Erectile Dysfunction
9 minute read

Guide to Erectile Dysfunction: Symptoms, Causes and Latest Treatments

Written by
Reviewed by
Dr. Joseph Santos & Dr. Ai Nhi Bui

Erectile dysfunction is a common condition that affects many men. One study from 2010 states that 40% of Australian men experience ED, and another from 2017 cites that 61% of Australian men aged 45 and older are affected. Occasionally a man may encounter ED problems, but when it happens routinely and consistently enough to disrupt your sex life, then seeking investigation and treatment from a licensed doctor is recommended. This guide will answer some of your most common questions and concerns around ED treatment, causes and symptoms.

Table of Contents:

  1. What is erectile dysfunction?
  2. Common signs and symptoms of ED
  3. Common causes of ED
  4. Erectile dysfunction diagnosis
  5. Erectile dysfunction medications and treatment
  6. Getting prescriptions and treatment from an online doctor for ED
  7. Erectile dysfunction FAQs

What is erectile dysfunction?

Erectile dysfunction or ED is defined as trouble getting or maintaining erections that are sufficient enough for sex. This occurs when there is insufficient blood flow to the penis, and when the penis is unable to trap blood to sustain an erection. It is also referred to as impotence.

While ED can affect men of all ages, the risk of developing the condition increases with age.

ED symptoms and signs

The three most common erectile dysfunction symptoms include:

  1. Difficulty getting an erection
  2. Softer erections
  3. Erections that cannot be maintained

However, experiencing problems with erections isn’t always a cause for concern. According to the Cleveland Clinic, it’s normal to have trouble with erections for up to 20% of sexual encounters. If you are having trouble getting and maintaining an erection for more than 50% of sexual encounters, then this may be an indication of a medical issue. 

Erectile dysfunction can also decrease your desire for sex, contribute to or cause anxiety and depression, or be the cause of relationship stress between you and your partner.

Common causes of ED

There are many possible erectile dysfunction causes, and they can include both emotional and physical conditions. Some of the most common possible causes of ED include: 

Just one of these factors could be the sole cause of ED, or it could be caused by several of them. That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions. 

Let’s explore how the most common causes lead to ED.

Diabetes and ED

Erectile dysfunction is common in men who suffer from diabetes, and the condition tends to develop 10 to 15 years earlier than men without diabetes. The cause of erectile dysfunction in men with diabetes stems from damage to nerves and blood vessels caused by poor long-term blood sugar control. 

Cardiovascular disease and ED

Because adequate blood flow to the penis is required to get and maintain an erection, any pre-existing physical conditions that impact heart health and arteries can lead to ED. This includes conditions like hypertension (high blood pressure) and high cholesterol.

If you have high blood pressure, some of the medications you are on can also affect sexual function and cause ED. The drugs that are more likely to do this are beta blockers and diuretics, however, this is not a common side effect and will not happen to everyone. If you are concerned that the blood pressure medication you’re taking may be contributing to ED, speak to your doctor. 

Stress-induced ED

There’s a well-documented link between mental health conditions and erectile dysfunction. Stress and anxiety can interrupt how the brain sends messages to the penis to allow extra blood flow, making it difficult to get and maintain an erection. 

ED can also be caused by negative thoughts related to sex. Men can feel pressure to please their partners or feel insecure about their sexual performance or body image, which can lead to performance anxiety-induced ED. This can sound like a vicious cycle, since dealing with ED can exacerbate any previous performance anxiety in the bedroom. It is also possible for certain medications that treat mental health conditions to cause erectile dysfunction or low libido. 

Hormonal imbalances and ED

Hormonal imbalances in the body can cause erectile dysfunction. The common culprits include increased prolactin, imbalanced thyroid hormones, hormones used to treat prostate cancer and in some cases, low testosterone.

The link between poor lifestyle and impotence

Several unhealthy lifestyle factors can lead to or exacerbate erectile dysfunction. These poor lifestyle factors include weight problems, high alcohol consumption, drug use, tobacco use and lack of physical activity. 

Even an occasional cigarette can lead to a significant decrease in erectile performance. Studies suggest that smokers may be twice as likely to develop erection problems compared to non-smokers. This is because smoking damages blood vessels, resulting in poor circulation throughout the body, including blood supply to the penis. The risk of smoking-related ED is compounded when combined with other ED-related conditions, such as diabetes, high blood pressure and obesity.

Maintaining a healthy diet and weight can help to improve or avoid the symptoms of many conditions, such as diabetes, heart disease and high blood pressure. Erectile dysfunction is no different. 

Some studies have shown a clear link between weight loss and improved sexual performance. A 2005 study looking at the effects of weight loss on erectile dysfunction showed that 31% of men who lost a higher amount of weight reported restored erectile function. A recent study from the University of Adelaide shows that men who are obese or overweight are more likely to suffer from ED, but that ED can be improved or resolved through weight loss and improvements in physical activity. 

Alcohol consumption and drug use are also predisposing factors for ED as they can alter the way the body functions from a vascular and hormonal perspective.

