Erectile dysfunction (ED) is the inability to get or maintain an erection long enough to have sexual intercourse. There are many different causes, which may include conditions that affect your blood vessels, neurological conditions, mental health conditions and injuries. A healthcare provider can diagnose and treat erectile dysfunction.
Your feelings play a major role in getting and maintaining an erection. Feeling relaxed, confident and aroused is essential. But it is 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 are having difficulty getting or maintaining an erection, it is 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 is important to talk to a healthcare provider if you have problems getting and maintaining an erection.
Other names for erectile dysfunction include:
Healthcare providers separate ED into several categories:
- Vascular erectile dysfunction. Vascular ED includes causes that affect the blood vessels that send blood to the tissues in your penis that allow you to get and maintain an erection, or the valves in the penis that normally hold blood inside. Vascular ED is the most common type of ED.
- Neurogenic erectile dysfunction. Neurogenic ED occurs as a result of nerve problems, which prevent signals from traveling from your brain to your penis to create an erection. This can happen because of trauma, pelvic surgery, radiation therapy or neurologic conditions like stroke, spinal stenosis and multiple sclerosis (MS).
- Hormonal erectile dysfunction. Hormonal ED refers to ED that happens as a result of testosterone deficiency, or in some cases as a result of thyroid issues.
- Psychogenic erectile dysfunction. Psychogenic ED involves psychological conditions (conditions that affect your thoughts, feelings or behavior) that can cause ED.
- How common is erectile dysfunction?
- Erectile dysfunction is the most common sex-related condition that men and people assigned male at birth (AMAB) report to healthcare providers, especially as they age and develop other health issues.
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What is the usual age for erectile dysfunction?
Providers and medical researchers estimate that erectile dysfunction affects over 50% of people who identify as male between the ages of 40 and 70. And those numbers may be higher — many do not seek help for the condition due to embarrassment or shame.
Symptoms and Causes
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.
The factors may include:
- Certain conditions or diseases
- Diabetes and diabetes-related neuropathy.
- High blood pressure (hypertension).
- High cholesterol (hyperlipidemia).
- Vascular disease.
- Chronic kidney disease.
- Atherosclerosis.
- Peyronies disease.
- Low testosterone (testosterone deficiency).
- Stroke.
- Epilepsy.
Injuries (trauma) to your penis and surrounding areas can also cause ED. They include:
- Penile fracture.
- Injuries to your pelvis bones (hip bones, sacrum and tailbone), bladder, prostate and spinal cord.
- Pelvic surgery, including prostate, colon or bladder cancer surgery.
- Radiation therapy.
- Certain medications
Erectile dysfunction is a common side effect of many prescription drugs. Common medications that list ED as a potential side effect include:
- Antidepressants.
- Anti-anxiety medications (anxiolytics).
- Blood pressure medications.
- Diuretics.
- Antihistamines.
- Chemotherapy drugs.
- Parkinsons disease drugs.
- Prostate cancer drugs.
- Antiarrhythmics.
- Sedatives.
- Muscle relaxers.
- Antiseizure medications.
Substances that have addiction potential may cause ED, including:
- Alcohol.
- Amphetamines.
- Barbiturates.
- Cocaine.
- Marijuana.
- Methadone.
- Nicotine.
- Opioids.
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.
Psychological and/or emotional conditions
- Depression.
- Anxiety.
- Stress.
- Fear of sexual intercourse or intimacy (genophobia).
- Low self-esteem.
