Over 80% of ED is caused by treatable physical issues1. Whether from disease, surgery, or injury – ED isn’t inevitable. Below, we break down how each condition contributes to ED and what recovery can look like.
One diagnosis,
many causes.
Prostate Cancer
Treatment of prostate cancer – whether prostatectomy, radiation therapy, or hormone therapy – often renders men impotent. You can add years to your life with these treatments and keep life in those years. The options are not mutually exclusive.
97
five-year relative survival rate for prostate cancer.2
314
new cases of prostate cancer annually in the US.3
Things to know:
- Surgery and radiation both lead to large declines in sexual function with comparable ED 5 years post treatment4
- Hormone therapy has the most profound effect on sexual function5
- With early and proper interventions men with treatment-induced ED can regain a satisfying sex life
Peyronie’s Disease
Peyronie’s is a condition in which scar tissue develops within fibrous envelope of the erectile tissue in the penis. This scarring can cause the penis to curve during an erection and in some cases can compromise the ability to maintain the rigidity necessary for penetration because the affected areas do not fill with blood as efficiently.
88
of men experience complete resolution of penile curvature with a penile prosthesis.6
13
men in the US with symptoms of Peyronie’s Disease.7
Things to know:
-
Peyronie’s often interferes with sexual function7.
-
Surgical treatments are the most effective for improving penile curvature6.
-
Penile prosthesis with modeling both straightens curvature and restores erection potency6.
Spinal & Pelvis Injury
Spinal and pelvic trauma can disrupt the nerves and blood vessels that drive erections and yet men rank sexual function as one of the most important factors in life satisfaction after injury. Fortunately, even in the most severe neurogenic ED, erections can be restored for most men.
75
of spinal cord injuries result in persistent ED.8
36
of pelvic fractures result in persistent ED.9
Things to know:
- The incidence of chronic erectile dysfunction following a spinal cord or pelvic injury varies depending upon the severity and type of injury10
- Across the six months following the incident men typically gain some erectile function back9
- Some erectile function can mean reflex erections which often are not sufficient for intercourse10
Diabetes
Chronic high blood sugar levels – whether from Type 1 or Type 2 diabetes – can damage blood vessels and nerves that are essential for erectile function11. As well, the hormonal changes associated with diabetes can reduce erectile function12. The good news is that there are many effective treatments for diabetic men with ED.
50
of men with diabetes have ED.12
40
of men with ED do not respond to oral therapies.13
Things to know:
- Lifestyle changes aimed at improving blood sugar control and heart health improve ED on their own and enhance the effectiveness of other ED treatments11.
- Diabetic men have a higher chance of not responding to oral medications, even after trying the maximum dose14.
- When oral medications prove ineffective, other therapies almost always help.
Heart Disease
Cardiovascular disease and erectile dysfunction share common causes – damaged arteries reduce blood flow to both the heart and penis15. Better circulation means better erectile function. Most men with heart disease can be safely and successfully treated for ED16.
50
of men with heart disease who experience ED.17
3
on average by which ED often precedes a first heart attack or other cardiovascular event.15
Things to know:
- Erectile dysfunction can be an early indicator of heart disease; any treatment approach should address both sexual function and heart safety18.
- Lifestyle modifications to optimize overall cardiac health are strongly encouraged alongside any erectile dysfunction treatment19.
- Men taking nitrate drugs for chest pain cannot use oral ED medication16.
References
- Khera M Goldstein I (2011) BMJ Clin Evid. 2011 Jun 29. https://pubmed.ncbi.nlm.nih.gov/21711956/
- American Cancer Society. (2024). Survival rates for prostate cancer. https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/survival-rates.html
- American Cancer Society. (2024). Key statistics for prostate cancer. https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
- Resnick, M. J., et al. (2013). Long-term functional outcomes after treatment for localized prostate cancer. The New England Journal of Medicine, 368(5), 436–445. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735098/
- Nguyen, P. L., et al. (2015). Adverse effects of androgen deprivation therapy and strategies to mitigate them. European Urology, 67(5), 825–836. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005072/
- Usta MF, Bivalacqua TJ, Sanabria J, Koksal IT, Moparty K, Hellstrom WJ
(2003). Patient and partner satisfaction and long-term results after surgical treatment for Peyronie’s disease. Urology. 2003 Jul - DiBenedetti D.B., et al. (2011). A Population-Based Study of Peyronie’s Disease: Prevalence and Treatment Patterns in the United States. Advances in Urology. 2011 Oct.
- Zizzo J, Gater DR, Hough S, Ibrahim E.(2022) Sexuality, Intimacy, and Reproductive Health after Spinal Cord Injury. J Pers Med. 2022 Dec 1 https://pmc.ncbi.nlm.nih.gov/articles/PMC9781084/?utm_source=chatgpt.com
- Harvey-Kelly KF, Kanakaris NK, Eardley I, Giannoudis PV. (2011)Sexual Function Impairment After High Energy Pelvic Fractures: Evidence Today. Journal of Urology [Internet]. 2011 Jun 1
- Previnaire JG, Soler JM, Alexander MS, Courtois F, Elliott S, McLain A.(2017) Prediction of sexual function following spinal cord injury: a case series. Spinal Cord Ser Cases. 2017 Dec 13
- Mayo Clinic. Erectile Dysfunction. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20043927
- Endocrinology Advisor. Diabetes and Erectile Dysfunction. https://www.endocrinologyadvisor.com/features/diabetes-and-erectile-dysfunction
- Diabetes Self-Management. When Viagra Doesn’t Work. https://www.diabetesselfmanagement.com/managing-diabetes/complications-prevention/when-viagra-doesnt-work
- Endothelial Rehabilitation: The Impact of Chronic PDE5 Inhibitors on Erectile Function and Protein Alterations in Cavernous Tissue of Diabetic Rats
De Young, Ling X. et al.
European Urology, Volume 54, Issue 1, 213 – 220 - Yannas D, Frizza F, Vignozzi L, Corona G, Maggi M, Rastrelli G. Erectile Dysfunction Is a Hallmark of Cardiovascular Disease: Unavoidable Matter of Fact or Opportunity to Improve Men’s Health? J Clin Med. 2021 May 20
- American Heart Association. Sexual Activity and Heart Disease. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/sex-and-heart-disease
- Prevalence and Risk Factors for Erectile Dysfunction in the US
Selvin, Elizabeth et al.
The American Journal of Medicine, Volume 120, Issue 2, 151 – 157 - Vlachopoulos, C., Xanthakis, V., Ioakeimidis, N., et al. (2021). The role of erectile dysfunction as a cardiovascular risk factor: Current data and future directions. Therapeutic Advances in Cardiovascular Disease, 15, 1–12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8161068
- Esposito, K., Giugliano, F., Di Palo, C., et al. (2004). Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. The American Journal of Medicine, 117(7), 510–516. https://www.amjmed.com/article/S0002-9343(06)00689-9/fulltext
TREATMENT OPTIONS
Where there is innovation, there is hope.
Modern treatment options are more effective, less invasive, and more personalized than ever before. Whether you’re just beginning to explore solutions or looking for what’s next, you're not out of options – you’re on the edge of new possibilities.
Listen to the real stories of strength and triumph over ED.
Stay up-to-date with the latest Edin insights & resources.
+20k
Join over 20,000 men. Put an end to your ED.