A man’s impotence, or inability to achieve or maintain an erection, might be a symptom of a medical problem.
Erectile dysfunction (ED) is a male’s inability to get an erection that’s firm enough for sexual intercourse.
The condition is also called impotence.
ED can result in an unsatisfactory sex life and cause other problems, including:
- Low self-esteem
- Relationship problems
The condition is also one of the causes of male infertility, if a man is unable to impregnate his partner.
Erectile dysfunction is often a symptom of underlying medical problems, such as:
- Cardiovascular disease
- Neurological diseases
- Alcoholism or drug abuse
- Hypogonadism or low testosterone
- Smoking history
Treatments for ED, including oral medications, are generally highly effective.
Erectile dysfunction affects between 7 and 52 percent of men, depending on the specific group being studied, according to various research.
Age is a major factor in developing ED.
About half of men older than 60 will experience the condition, while fewer than 10 percent of men under age 60 experience it.
Symptoms of Erectile Dysfunction
The occasional inability to get an erection is considered normal.
The condition is only called erectile dysfunction when one or more of the following happens frequently, or lasts a long time:
- Difficulty getting an erection
- Difficulty keeping an erection
- Reduced sexual desire
Causes of Erectile Dysfunction
Getting and keeping an erection involves many physical and psychological factors, and the condition can have many causes.
- Atherosclerosis (hardening or narrowing of the arteries)
- High cholesterol
- High blood pressure
- Parkinson’s disease
- Multiple sclerosis (MS)
- Substance abuse, including alcoholism
- Sleep disorders
ED can also result from injuries to the pelvic area or spinal cord, or as a side effect of surgery.
Treatments for enlarged prostate (benign prostatic hyperplasia, or BPH) or prostate cancer may cause ED, as can some prescription medications.
A condition called metabolic syndrome can also cause ED.
Men with metabolic syndrome have high blood pressure, high cholesterol, elevated insulin levels, and excess fat around the waist.
Psychological factors are often involved in ED. These can include:
- Problems with relationships
ED can be caused by a combination of physical and psychological factors.
Risk Factors for ED
Men with diabetes or heart conditions are at a higher risk for ED, as are those who use tobacco or are seriously overweight.
Other risk factors for the condition include:
- Taking certain medications, including antihistamines, blood pressure drugs, and antidepressants
- Prostate surgery
- Radiation treatment for cancer
- Injury to the penis, or to the nerves or arteries that control erections
- Abusing drugs or alcohol
- Stress, anxiety, depression and other psychological factors
Men who spend lots of time bicycling may also be at risk for ED, since bicycle seats can injure nerves and blood vessels that assist in erections.
Erectile Dysfunction Treatment
Oral medications (sometimes called “erection pills”) are the most common treatment for ED and are generally effective.
- Cialis (tadalafil)
- Levitra (vardenafil)
- Stendra (avanafil)
- Viagra (sildenafil)
These ED medications can cause a dangerous and irreversible drop in blood pressure if they’re taken with certain other medications, including nitroglycerin or any other nitrates used for chest pain.
Less serious side effects may include vision changes, headache, flushing, back pain, and upset stomach.
Another treatment for ED is injecting Caverject (alprostadil) into the penis just before sex. Suppositories of the drug placed in the urethra may also be used instead of injections.
Testosterone therapy may be tried as an ED treatment if a man has below-normal levels of the hormone testosterone.
Manual devices can also be used to treat ED.
Electric or hand-powered vacuum pumps remove air from a hollow tube placed over the penis, drawing blood into the organ. Placing a ring around the base of the penis then helps maintain the erection.
Men who don’t respond to any of these ED treatments may decide to have semirigid rods surgically implanted in the penis.
Surgery may also be used to repair damaged or obstructed blood vessels, which can cause or contribute to ED.
If your ED seems related to psychological factors, your doctor may recommend counseling or psychotherapy.
Natural Remedies for ED
Lifestyle changes may help prevent or resolve ED, and most are important for your overall health, too.
Helpful steps include:
- Losing weight
- Quitting smoking
- Managing stress, anxiety, and other mental health concerns
- Getting treatment for drug or alcohol abuse
- Maintaining a healthy relationship
Alternative Remedies for Erectile Dysfunction
Many herbal and other “natural” substances are marketed as treatments for ED.
The Food and Drug Administration (FDA) has warned against the risk of contamination — and dangerous dosages of potentially harmful drugs — in some dietary supplements marketed as “herbal Viagra.”
The FDA recommends caution before purchasing or using any pills, beverages, chewing gum, or dissolving oral strips that:
- Promise results as soon as within half an hour
- Claim to be alternatives to prescription ED drugs
- Are sold through unsolicited e-mails
- Are sold in single-serving packages
Also be suspicious of “all-natural” ED remedies that have labels written entirely or mostly in a language other than English, or that seem to be copying the appearance of FDA-approved drugs.