Erectile Dysfunction: Symptoms, Causes & Treatment

This video goes through a summary of Erectile Dysfunction and answers the following questions:

  1. Can you get Erectile Dysfunction from COVID-19?
  2. What is the main cause of Erectile Dysfunction?
  3. Which Erectile Dysfunction Drug is the best?
  4. Are there different types of Erectile Dysfunction?

Erectile Dysfunction can be a complex matter to understand. We are here to help break down all the components and questions you may have:

What is Erectile Dysfunction (ED)?

Erectile dysfunction, or ED, is the consistent inability to sustain an erection sufficient for sexual intercourse.

In other words, erectile dysfunction is when someone cannot “get up” or hold an erection firm long enough.

It can be:

  • A total inability to have an erection
  • The ability to have an erection, but only some of the time

Erections occur when sexual stimulation and excitement cause the brain, nerves, heart, blood vessels and hormones to work together to rapidly increase the amount of blood flowing to the erectile tissue of the penis. The blood becomes trapped and held in the two spongy chambers (called the corpus cavernosa) in the shaft of the penis. As the chambers fill with blood, they expand, and the penis becomes firm and elongated.

Erectile dysfunction in men tends to be more common as they age, but this also affects men at all stages of life.

Erectile Dysfunction Causes

Erectile dysfunction: why and how does it happen?

Erectile dysfunction causes could be physical or psychological.

Psychological Erectile Dysfunction

Psychological erectile dysfunction is a condition that can be caused by anxiety, depression, stress, or other mental health issues.

The most common symptom of psychological ED is an inability to get an erection firm enough for sexual activity. However, some people with psychological ED may be able to get an erection but have trouble maintaining it during sex.

Here are the most common psychological conditions that can cause erectile dysfunction or make it worse.


Stress outside of your sex life can also have a significant impact on your ability to achieve and sustain an erection.


Depression is caused by many things, like the environment, chemical imbalances in the brain, unresolved trauma, family history, health problems, and using drugs or alcohol.


Sexual performance anxiety is often a factor in impotence, but generalised anxiety can also affect your body’s ability to perform and succeed in the bedroom.


People who have erectile dysfunction often can feel like they’re not good enough and have low self-esteem.

Relationship Dysfunction

For many people in romantic relationships, sex is an important way to communicate, connect, and feel closer to each other. When there are problems in your relationship, it can also hurt your sex life.

While physical causes of ED are often treatable with medication or other interventions, psychological causes can be challenging to manage. And while there’s no one-size-fits-all approach to treating psychological ED, there are ways you can help yourself feel better and improve your sexual health — even if you don’t see results right away.

Want to know more about psychological erectile dysfunction? Click here

Physical Erectile Dysfunction

There are several conditions and causes that lead to physical erectile dysfunction, such as heart disease, high blood pressure, Parkinson’s disease, certain medications, tobacco use, sleep disorders or alcoholism.

In most cases, erectile dysfunction is a symptom of a physical cause.

  • Over 80% of men with erectile dysfunction can trace its origin back to a physical problem or disorder. Physical causes of erectile dysfunction include:
  • Diseases like diabetes, high blood pressure, high cholesterol or heart disease.
  • Operations such as prostate removal that cause local trauma to the erectile mechanism
  • Substance use such as the use of tobacco, alcohol, drugs or some medications
  • Hormonal disorders such as low testosterone
  • Peyronie’s disease
  • Surgeries or injuries that affect the pelvic area (such as prostatectomy) or the brain and spinal cord


It is a common misconception that psychological erectile dysfunction is more prevalent. Thoughts and emotions always play a role in getting an erection, but erectile dysfunction is primarily caused by something physical. Sometimes, it may be the first sign of an underlying medical problem. As such, while erectile dysfunction treatments may involve sexual counselling, medical and surgical interventions are also available and effective.

Erectile Dysfunction Treatments

Erectile dysfunction treatments are determined by the cause and whether psychological or physical factors cause it.

There’s no one erectile dysfunction cure. But there are several erectile dysfunction treatment options available today. These include:

  • Medications such as Viagra or Cialis
  • Penile injection therapy
  • Penile prosthetic surgery

If the non-surgical treatment options are ineffective for you, erectile dysfunction surgery by implantation of a penile prosthesis can be considered. The implant is a three-piece, fluid-filled inflatable prosthesis that consists of two inflatable cylinders placed in the penis, a pump implanted in the scrotum and a fluid-filled reservoir placed in the lower abdomen.

You can read more about Penile prosthetic surgery here and watch Dr Katelaris’ video on erectile dysfunction treatments here.

The Latest & Most Effective in Erectile Dysfunction Treatment

There are many erectile dysfunction treatment options available today, including non-surgical and surgical options. If you’re considering treatment options for erectile dysfunction, it’s important to consult with an erectile dysfunction specialist first so they can recommend the best treatment plan for your needs.

