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Innermost Secrets / Innermost Living / Body Clock
Skip Navigation LinksMale Sexual Problems
Page modified at: 08/12/2009

50 percent

More than 50% of men between the ages of 40 and 70 years experience ED to some degree. And millions of men are doing something about it

On OffEvery once in a while, men can have problems getting or maintaining an erection that is hard enough for sexual intercourse. With ED (erectile dysfunction), erection problems keep happening.

If you have ED or think you may have it, you are not alone.

ED isn't just about being tired or stressed. Chances are that your ED may have a physical cause, such as another health condition or a side effect of a medicine that you may be taking. For that reason, ED may not just go away on its own. However, it can be effectively treated in most men.

What Is ED?
EDWhen a man has ED (erectile dysfunction), he may not be able to get an erection that's hard enough for sexual intercourse. Or he may have difficulty keeping an erection until the end of sexual intercourse. ED is sometimes called impotence. Many men have erection problems every once in a while. But with ED, problems happen again and again.

ED can range from frequently not being able to get or keep an erection to never being able to achieve one or keep one.

To get and maintain an erection that is firm enough for sexual intercourse, a sequence of events must occur in the body. Sexual stimulation triggers the brain to send nerve messages to the penis. This signals blood to flow into the penis, which causes the penis to get hard. Blood stays trapped in the penis until sexual activity is completed. ED can happen when any one of these events is disturbed.

How can ED affect a man or his partner?

ED CoupleED can affect more than just your body.
It may also affect how you feel about yourself

Cause depression and stress

Cause guilt or anxiety about not being able to have sex when you and your partner want to

Affect your partner and your relationship with your partner

When does ED occur?
ED can happen at any age.
As men age, ED becomes more common. But simply getting older does not cause ED. ED may be caused by health problems that can happen with age, such as diabetes or high blood pressure.

How common is ED?
More than 30 million men older than 50 in the United States are affected by some degree of ED (erectile dysfunction). And nearly 70% of these cases of ED have physical causes. These causes can include health conditions, injury, and medicine side effects. Psychological factors can also play a role in causing ED.

What causes ED?

Possible Physical Causes of ED
High blood pressure (also called hypertension)
High blood pressure can lead to damage to the blood vessels, which results in decreased blood flow. Not enough blood flows into the penis to get a firm erection.

Diabetes (high blood sugar)
Diabetes can increase the risk for having ED. Over time, high blood sugar can damage blood vessels and nerves in the penis.

High blood cholesterol
Over time, high blood cholesterol can cause blood vessels in the penis to narrow. Not enough blood flows into the penis to give a firm erection.

Nerve diseases
Men with diseases that affect the nerves, such as Parkinson’s disease and multiple sclerosis, are at a higher risk for having ED. The penis does not receive nerve messages from the brain or spinal cord. Without the nerve messages, blood does not flow into the penis.

Injuries or surgery to the pelvic area
Injuries or surgery to the pelvic area (especially prostate and rectal surgery) can damage nerves or blood vessels in the penis.

Low hormone levels
Low male hormone levels (such as testosterone) can decrease a man’s desire for sex and affect his ability to get an erection. Men with thyroid hormone levels that are too low or too high can also have ED.

ED as a possible side effect of medicine
Taking certain medicines may cause ED as a side effect. Medicines that can cause ED include: Some medicines that treat high blood pressure, depression, or psychiatric conditions and Antihistamines

Be sure to tell your doctor about all the medicines you take, including herbal supplements. And always talk with your doctor before you stop taking any medicines that your doctor has prescribed.

Lifestyle factors
Certain lifestyle factors may increase the risk for getting ED, such as:
Being overweight
Drinking too much alcohol
Not being physically active
Using recreational drugs, such as marijuana, cocaine, or heroin

Psychological Causes of ED
About 10% to 20% of all cases of ED may be caused by emotional or personal issues, such as:
Stress at work, at home, or in social life
Anxiety about sexual performance
Relationship problems
Men with a physical cause for ED may also develop these problems.

Can ED be treated?
In most men, ED is treatable whether the cause is physical or psychological. When you make the decision to talk with your doctor about ED, you are taking an important step toward better sexual health. Because ED may be an early warning sign of other health conditions, such as cardiovascular disease, high blood pressure, or hypothyroidism, it is important to tell your doctor if you think you might have ED.

What are the treatment options for ED?

Lifestyle Changes
To help treat ED, your doctor or other healthcare professional may suggest you make some lifestyle changes, such as:

  • Quit smoking
  • Get to and stay at a healthy weight
  • Exercise regularly
  • Limit alcohol
  • Stop using recreational drugs (such as marijuana, cocaine, or heroin)

These changes may also help to improve health conditions that may be related to ED, such as diabetes, heart disease, and high blood pressure.

To have a satisfying sexual experience, your mind and your body need to work together. When emotional or relationship problems get in the way, they can make ED worse. Sometimes a man or a couple can benefit from talking with a trained counselor to help resolve personal issues that might be interfering with sexual intimacy. Some of these issues might include anger, resentment, lack of trust, fear of not being able to perform sexually, or disappointment. Some doctors believe that a combination of medical treatment and counseling for ED may achieve the best results.

