Erectile dysfunction (ED), or impotence, is the inability to consistently get or keep an erection (hard penis) long enough to have satisfactory sex. To maintain an erection, blood must be able to flow into and stay in the penis until orgasm.
Men often have problems with their erections once in a while. If ED occurs often, medical treatment may help.
ED can happen at any age, but is more common in men older than 65. Physical problems cause about 70 percent of cases; emotional issues cause about 10 to 20 percent; and 10 to 20 percent have a mixed physical and emotional cause.
The cause of erectile dysfunction (ED) is most often a physical problem, such as a disease or drug side effects.
The most common causes of ED are health problems that affect blood vessels and blood flow in the penis. These include hardening of the arteries (atherosclerosis), which is linked to diabetes, obesity, smoking, high blood pressure, and high cholesterol. Therefore, ED may be a sign of heart disease or other serious health problems.
Rare causes of ED include scarring and curving of the penis (Peyronie’s disease).
If you have been having ED for more than two months, you should see a doctor to find the cause. To detect the cause of ED, your doctor will take a history of when you started to have problems with erections and sex drive, illnesses or injuries that could cause ED, and any recent physical or emotional changes in your life. You also will need to list all the medications you take. The evaluation most often includes a physical exam and a blood test to check testosterone levels.
Depending on the results, your doctor may also order blood tests for other hormones, fasting blood glucose (sugar), and cholesterol. Your doctor may also test for liver, kidney, and thyroid function. Rarely, some men need special tests to check nerve function, blood vessels, and blood flow.
Treatment for ED will depend on the cause and how serious your condition is. Treatment options can include the following.
Devices and surgery
Dietary supplements are unproven treatments for ED, and some contain harmful ingredients.
All treatment options have risks. Finding the right treatment for you may take several tries. Your doctor will work with you to find the best treatment option for you. If the cause of your ED is a hormone imbalance, your doctor might refer you to an endocrinologist (an expert in hormone-related conditions).