Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

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Am Fam Physician. 2006;74(9):1567-1568

What is erectile dysfunction?

Erectile dysfunction is when a man can’t get an erection to have sex or can’t keep an erection long enough to finish having sex. Erectile dysfunction also is called impotence. It can occur at any age, but it is more common in men older than 65.

Is it just a part of old age?

As you get older, you may need more stimulation (such as stroking and touching) to get an erection. You also might need more time between erections. Erectile dysfunction doesn’t have to be a part of getting older.

What causes erectile dysfunction?

High blood sugar levels or blood pressure can cause erectile dysfunction. It’s important to follow your doctor’s directions when taking medicines for these problems.

Sometimes your hormones can get out of balance and cause erectile dysfunction. Your doctor can do blood tests to check your hormones.

Some medicines can cause erectile dysfunction. Your doctor may take you off of a medicine or give you a different one.

Drinking too much alcohol, smoking, and abusing drugs also can cause erectile dysfunction.

Problems in the relationship with your sex partner can cause erectile dysfunction. You might try therapy to see if improving your relationship helps your sex life. Therapy probably will help you more if your sex partner is included. Couples can learn new ways to please each other and to show affection. This can reduce your anxiety about having erections.

Other causes include:

  • Atherosclerosis (ath-er-oh-skleh-RO-sis). This is when your arteries harden.

  • Brain or spinal cord injuries

  • Being tired

  • Hypogonadism (which causes lower testosterone levels)

  • Liver or kidney failure

  • Multiple sclerosis (which affects your muscles)

  • Parkinson’s disease (which affects your nervous system)

  • Radiation therapy to the testicles

  • Stroke

  • Some types of prostate or bladder surgery

How do I know if I have erectile dysfunction?

Your doctor may ask you questions and examine you. Your blood and urine may be tested. Other tests also may be needed. Your doctor will decide which tests are right for you.

How is erectile dysfunction treated?

It depends on what is causing it. After your doctor checks you for causes of erectile dysfunction, he or she may give you a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you should try them.

If the medicines aren’t right for you, you could try using vacuum pump devices. Surgery may be an option. Your doctor may send you to a specialist to talk about these options.

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