  • Making lifestyle modifications. Quitting smoking, losing weight and eating healthier will improve your ability to have and maintain an erection.
  • Oral medications, called PDE5 inhibitors. The most famous of these is Viagra, but similar medications include Cialis or Levitra. Some of these are taken once daily, and some are taken “on-demand” before sex. They work by increasing the blood flow to the erectile tissue in the penis.
  • Vacuum constriction devices. For some kinds of erectile dysfunction, a vacuum constriction device that increases blood flow to the erectile tissue by creating negative pressure around the penis may be effective.

If you are having erection problems, the above treatment options may be effective in restoring your penis function. The decision is yours on whether to take an active role in your own health and seek out and educate yourself on these erectile dysfunction solutions.

Frequently Asked Questions (FAQs)


According to some studies, ED is the most common type of sexual dysfunction in men.

Even though the chance of having ED increases with age, young men can still have it. A study in the Journal of Sexual Medicine found that about 26% of men under the age of 40 had erectile dysfunction (Capogrosso et al., 2013).

You can also listen to Dr. Katelaris and Steve Price’s in-depth discussion on Erectile Dysfunction in the 2GBs HealthMatters Program here.


In most cases, erectile dysfunction is a symptom with a physical cause. Over 80% of men with erectile dysfunction can trace its origin back to a physical problem or disorder.

Several factors can cause a weak erection. To name a few: diabetes, heart conditions, being overweight, having previous treatments for other conditions, certain medications, mental health conditions, injuries, tobacco use, drug use, and alcohol use.


There are many things that can cause erectile dysfunction. However, if there aren’t any physical health problems or conditions, we need to look deeper to find out what’s going on. Erectile dysfunction can also be caused by psychological factors.

Just like there is no single physical cause for ED, there is no single psychological cause for ED in men. Instead, psychological ED can be caused or made worse by a number of things, such as:

  • Anxiety, whether it’s about life in general or about sex
  • Fear of sexual failure or poor sexual performance
  • Having feelings of guilt about doing sexual things
  • Stress about sex or long-term stress from other problems
  • Depression and other disorders of the mind
  • Problems in relationships
  • Excessive porn consumption
  • Low self-esteem

While erectile dysfunction is a physical condition, psychological issues can also be causes and effects of erectile dysfunction.


Typically, the recovery time for the most common erectile dysfunction surgery, the Penile Prosthetic Implant, is around six weeks. After that, sexual activity can be continued safely.


Yes, erectile dysfunction therapy is available when the ED is caused by psychogenic causes, such as loss of partner or relationship problems. It is best to discuss your options with a urologist for erectile dysfunction.


Many men confuse premature ejaculation with erectile dysfunction, but they are two separate things. Erectile dysfunction is the inability to start and maintain an erection for sexual activity. On the other hand, premature ejaculation is when a man gets an orgasm too quickly. Too quickly to satisfy his partner or to satisfy himself.


Sex is a very important part of life. It’s something that brings people together and shows their love and commitment to each other. It’s also important for men because it helps them feel good about themselves, but if they have erectile dysfunction problems, then they may be too embarrassed to talk about it. But that’s what we’re here for! We understand what you’re going through, and we’re here to help.

Dr. Katelaris has been helping men like you for more than 35 years. You are not alone in this. You don’t have to be. You can trust us, and together, we will figure out an individualised treatment option for your condition.

For tips how to talk about Erectile Dysfunction watch this video here


You may already be aware that smoking impairs the elasticity of your heart and lungs’ blood vessels. Experts believe it has a similar effect on the penile blood vessels. As a result, erections become shorter as blood vessels reach their maximum length.

Smoking is a strong risk factor for erectile dysfunction. Men who smoke have ED twice as often as men who don’t smoke.

Because of how the chemicals in cigarettes affect the blood vessels in the penis, smoking can impair your ability to get and maintain an erection. An erection occurs when the arteries of the penis dilate and fill with blood in response to impulses from the penis’s nerves. The nerves respond to the brain’s sexual arousal impulses. Even if the neurological system is healthy, it may be physically impossible to achieve an erection if the blood vessels are unhealthy due to smoking.

Learn more about how smoking can cause erectile dysfunction here.


According to research, lifestyle changes can improve erectile function. In a five-year study, roughly one-third of Australian males aged 35 to 80 had erectile dysfunction. These difficulties improved spontaneously in 29% of men, suggesting that modifiable factors, such as lifestyle, were responsible for the reversal of erectile dysfunction (Esposito et al., 2015).


If you have trouble getting or keeping an erection and have been wondering what you can do to help, you can take some natural remedies and talk to a specialist to improve your performance.

These are no substitute for getting treatment and talking to a specialist, but they may help.

Here are some natural remedies you can do:


Eating a well-balanced diet may help you keep your sexual function and lower your chance of getting ED.


Exercise may help protect against and treat ED. It may work especially well if your ED is caused by, among other things, being overweight, not being active, or having heart disease.

Physical activity can help with ED by making blood vessels healthier, lowering stress, and raising testosterone levels.


A study from 2017 found that men who worked night shifts and said they slept less well were more likely to have ED (Pastuszak et al., 2017).

Researchers in 2019 also found that people with sleep problems were more likely to get ED (Cho & Duffy, 2019). Another study says that people with obstructive sleep apnea are more likely to have ED (Kellesarian et al., 2018).

