Last Updated: May 10, 2018

Erectile Dysfunction (ED)

Overview

Erectile dysfunction (ED) is a sexual disorder where a man is not able to get or maintain an erection for sexual intercourse. An estimated 30 million men in the United States are affected by ED, also referred to as “impotence.” Although the risk of ED increases with age, the natural process of aging is not the cause.

The process of forming an erection begins when a man experiences sensory or mental stimulation, which sends signals from the brain to nerves in the penis. These impulses relax local muscles, allowing a rush of blood that expands the penis to a full erection. A normal erection lasts until after sexual climax, when local muscles contract to stop blood inflow. Loss of function at any of these steps can lead to ED.

ED can cause social/emotional anxiety and have a negative impact on intimacy. Additionally, it poses a challenge for partners trying to become pregnant. It is critical to discuss ED with a physician in case it is a symptom of an underlying medical condition, such as heart disease and diabetes.  Depending on the cause, a variety of treatment options are available.

Causes and Risk Factors

ED is caused by a range of emotional, psychological and physical conditions that affect the normal process of achieving an erection. In some instances, multiple factors are involved. Physical conditions can cause ED by damaging the nerves, muscles, arteries and fibrous tissues involved in an erection, while psychological/emotional factors interfere with the initial sensory stage of arousal. Sometimes the anxiety associated with ED exacerbates the condition.

Physical Causes

Psychological Causes

Risk Factors

Symptoms

The symptoms of ED include:

Diagnosis and Treatment

Physicians diagnose ED by performing a physical exam and questioning the patient about their symptoms. The following tests may be performed to identify the cause of ED:

Lifestyle changed can often remedy ED and restore sexual function back to normal. These include avoiding tobacco, drugs and alcohol, and improving physical fitness. Additionally, receiving proper therapy for anxiety, depression and other psychological triggers of ED is important.

If ED is the result of a health condition, such as diabetes or heart disease, then therapy is focused on treating those conditions. Patients who develop ED due to prescription medication can talk to their doctors about alternative medications. Therapies specifically targeting ED include drugs, pumps and surgery (as a last resort).

Prevention

Regular exercise and mental health welfare are effective ways of preventing the lifestyle causes of ED. It is also important to limit alcohol and avoid drugs and tobacco.

Sources

Additional Resources

Home Health Testing Guides

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Authored by: Tina Shahian, PhD