Erectile dysfunction (ED) is the inability to get and maintain an erection for sexual intercourse. While more common in older men, ED is not a regular part of aging. It is a serious condition that can take a toll on your mental health and relationships. Treatment for ED ranges from simple lifestyle habit changes and medication to medical devices and surgery. ED is a curable condition.
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What Is Erectile Dysfunction?
Erectile dysfunction (ED) occurs when a man can't get or maintain an erection hard enough for intercourse. ED can happen if an insufficient amount of blood is flowing into the penis, the penis can't trap the blood during an erection, or nerve signals from the brain can't reach the penis.
There may be many reasons for failing to achieve an erection at certain points in life, due to stress or lifestyle habits like drinking alcohol in excess. But ED is an ongoing condition that can cause mental health issues and relationship problems if not treated.
Thankfully, there are multiple treatment options available for those suffering from ED. Health care professionals try to find and treat the root cause or underlying condition first. Depending on your overall health history, treatment may include lifestyle changes, medication, medical device help, or surgery.
How common is erectile dysfunction?
ED is common — a lot more common than you might have thought. It is estimated that between 30 million and 50 million men have ED in the U.S. alone. While it more frequently affects older men, it is not a normal part of aging — instead, it’s usually a sign of a more serious issue.
What causes erectile dysfunction?
There are many causes for ED — from health conditions to lifestyle habits to certain medications and mental health conditions.
The most common reason for ED is underlying diseases and conditions, which include:
- Chronic diseases such as chronic kidney disease and chronic obstructive pulmonary disease.
- Conditions related to the male reproductive system, such as an enlarged prostate.
- Diabetes.
- High blood pressure.
- Injury or surgery.
- Low testosterone or other hormonal imbalances.
- Multiple sclerosis.
- Obesity.
- Parkinson's disease.
- Spinal cord injuries.
ED can also be a side effect of taking certain medications, including:
- Antidepressants.
- Appetite suppressants.
- Allergy medication.
- Blood pressure medication.
- Chemotherapy.
- Heartburn medication.
- Sedatives.
- Ulcer medication.
Mental health conditions or interpersonal issues that can cause ED include:
- Anger.
- Anxiety.
- Body dysmorphia or body-image issues.
- Depression.
- Isolation or loneliness.
- Low self-esteem or confidence.
- Poor communication with your partner.
- Stress.
Certain lifestyle habits can cause ED, such as:
- Abusing alcohol.
- Abusing recreational or illicit drugs.
- Being overweight or obese.
- Smoking tobacco.
Erectile dysfunction risk factors
You are more likely to suffer from ED at some point in your life if you:
- Drink alcohol frequently.
- Have other health conditions such as diabetes, heart disease, or obesity.
- Take certain medications such as antidepressants or blood pressure medicine.
- Smoke cigarettes.
- Suffer from mental health conditions such as anxiety, depression, or chronic stress.
Complications of erectile dysfunction
ED can cause other complications, such as:
- Inability to conceive a baby with partner.
- Relationship strain and loss of intimacy with partner.
- Unfulfilling or embarrassing sex life.
- Worsening mental health conditions that include low self-esteem and depression.
How can I prevent erectile dysfunction?
The best way to prevent erectile dysfunction is by assessing your lifestyle and creating healthier habits.
Habits to include:
- Avoiding recreational and illicit drug use.
- Eating a balanced diet.
- Exercising regularly.
- Limiting or avoiding alcohol consumption.
- Reducing stress.
- Seeing a mental health counselor or therapist.
- Quitting smoking tobacco.
What Are the Signs and Symptoms of Erectile Dysfunction?
The primary symptom of ED is not being able to get or keep an erection on a regular basis. If you can't get or maintain an erection at least 25% of the time you have sex, or if your erection problems are becoming more frequent, you may have ED.
It’s important to remember that ED can also be a symptom of a different underlying health condition.
When should I see a doctor about my erectile dysfunction symptoms?
If you are experiencing any of the above symptoms, it is best to talk with your doctor about erectile dysfunction. These personal conditions may feel awkward or uncomfortable to talk about, but having an open conversation with your doctor is your best chance at treating the issue and restoring your sex life.
How Do You Diagnose Erectile Dysfunction?
To determine if you have ED, your doctor will review your medical history with you, perform a physical exam, and order some tests.
