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Erectile Dysfunction

Last updated March 21, 2018

Erectile dysfunction (ED) is a medical problem found in males. It is characterized by the inability to secure or keep an erection long enough for sexual intercourse.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Impotence

What is Erectile Dysfunction? (Definition/Background Information)

  • Erectile dysfunction (ED) is a medical problem found in males. It is characterized by the inability to secure or keep an erection long enough for sexual intercourse.
  • While it is normal to have trouble getting or keeping an erection from time to time, people suffering from ongoing difficulties should consult a medical professional.
  • Without medical help, erectile dysfunction can not only cause sexual difficulties, but also influences other parts of life. It can cause stress, relationship problems, and self-confidence issues that may result in the development of other medical issues.
  • Many people may hesitate to consult their doctor to treat ED. Although it may be an uncomfortable conversation, it is important as the source of your erectile dysfunction may be from another health problem like heart disease or diabetes. By diagnosing your erectile dysfunction, other health problems can be assessed as well. 

Who gets Erectile Dysfunction? (Age and Sex Distribution)

  • Erectile dysfunction occurs exclusively in males. It can affect men of all ages, although it is more common in middle-age and older men.
  • Most men will suffer from erectile dysfunction sometime in their life.
  • In America, it is estimated that 30% of men between the age of 40 and 70 suffer from ED.

What are the Risk Factors for Erectile Dysfunction? (Predisposing Factors) 

Common risk factors of erectile dysfunction include:

  • Advancing age
  • Diabetes
  • Heart disease
  • Tobacco use
  • Overweight/obese
  • Alcohol use
  • Use of certain medications, including antidepressants, antihistamines
  • Stress 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Erectile Dysfunction? (Etiology) 

  • Normally, erections occur due to various nerve and muscle stimulations. The nerves in the penis must send and receive signals properly, blood circulation to and from the penis must be sufficient, the veins of the penis must be able to sustain blood through the penis, and the brain must send and receive signals to begin this chain of events. If problems arise in any part of the pathway, erectile dysfunction is likely to occur. 
  • Stress or other emotional issues can also cause erectile dysfunction. When people are stressed, they will likely have trouble focusing on an erection and not be able to develop one. This can become a cycle where they develop anxiety due to the inability to maintain an erection, which further worsens their situation.
  • Various medical conditions can also cause erectile dysfunction to occur. The following medical conditions likely cause damage to one step in the pathway to an erection:
    • Heart disease
    • Atherosclerosis (blood vessel blockages)
    • High cholesterol
    • Diabetes
    • Obesity
    • Low testosterone
    • Parkinson’s disease
    • Multiple sclerosis

Damage or mistakes during surgery can also cause erectile dysfunction. This is especially problematic when surgery occurs in the pelvic or spinal cord area.

What are the Signs and Symptoms of Erectile Dysfunction?

Common signs and symptoms of erectile dysfunction include:

  • Difficulty getting an erection
  • Difficulty sustaining an erection
  • Low sexual desire
  • Depression

If your erectile dysfunction is caused by another medical problem, symptoms will also include those that are associated with that medical condition.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

How is Erectile Dysfunction Diagnosed?

  • In most cases of erectile dysfunction, a physical exam and a collection of medical history will be adequate enough for your doctor to make a diagnosis of erectile dysfunction.
  • In cases where your doctor believes that your erectile dysfunction is caused by damage to the body, more tests will likely be required. These can include:
    • Physical exam of penis and testicles to test nerve function
    • Blood test to check for heart disease, diabetes
    • Urine test to check for diabetes, other medical conditions
    • Ultrasound to determine blood flow levels to and from the penis

If your doctor suspects that the source of your erection problems is psychological, they may suggest an overnight erection test. This involves wrapping tape around the penis before you go to sleep. If the tape is broken in the morning, it indicates that you had an erection sometime during the night. This shows that the source of your erectile dysfunction is likely psychological and not physical.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Erectile Dysfunction?

  • In many cases of erectile dysfunction, complications can arise. These can include:
    • Stress or anxiety due to the inability to produce an erection
    • Embarrassment
    • Low self-esteem
    • Relationship problems

How is Erectile Dysfunction Treated? 

  • A variety of treatment options are available to treat erectile dysfunction. The most common are oral or other types of medications.
  • Common oral medications include Viagra (Sildenafil), Cialis (Tadalafil), and Levitra (Vardenafil). All of these medications increase the effects that nitric oxides have on the penis so that the penile muscles can relax. This, in turn, increases blood flow to the area and makes it easier to develop an erection.
  • If oral medications do not improve your condition, your doctor may suggest other forms of medications. Alprostadil self-injections involve using a needle to inject alprostadil into the penis. This allows for an erection that typically lasts for one hour.
  • If medications prove ineffective, different treatment options are available.
    • A penis pump can be used to create a vacuum that sucks blood into the penis. Once an erection has been achieved, a tension ring is placed around the penis to maintain the blood in it.
    • Penile implants can also be placed into the two sides of the penis. These implants have inflatable rods that can be controlled so that men with erectile dysfunction can produce erections when they want and for however long they want.

If your erectile dysfunction is caused by psychological rather than physical reasons, your doctor may suggest psychological counseling. 

How can Erectile Dysfunction be Prevented?

  • Erectile dysfunction occurs in men of all ages and physical statures. For this reason, it is often difficult to pinpoint the best prevention methods.
  • The most effective way of preventing erectile dysfunction is to make good, healthy lifestyle choices. It is important to eat healthy and exercise regularly, avoid excessive smoking or alcohol usage, and treat any existing medical conditions that you may have. 

What is the Prognosis of Erectile Dysfunction? (Outcomes/Resolutions)

  • With proper diagnosis and treatment of erectile dysfunction, most men are able to return to normal functioning. They regain their ability to produce erections and resume normal sexual functioning.
  • In many cases, however, people are too nervous or shy to approach their doctor about their erection issues. These individuals usually suffer prolonged erection problems that can impact all aspects of their life as their condition worsens.

Additional and Relevant Useful Information for Erectile Dysfunction:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/sexual-health/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 5, 2013
Last updated: March 21, 2018