Weight loss

Researchers in 2020 found that ED was much more common in men who were obese, overweight, or had a larger waist circumference (Pizzol et al., 2020).

A small study from 2014 showed that men with obesity who had gastric bypass surgery had better blood vessel health and ED (Kun et al., 2014). Another research done in 2017 found that ED also got better after bariatric (weight loss) surgery (Glina et al., 2017).

Vitamins and Supplements

There are vitamins and supplements that can help improve blood flow to that important area.

You can learn how vitamins, supplements, and living a healthy life can help treat ED here.


If your erectile dysfunction is mild, you don’t need surgery. Most of the time, Viagra or Cialis works very well for men with mild ED. However, some men find that these drugs don’t give them the results they want. Men who take nitroglycerin or nitrate-based medications, for example, can’t take PDE5 inhibitors, which are the most common medicines for erectile dysfunction. Moreover, men with erectile dysfunction because of an injury or other trauma may also find that these medicines aren’t enough. They may need procedures that can fix their problem to get their erections back. For these men and many others with underlying health problems, surgery may be the only solution that is possible.

Whether mild or severe, in the field of erectile dysfunction, the treatment is based on the patient and their condition. Your specialist will recommend the best treatment option possible.

For more information regarding this, you can check out Dr. Katelaris discussion here.

What is it like to live with Erectile Dysfunction?

Our patient education series are videos for patients dealing with Erectile Dysfunction (ED) produced by Katelaris Urology and feature Dr Katelaris as well as patients who have experience prostate cancer and erectile dysfunction.

In this video, Davide Sandoe shares the silver lining of surviving prostate cancer, coming to grips with early incontinence, seeking options and eventually getting a penile implant.

This video features David Sandoe OAM and Pam Sandoe OAM, who survived prostate cancer surgery and decided to have a penile prosthesis to restore their Quality of Life as a couple. David is a former National Chairman of Prostate Cancer Foundation of Australia (PCFA) and Pam Sandoe OAM is a former PCFA Prostate Cancer Support Group Co-Leader at Sydney Adventist Hospital, this is their ED story.

Looking for an Erectile Dysfunction Specialist Sydney?

Erectile dysfunction isn’t just a problem for older men. Millions of men of all ages have trouble maintaining an erection when they want and/or need it. Thankfully, new developments in erectile dysfunction treatments mean that there is hope for millions of people who have erectile dysfunction, whether your problems are age-related or the result of another condition.

If you’re looking for a reliable and trusted erectile dysfunction clinic in Sydney, Dr Katelaris is an erectile dysfunction specialist in Sydney with over 35 years of experience in the field. He has been awarded the coveted Noel Newton medal from the Royal Australasian College of Surgeons. He has also been granted the highly recognised Keith Kirkland Prize from the Australian and New Zealand Urological Society.

Get in touch with us here to find out how we can help.


Capogrosso, P., Colicchia, M., Ventimiglia, E., Castagna, G., Clementi, M. C., Suardi, N., Castiglione, F., Briganti, A., Cantiello, F., Damiano, R., Montorsi, F., & Salonia, A. (2013). One patient out of four with newly diagnosed erectile dysfunction is a young man—worrisome picture from the everyday clinical practice. The Journal of Sexual Medicine, 10(7), 1833–1841.

Cho, J. W., & Duffy, J. F. (2019). Sleep, sleep disorders, and sexual dysfunction. The World Journal of Men’s Health, 37(3), 261.

Esposito, K., Maiorino, M. I., & Bellastella, G. (2015). Lifestyle modifications and erectile dysfunction: What can be expected? Asian Journal of Andrology, 17(1), 5.

Glina, F. P., de Freitas Barboza, J. W., Nunes, V. M., Glina, S., & Bernardo, W. M. (2017). What is the impact of bariatric surgery on erectile function? A systematic review and meta-analysis. Sexual Medicine Reviews, 5(3), 393–402.

Kellesarian, S. V., Malignaggi, V. R., Feng, C., & Javed, F. (2018). Association between obstructive sleep apnea and erectile dysfunction: A systematic review and meta-analysis. International Journal of Impotence Research, 30(3), 129–140.

Kun, L., Pin, Z., Jianzhong, D., Xiaodong, H., Haoyong, Y., Yuqian, B., & Hongwei, Z. (2014). Significant improvement of erectile function after roux-en-y gastric bypass surgery in obese Chinese men with erectile dysfunction. Obesity Surgery, 25(5), 838–844.

Pastuszak, A. W., Moon, Y. M., Scovell, J., Badal, J., Lamb, D. J., Link, R. E., & Lipshultz, L. I. (2017). Poor sleep quality predicts hypogonadal symptoms and sexual dysfunction in male nonstandard shift workers. Urology, 102, 121–125.

Pizzol, D., Smith, L., Fontana, L., Caruso, M. G., Bertoldo, A., Demurtas, J., McDermott, D., Garolla, A., Grabovac, I., & Veronese, N. (2020). Associations between body mass index, waist circumference and erectile dysfunction: A systematic review and meta-analysis. Reviews in Endocrine and Metabolic Disorders, 21(4), 657–666.