First, you can expect your doctor to discuss your health history, including your physical health condition, mental health state, and current ED symptoms.
Be prepared to answer questions about the issues you're having with erections, as well as your lifestyle. Your doctor may ask you what over-the-counter or illicit drugs you take, how much alcohol you drink, and whether you're stressed or anxious. Your answers to these questions will help give your doctor a total picture of your health and lifestyle, so it's important to be as honest as possible.
Next, your doctor may perform a physical exam of your genital area to look for any other conditions.
Then, they will likely check your blood pressure and order urine and blood tests. They may also suggest getting an ultrasound of your penis if they want to check on blood flow.
Tests to diagnose erectile dysfunction
Tests your doctor may order include:
- Nocturnal erection test — This test involves wearing a device to monitor nighttime erections. If you have erections while sleeping or when you wake up, the cause of your ED likely isn't physical. It may be caused by stress, a relationship issue, or another emotional or psychological problem. If your doctor believes that's the case, they may suggest psychological tests or counseling.
- Intracavernosal injection—Also called an injection test, this test will help your doctor understand your condition by measuring the length and stamina of your erection through a medicine injected into the penis.
How Do You Treat Erectile Dysfunction?
Treatment for ED depends on what's causing the problem. There are many options for treating ED today, and your care team will talk with you (and your partner) about which methods are most appropriate for you.
Lifestyle changes to treat erectile dysfunction
Oftentimes, changing some lifestyle habits can make a big difference in improving erectile dysfunction.
Many men have more consistent erections and a healthier sex life when they:
- Adopt better sleep habits.
- Cut back on alcohol
- Eat a healthier diet.
- Exercise regularly.
- Lose weight.
- Quit smoking.
Counseling and therapy to treat erectile dysfunction
Finding a therapist who specializes in sexual health can help improve symptoms significantly, especially if they are worsened by stress within your relationship. Talking about the condition with your partner and a couples counselor can also be beneficial. Therapy is known to help alleviate depression, anxiety, and stress, which can all make ED worse.
Medications to treat erectile dysfunction
Some medications you are taking may be making your ED worse. It’s important to talk with your doctor about all medications and supplements you are currently taking to see if you can switch medications, change dosage, or stop taking a medication altogether. Do not do this without consulting your doctor first.
In addition to stopping or changing medication, your doctor may also prescribe new medications for your ED, most likely phosphodiesterase type 5 (PDE5) inhibitors. These medications bring more blood flow to the penis for a healthier erection.
Here’s what you need to know:
- Injectable medication — You may choose to receive PDE5 as a self-injection, typically into the spongy tissue on the side of the penis.
- Suppository — These same medications can also be received via a small suppository, or solid form of medicine that is inserted into the urethra — the tube that connects your bladder to the tip of your penis.
- Testosterone — If you have low testosterone (low-T), your doctor may prescribe a boost of T in the form of oral medication, gel, or a patch you adhere to your skin.
- Other medications — Some people say certain vitamins, minerals, or other supplements have helped with ED. Talk to your doctor before you start any third-party treatment plans for your erectile dysfunction.
Medical devices to treat erectile dysfunction
Your doctor may offer a vacuum erectile device (VED) to help you create and maintain erections. This instrument includes a plastic tube that you place around your penis, a pump that creates a vacuum, and an elastic ring that helps keep you erect. You use this device before sexual activity.
VEDs can take practice and may bring some slight side effects, including:
- Penis feels cold or numb.
- Penis looks bruised or purple.
- Weakened ejaculation.
Surgery to treat erectile dysfunction
Most men can treat their ED without needing surgery. Some, however, may need a procedure to help alleviate their symptoms.
The two surgeries to treat ED are:
- Penile implants — Also called a prosthesis, this procedure involves inserting a semirigid or inflatable implant into the penis so it can become erect and then flaccid again. There are a few different types of implants, and your doctor may suggest a certain one depending on the severity of your condition and other health factors, such as age and overall health.
- Vascular reconstructive surgery — This surgery is a rare treatment method for ED that has weak treatment results. Typically reserved for younger men who have tried all other treatment methods, this procedure involves transferring an artery from a muscle in another part of the body (usually the abdomen) to the penis to create more blood flow for erections.
There are risks when choosing surgery options, so it’s important to work with your care team and make the best decision for you and your life.
