure. It is unlikely that men experiencing ED following prostate radiation therapy will see much improvement.  During this time, your GP or urologist is likely to prescribe ED medication to help overcome erectile problems. Penis pumps may also be recommended where medical intervention is not possible.

How to treat erectile dysfunction permanently

When it comes to the onset of ED, there are often underlying issues that require resolution prior to tackling any secondary aggravators. Once the primary source of ED has been identified and addressed, it is possible to reverse and treat the condition permanently. In some primary cases – for example if a man has never been able to achieve or maintain a rigid erection – treating ED permanently is more of a challenge, depending on the cause. Erectile problems caused by psychological factors can be treated with therapy and counselling, however, response to counselling will vary depending on the individual. Where the issue is physical, the root cause will need to be identified and treated. Where this is not possible, medical intervention using ED treatments may help.

Similarly, a medical condition such as Parkinson’s disease, Multiple Sclerosis or irreversible nerve damage may make curing ED unlikely or impossible. In the event that you believe you are suffering from the onset of ED symptoms, consult a medical professional in order to determine your best course of action. Early identification – and the understanding that erectile dysfunction is a normal, common, and treatable ailment – can go a long way toward preventing further complications.

FAQs:

Does erectile dysfunction go away by itself?

Erectile dysfunction can go away by itself if the cause is psychological. It may take therapy or counselling to help restore confidence, but it is usually temporary. ED caused by physical factors is harder to reverse and depends on the extent of damage caused by long-term conditions. Treating the underlying issues early on increases the chances of ED going away.

Is erectile dysfunction normal?

ED is an overwhelmingly common and normal condition that affects millions of men around the world. If ED isn’t caused by a significant underlying condition such as diabetes or heart disease, your chances of recovery following treatment are very high.

Can young people suffer from ED?

Despite generally having a high testosterone level, many young men can – and regularly do – experience the symptoms of erectile dysfunction. Hormonal imbalances, alcohol consumption and performance anxiety can play a part in causing ED in young people. Psychological factors are one of the main culprits in causing ED in younger men.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.