Erectile Dysfunction

Erectile dysfunction (impotence) is the incapability to get and maintain an erection firm enough for sex.

Having an erection problem from time to time isn’t necessarily a cause for concern. If erectile dysfunction is ongoing, it can cause stress, affect self-confidence, and contribute to relationship issues. Problems getting or keeping an erection can also be a sign of an underlying health condition that requires treatment and a threat factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re apologetic. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, they might require medications or other direct treatments.

Symptoms

Erectile dysfunction symptoms might include persistent:

Trouble getting an erection
Trouble keeping an erection
Reduced sexual desire

Causes

Male sexual arousal is a complicated process that affects the brain, emotions, hormones, nerves, muscles and blood vessels. Erectile dysfunction can result from a situation with any of these. Likewise, stress and mental health problems can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological problems causes erectile dysfunction. For example, a minor physical condition that slows your sexual response might cause worry about maintaining an erection. The resulting stress can lead to or worsen erectile dysfunction.

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

Heart disease
Low testosterone
Clogged blood vessels (atherosclerosis)
High cholesterol
Certain prescription medications
High blood pressure
Diabetes
Obesity
Parkinson’s disease
Multiple sclerosis
Tobacco use
Peyronie’s disease — development of scar tissue inside the penis
Alcoholism and other forms of substance abuse
Sleep disorders
Treatments for prostate cancer or enlarged prostate
Surgeries or injuries that affect the pelvic area or spinal cord

Psychological causes of erectile dysfunction

The brain plays a critical role in triggering the sequence of physical events that cause an erection, starting with feelings of sexual excitement. Some things can interrupt sexual feelings and cause or worsen erectile dysfunction. These include: