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Erectile dysfunction, or ED, occurs when a man can't get or maintain an erection hard enough for intercourse. This 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.
While ED is common, affecting about 30 million men in the U.S., it more frequently affects older men. However, ED isn't a normal part of aging — instead, it's usually a sign of a more serious issue.
Causes of ED include:
ED can also have psychological roots. It can be caused by:
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 percent of the time you have sex, or if your erection problems are becoming more frequent, you should see your doctor.
To determine if you have ED, your doctor will perform a physical exam of your genital area, check your blood pressure, and order urine and blood tests. They may suggest getting an ultrasound of your penis.
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 open as possible.
Your doctor may also suggest you wear 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.
Treatment for ED depends on what's causing the problem. Often, making lifestyle changes can make a big difference. Many men have more consistent erections and a healthier sex life when they:
Other treatments include: