Matthew Wosnitzer, MD, is a board-certified urologic surgeon and physician scientist. He specializes in male infertility.
Erectile dysfunction (ED) is the inability to achieve or maintain an erection that lasts long enough for a man to have satisfying intercourse or orgasm. Occasional bouts of ED are common: 43% of men in the United States experience erectile difficulties from time to time.
From a medical standpoint, failure to achieve an erection 20% of the time is typically not cause for concern. If it occurs more than 50 percent of the time, there is likely an underlying physical and/or psychological reason for the problem.
Also known as impotence, ED is more prevalent in older men—44% of men ages 60 to 69 and 70% of men 70 years and older experience erectile difficulties, compared to just 5% of men under age 40. Other risk factors include vascular disease (including diabetes and hypertension), obesity, smoking, neurological disorders, psychological states (stress, depression), pelvic surgery, and trauma. Treatment options include oral medications, intraurethral medications, injectable medications, vacuum device, diet/habit changes, or other options including surgery.
ED can be the first sign of a more serious health problem and should prompt a baseline cardiac (heart) evaluation.
Erectile dysfunction (ED) occurs when a man is unable to achieve or maintain an erection. Under normal conditions, sexual stimulation causes blood to rush into the penis making it rigid and stays trapped until ejaculation. In ED, a breakdown in the process is caused by physical or psychological issues. Age, medications, medical conditions (diabetes, hypertension for example), and lifestyle factors such as stress and drinking alcohol increase the risk of ED.
Most men fail to achieve or maintain an erection occasionally and roughly one in 10 adult males experience erectile dysfunction (ED) on a long-term basis. ED does not have to be permanent and can be treated with medication, hormones, therapy, injections, and vacuum devices. In some cases, if medication is not effective, penile implant surgery is used to relieve ED.
Erectile dysfunction (ED) can be very troubling, but it can be fixed. Risk factors are reduced when possible. The most common treatment for ED is prescription medications that help to achieve an erection. If these are not effective, additional medications are considered, including penile injection. Non-drug alternatives include vacuum devices and penile constriction rings. If there is a psychological cause for ED, therapy can help.
Yes, stress can contribute to erectile dysfunction (ED). The brain plays an important role in sexual arousal—it triggers the physical response that causes an erection. Stressful experiences, relationship difficulties, and anxiety about sexual performance can interfere with sexual excitement. Sometimes a previous bout of ED leads to worries of another episode and it becomes a negative loop.
Drinking alcohol can lead to erectile dysfunction (ED). Some men experience difficulty achieving or maintaining an erection after a night of heavy drinking, but this is usually temporary. Chronic alcohol use can lead to long-term ED. One study found 37% of men who meet the criteria for alcohol-use disorder experienced sexual dysfunction, with 25% experiencing ED.
The occasional bout of erectile dysfunction (ED) is probably nothing to worry about, but if you are regularly having difficulty achieving and maintaining an erection, it may be a sign of a more serious health condition including cardiac issues. Medical conditions that affect circulation or the nervous system, including high blood pressure, diabetes, and neurological diseases, can all cause erectile dysfunction.
Arterial hypertension is high blood pressure in the arteries. It is diagnosed when blood pressure is persistently at or above 140/90 mm Hg. Arterial hypertension is a common and treatable condition.
Hemodynamics is the study of blood flow and the structures it flows through, including veins, arteries, and capillaries. The term is also used to refer to measurements of cardiovascular function, such as cardiac output and arterial pressure.
Organic erectile dysfunction is difficulty achieving or sustaining an erection rigid enough for intercourse, due to physical causes. Heart disease, diabetes, depression, neurological issues, certain medications, and hormonal imbalances can result in organic erectile dysfunction.
Psychogenic erectile dysfunction is the persistent inability to achieve or maintain an erection rigid enough for sexual performance, due primarily to psychological or interpersonal factors. Performance anxiety and relationship issues are common psychogenic causes.
Sexual dysfunction refers to problems that prevent an individual or couple from enjoying and completing the sex act. The issue can occur during any point of the sexual response cycle—desire, arousal, plateau, orgasm, and resolution. Both men and women can experience sexual dysfunction.
Pastuszak AW. Current diagnosis and management of erectile dysfunction. Curr Sex Health Rep. 2014;6(3):164-176. doi:10.1007/s11930-014-0023-9
Cleveland Clinic. Erectile dysfunction. Updated October 14, 2019.
Burnett AL, Nehra A, Breau RH. Erectile dysfunction: AUA guideline. J Urol. 2018 Sep;200(3):633-641. doi: 10.1016/j.juro.2018.05.004.
Jordan J, Kurschat C, Reuter H. Arterial hypertension. Dtsch Arztebl Int. 2018;115(33-34):557-568. doi:10.3238/arztebl.2018.0557
Secomb TW. Hemodynamics. Compr Physiol. 2016;6(2):975-1003. doi:10.1002/cphy.c150038
Johns Hopkins Medicine. Erectile dysfunction.
Rew KT, Heidelbaugh JJ. Erectile dysfunction. Am Fam Physician. 2016;94(10):820-827.
Cleveland Clinic. Sexual dysfunction. Updated January 24, 2015.
Cleveland Clinic. Erectile dysfunction: management and treatment. Updated October 14, 2019.
Prabhakaran DK, Nisha A, Varghese PJ. Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: a cross-sectional study. Indian J Psychiatry. 2018;60(1):71-77. doi: 10.4103/psychiatry
U.S. Library of Medicine. Erectile dysfunction. Medline Plus.
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