What happens physically when a man has erectile dysfunction?

Typically there's a lack of blood flow to the penis, or the penis isn't able to trap and hold blood long enough to keep the erection. Either can happen for a variety of underlying health conditions that affect the circulatory system, such as high blood pressure, heart disease, diabetes, or certain cancer treatments.

How can I tell if I have ED?

One of the following criteria must be met in order to have erectile dysfunction: Ability to get an erection sometimes when you want to have sex, but not always Ability to get an erection but unable to keep it Unable to get an erection under any circumstance

Is there a self-test for erectile dysfunction?

There is no diagnostic test for ED. On occasion, a urologist will have a patient do a nocturnal penile tumescence (NPT) test , which can indicate if he is having spontaneous erections during sleep, or a penile plethysmograph, which evaluates blood flow to the penis in response to arousing material.

Symptoms of Erectile Dysfunction

By

Jenny Lelwica Buttaccio, OTR/L

Updated on March 27, 2022

Medically reviewed by

Matthew Wosnitzer, MD

At one point or another, most adult men will have trouble getting or keeping an erection long enough to have sex. This usually resolves on its own with little or no treatment. But when it becomes an ongoing problem, it is called erectile dysfunction (ED).

In addition to problems with getting a satisfactory erection, ED can lead to emotional and psychological problems too, including feelings of shame and guilt. In some cases, ED can lead to a loss of intimacy that affects the mental well-being of both partners.

This article discusses the signs and symptoms of erectile dysfunction. It also mentions several ejaculation-related conditions that often occur alongside ED, as well as when you should see your doctor.

Frequent Symptoms

Erectile dysfunction is a common problem among men, affecting some 30 million men in the United States. ED typically develops over time. But it can happen suddenly for what seems like no reason at all.

The main symptoms of erectile dysfunction are:

Difficulty getting an erection: The inability to get a firm enough erection to have sex when you desire it
—OR—
Difficulty keeping an erection: The inability to keep an erection firm for long enough to complete sex or truly enjoy it

Frequency of your erection issues is what defines the difference between having ED and not. Having symptoms from time to time, rather than often, is typically not a sign of erectile dysfunction.

For many men, ED also causes emotional and psychological distress. ED can affect your relationships and your self-esteem, and may lead to feelings of guilt, embarrassment, shame, or other difficult emotions.

Associated Conditions

Some men with ED have problems with ejaculating (ejaculatory dysfunction), while others are able to ejaculate one or more times during sexual intercourse.

Erectile dysfunction and ejaculatory dysfunction are the two most common sexual difficulties in men. They are separate disorders, however, that often occur together.

Types of ejaculatory dysfunction include:

Premature ejaculation: When a man ejaculates within minutes of penetration or sooner than he and his partner would like
Delayed ejaculation: When a man is unable to ejaculate within a reasonable timeframe of sexual stimulation
Retrogade ejaculation: When a man is able to reach sexual climax, but his semen goes into his bladder rather than exiting through his penis
Anejaculation: When a man is unable to ejaculate semen

Other physical conditions that may or may not occur alongside ED include:

Reduced libido or sex drive
Anorgasmia, or failure to become aroused after sufficient stimulation
A dysfunction in the pelvic floor muscles
Trauma to the pelvis, such as pelvic fractures
Low testosterone levels

Erectile dysfunction may be a risk factor for heart attacks and strokes, according to research published by the American Heart Association. If you have symptoms of ED, consider getting screened for cardiovascular disease.

Complications

Erectile dysfunction can affect your mental health and wellbeing, along with that of your partner. It can lead to such complications as:

Unfulfilled sex life
Loss of intimacy with your partner
A strained relationship with your partner
Depression, anxiety, low self-esteem
Inability to get a female partner pregnant

These complications can both contribute to ED symptoms and happen as a result of them.

If you are experiencing ED, getting professional help can prevent you from falling into a cycle of physical and psychological ED symptoms.

Fortunately, almost all cases of erectile dysfunction are treatable.

When to See a Healthcare Provider

If you have difficulty getting or keeping an erectile on occasion—for example, after a night of drinking or a stressful work day—you probably don't need to worry. Most men experience this at one point or another.

But if getting or keeping an erection is something that occurs 25% of the time or more, then you could have ED and should consider seeing a healthcare provider.

In addition, if symptoms are consistently getting worse, there could be a physical cause that should be investigated.

It's also time to get professional help if:

You have anxiety about your ability to get or keep an erection
Your symptoms are creating an issue between you and your sexual partner
Getting an erection is painful

Erectile Dysfunction Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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Summary

Erectile dysfunction is defined as an inability to get or keep an erection 25% of the time or more. Aside from these physical symptoms, it can also cause emotional and psychological symptoms, such as anxiety, depression, and lost self-esteem.

Several disorders can happen alongside erectile dysfunction, including premature ejaculation and reduced sex drive. If your symptoms are becoming a regular issue, causing you anxiety, or creating tension in your relationship, make an appointment to see a healthcare provider.

A Word From Verywell

Despite how common erectile dysfunction is, many men feel deeply uncomfortable talking about it with their sexual partner(s). Being unable to talk about your needs can only place further stress on your relationship and yourself.

Be honest and open with your partner when discussing your ED. Listen to what they have to say. And if intercourse is not an option, explore other exciting ways to give and receive sexual pleasure—together.

Frequently Asked Questions

What happens physically when a man has erectile dysfunction?

Typically there's a lack of blood flow to the penis, or the penis isn't able to trap and hold blood long enough to keep the erection. Either can happen for a variety of underlying health conditions that affect the circulatory system, such as high blood pressure, heart disease, diabetes, or certain cancer treatments.
How can I tell if I have ED?
One of the following criteria must be met in order to have erectile dysfunction:
- Ability to get an erection sometimes when you want to have sex, but not always
- Ability to get an erection but unable to keep it
- Unable to get an erection under any circumstance
Is there a self-test for erectile dysfunction?

There is no diagnostic test for ED. On occasion, a urologist will have a patient do a nocturnal penile tumescence (NPT) test, which can indicate if he is having spontaneous erections during sleep, or a penile plethysmograph, which evaluates blood flow to the penis in response to arousing material.

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