Other ED Treatment Options
Your doctor may recommend other ED treatment options, such as injection therapy or surgery. These options may be suggested if you cannot take an oral medicine because of a health condition or interactions with other medicines you are taking.

Oral Prescription Medicines
Oral prescription medicines (tablets) are the most common medical treatment for ED. These medicines are convenient to use. Prescription ED tablets work well for most men who have mild, moderate, or severe ED. These medicines can work even when ED is caused by another medical condition, such as diabetes or high blood pressure.

CialisCIALIS is one of three medicines in this class of prescription drugs. These ED medicines help increase blood flow in the penis when a man is sexually stimulated. The medicines help a man with ED get and keep an erection that is firm enough for sexual activity. Once sexual intercourse is completed, blood flow to the penis lessens, and the erection goes away.

All ED tablets are not exactly the same. They can differ in:

* Length of time a single dose of medicine works
* Possible side effects
* Food or medicine interactions

If one medicine does not work for you, another one may. To find the treatment that's right for you, talk with your doctor.

For most men, oral medicines work well to treat ED. Research shows that some men who do not respond to these medicines may not be taking the medicine the right way or taking the right dose. Because the medicines come in different dosages, your doctor can adjust the dosage to help find the right dose that works for you.

CIALIS for daily use

CIALIS for daily use is a low dose ED (erectile dysfunction) treatment that is taken every day that can improve erectile function. It can be a very effective option for men with a range of ED severity and other health problems.

  • When taken every day, it can help you be ready anytime between doses.
  • You no longer have to plan sex around taking a pill
  • It is a clinically proven low-dose ED treatment option
  • Side effects were similar to those seen with 36-hour CIALIS

Cialis 5mgCIALIS for daily use is available in 2 doses (2.5 mg and 5 mg) so it's easy for your doctor to adjust your dose. You and your doctor will determine the dose that works best for you. Your doctor may change your dose of CIALIS depending on your body's response to the medicine and on your medical condition.

Your doctor must know about all the medicines (both prescription and nonprescription), vitamins, and herbal supplements you take. CIALIS and other medicines may affect each other. Your doctor needs to be aware of any potential drug interactions.


Always check with your doctor before you start or stop any medicines.
It is especially important for your doctor to know if you take medicines called nitrates (often used for chest pain), medicines called alpha blockers (sometimes prescribed for prostate problems or high blood pressure), other blood pressure medicines, antifungals, or medicines for HIV.

CIALIS works only with sexual stimulation
You won't get an erection just by taking CIALIS for daily use. Sexual stimulation is needed to get an erection. When sexual activity is over and blood flow to the penis decreases, your erection will go away.

CIALIS for daily use is convenient to take

Because the absorption of CIALIS is not affected by food, you can take daily CIALIS anytime during the day or evening. You can eat and drink what you want. But do not drink alcohol in excess (to a level of intoxication) when taking CIALIS. Too much alcohol can increase your chances of:

  • Headache
  • Dizziness
  • A drop in blood pressure
  • Increased heart rate

Cialis is not for everyone

Only your doctor can decide if CIALIS is right for you. Before taking CIALIS, ask if you're healthy enough for sexual activity and be sure to tell your doctor about all your medical conditions and all medications. Don't take CIALIS if you take nitrates as the combination can cause a sudden, unsafe drop in blood pressure.

CIALIS for daily use remains in your body for as long as you take it. Tell your doctor about all medications, especially if you take nitrates (often used for chest pain) or medicines for blood pressure, alpha blockers, antifungals, or HIV, so your doctor can be aware of potential drug interactions.

Don't drink alcohol in excess (to a level of intoxication) with CIALIS, as this may increase your chances of getting dizzy or lowering your blood pressure. CIALIS does not protect against sexually transmitted diseases, including HIV. The most common side effects with CIALIS were headache and upset stomach. Backache and muscle ache were also reported, sometimes with delayed onset.

As with any ED tablet, in the rare event of an erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury.

In rare instances, men taking prescription ED tablets (including CIALIS) reported a sudden decrease or loss of vision or hearing (sometimes with ringing in the ears and dizziness). It's not possible to determine if these events are related directly to the ED tablets or to other factors. If you have a sudden decrease or loss of vision or hearing, stop taking any ED tablet, including CIALIS and call your doctor right away.

Further Information and Support
The following can be helpful in various ways to ED sufferers and their partners:

Sexual Dysfunction Association (formerly The Impotence Association) Tel: 0870 7743571.

Institute of Psychosexual Medicine Tel: 020 7580 0631.

Family Planning Association (fpa)/Sexual Health Direct Tel: 0845 310 1334.

Brook Advisory Centres For Young People Tel: 08000 185 023.

Relate Tel:0300 100 1234.

British Association for Sexual and Relationship Therapy (BASRT) Tel:020 8543 2707.