Erectile dysfunction (ED) is a type of penile disorder. It affects your ability to get and maintain an erection firm enough for sexual intercourse.
Your feelings play a major role in getting and maintaining an erection. Feeling relaxed, confident and aroused is essential. But it’s normal to sometimes have erection issues. Erection problems can occur if you feel nervous, anxious, frustrated or tired. Drinking alcohol and/or using substances can also have an effect. It can also result from other conditions or as a side effect of certain medications or cancer treatments.
If you’re having difficulty getting or maintaining an erection, it’s a good idea to schedule an appointment with a healthcare provider for further discussion.
In many cases, ED can be the first symptom of another underlying problem, including heart disease. It’s important to talk to a healthcare provider if you have problems getting and maintaining an erection.
Other names for erectile dysfunction include:
Impotence.
Impotency.
What are the symptoms of erectile dysfunction?
Erectile dysfunction symptoms include:
Only sometimes being able to get an erection before sexual intercourse.
Being able to get an erection before sexual intercourse but not being able to maintain it during sexual intercourse.
Complete inability to get an erection.
Requiring a lot of stimulation to maintain an erection.
What causes erectile dysfunction?
There are many possible causes of ED, including conditions that affect your:
Circulatory system. Your circulatory system includes the blood vessels that carry blood throughout your body. Your penis needs adequate blood flow to become erect and maintain an erection. Your penis also relies on a series of valves to close when it fills with blood — in some cases, these valves stop working as they should.
Nervous system. Your nervous system includes your brain, spinal cord and nerves. They work together to send electrical impulses that help your body move and feel, including your penis.
Endocrine system. Your endocrine system includes the glands that create and release hormones. Hormones help tell your body to perform certain functions. Testosterone may help open up (vasodilate) your blood vessels, which helps blood flow to your penis.
These substances can affect and suppress your central nervous system. They can also cause severe damage to your blood vessels, which may lead to permanent erectile dysfunction.
The first step in treating erectile dysfunction is identifying the underlying cause. A healthcare provider will help determine the best treatment for you. Treatment options may include:
Cardiovascular exercise. Vigorous cardiovascular exercise for at least 45 minutes three times per week may help reverse some cases of mild ED. Cardiovascular exercises may include brisk walking, jogging, swimming, bicycling and jumping rope.
Quitting smoking. For men with mild ED, quitting smoking can lead to improvement after several months.
Oral medications that help increase blood flow to your penis, including sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®) or avanafil (Stendra®). Oral medications start to work within an hour.
Penile low-intensity focused shockwave therapy (LiSWT). This noninvasive treatment improves blood flow by using sound waves. It can take two months to see improvement.
Medications you inject directly into your penis to create an erection, including alprostadil (Caverject®), papaverine (Papacon®), phentolamine (Regitine®) or a combination of multiple medications. Injectable medications start to work within 10 minutes.
Testosterone replacement therapy, which is available as a gel, injection, patches and pellets. Testosterone replacement therapy starts to work within four weeks.
Penile implant procedure. A penile implant is a procedure in which a surgeon places a device into your penis to make it hard. The device doesn’t affect sensation, peeing or orgasm.
Will ED go away on its own?
ED will not likely go away on its own without changes to your lifestyle or some kind of treatment.
A healthcare provider can diagnose ED and determine its cause. They’ll review your medical history and perform a physical exam. They’ll also ask you questions about your personal and sexual history. These questions may make you feel embarrassed or awkward. But it’s important to be honest with the provider in order to quickly determine the cause. The questions may include:
Are you currently taking any medications, including prescription drugs, over-the-counter drugs, herbal supplements, dietary supplements and nonmedical drugs?
Has a healthcare provider ever diagnosed you with depression or anxiety?
Do you often feel stressed?
Are you experiencing any relationship problems?
How often are you able to get erections?
How hard are your erections?
How long are you able to maintain an erection?
Do you lose your erection because you ejaculate sooner than you would like?
When did you first notice symptoms of erectile dysfunction?
What exactly happened when you first had erectile dysfunction symptoms?
Do or did you experience erections at night or during the morning?
What sexual positions do you regularly engage in?
The provider may also ask to talk with your sexual partner. Your partner may be able to offer additional insight on potential causes.
The provider may order tests to confirm their diagnosis and determine the cause of your ED.
What tests will be done to diagnose erectile dysfunction?
It depends on what your healthcare provider suspects is causing erectile dysfunction. Your provider may order:
Before testing, your provider will explain what’s involved with a test and answer any questions you have. If you don’t feel comfortable, you can decide not to do the test at any time.
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