Causes of ED

Diagnosing erectile dysfunction

When you recognise that there may be an issue with your erectile performance and decide to see a doctor, they will usually ask you questions about your sexual and medical history, medications you may be currently taking and lifestyle to get an idea around what may be the cause of your sexual dysfunction. In some cases, a physical exam, imaging or blood test may be necessary. The more your doctor knows about you, the better they will be able to treat you. 

While it might be uncomfortable speaking to a doctor about something so delicate and personal to you, seeking help with ED is the right first step. It’s important to understand that erectile dysfunction is a very common condition that doctors treat and that a healthy sex life is an important part of being human.

ED medications and treatments

There are many ED treatment options, but what’s right for you will depend on a number of factors including underlying causes, lifestyle and age. There is no ‘best ED treatment’ or one size fits all approach, and your treatment plan will depend on your own unique needs and health.

Medications for erectile dysfunction

Medications are a popular non-invasive approach. There are prescription medications available in Australia that work well for many men. The most common ED drugs are known as PDE type-5 inhibitors, which typically come in the form of oral pills. They work by increasing the flow of blood to the penis by interfering with the breakdown of chemicals needed to maintain an erection. This then results in more of those chemicals staying in action for longer, which improves erectile performance. It’s important to note that PDE type-5 inhibitors do not help with low libido or premature ejaculation. Arousal and stimulation will still be required in order for an erection to be attained despite taking medication. The most commonly prescribed PDE5 inhibitors for ED in Australia are Sildenafil (Viagra), Tadalafil (Cialis), Avanafil (Spedra) and Vardenafil (Levitra).

Lifestyle changes for erectile dysfunction

You may also be able to make a few lifestyle changes. For example, it may help if you quit smoking, lose weight, exercise more often or cut down on how much alcohol you drink.

Psychological treatment for erectile dysfunction

When erectile dysfunction is caused by anxiety or depression, a psychologist with experience in this treatment can help. Talking about stress, anxiety and depression with a trained professional can help to make you feel more confident in yourself and your relationship. Depending on the severity of psychological factors, medications to treat this causal factor may need to be considered.

Devices or surgery for treating ED

While devices and surgical options exist, they are not a first-line treatment for erectile dysfunction. Vacuum constriction devices (VCD) are pumps for impotence that can be used to improve erectile performance. If ED is prolonged and severe, then vascular reconstructive surgery to improve blood flow to the penis may be considered. However, surgery is a route that is rarely recommended as it doesn’t always work. Penile injections are another second-line therapy for ED that can be considered if oral ED medications are not effective.

Getting prescriptions and treatment from an online doctor for ED

Many men prefer accessing treatment for erectile dysfunction in the most discreet way possible, and this can be achieved by accessing ED meds online. 

At Rosemary, you can access the latest ED treatments once you are assessed by one of our licensed Australian doctors. If you have previously been diagnosed with ED and prescribed medication, you can also use Rosemary to access ongoing scripts after completing an online assessment. All medication is delivered for free to your door in discreet packaging for additional privacy and convenience.

Frequently asked questions about erectile dysfunction

Is ED in young men common?

While the prevalence of ED in men increases with age, it is not insignificant in young men. According to a 2013 study published in the Journal of Sexual Medicine, erectile dysfunction is more common amongst younger cohorts of men than health professionals previously thought. 

Researchers of this study found that ED affected 26% of adult men under 40 years of age. 1 in 4 young men experience erectile dysfunction, meaning this condition is actually quite common.  

Can I treat erectile dysfunction naturally?

Depending on the cause of your erectile dysfunction, lifestyle modifications such as quitting smoking, reducing stress, avoiding alcohol, exercising and adhering to a healthy diet could help to reduce or improve symptoms. These types of lifestyle modifications could be considered a form of natural ED treatment to be used in conjunction with prescription medications, devices or therapy.

In terms of products sold as natural remedies for ED, there are a number of worrying supplements on the market that you need to be wary of. Supplements sold as “ED treatment” could potentially have dangerous ingredients that may interact with the regular medications you currently take.

Before considering taking any kind of supplement for ED, we recommend you speak to your doctor first so that they are able to rule out or identify any underlying causes and work out the best and safest course of treatment. Rosemary doctors can help advise you on a personalised treatment plan based on your medical history.

Can I do any exercises for ED?

Lifestyle improvements including an increase in physical activity has shown to be helpful for ED, so exercise in general should be included as part of a healthy lifestyle. 

Is there an ED cure out there?

There is no “instant ED cure.” However, erectile dysfunction can be improved through a variety of treatments and approaches that look to address the underlying cause. 

Where can I get erectile dysfunction medication in Australia?

Erectile dysfunction medication is prescription only, and there is currently no access to over-the-counter erectile dysfunction pills in Australia. 

To access these medications, you will need to be assessed and diagnosed by a doctor. You can complete an online assessment from the privacy of your home on Rosemary and a licensed online doctor will review within hours. Once medication has been prescribed, ongoing scripts can be supplied through Rosemary, and all of your medication will be shipped discreetly to your door within 2 business days. 

ED treatment online with Rosemary Health

ED is a common problem amongst men of all ages and Rosemary makes it easy to access real doctors and treatments to help in a discreet and convenient way. Learn more about erectile dysfunction treatment on Rosemary.


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