Please note: This information was current at the time of publication but now may be out of date.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. 

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Am Fam Physician. 2010;81(3):313

See related article on erectile dysfunction.

What is erectile dysfunction?

Erectile dysfunction (ED) is when a man can't get or keep a good enough erection to have sex that is satisfying for him and his partner. It is normal to have ED occasionally, but if it happens a lot, it may mean there is a bigger problem. Men can have ED at any age, but it usually happens in middle-aged and older men.

What causes it?

The most common cause of ED is not enough blood flow to the penis. Other causes include atherosclerosis (hardening of the arteries); high cholesterol or blood pressure; low testosterone levels; abnormal hormone levels; cigarette smoking; and alcohol, amphetamine, cocaine, heroin, and marijuana use. Anxiety, depression, stress, and a history of sexual abuse may also cause ED.

When you get an erection, signals from the brain are sent to the nerves and blood vessels in the penis. This allows the penis to fill with blood. Some medical conditions may block these signals, including strokes, spinal injuries, pelvic trauma, Parkinson disease, and multiple sclerosis. Prostate or pelvic surgery, and pelvic nerve damage from diabetes may also cause ED.

Many medicines can stop men from getting an erection or can decrease a man's desire to have sex. Some of the most common are medicines used to treat high blood pressure, depression, heartburn, allergies, pain, seizures, and cancer. Ask your doctor if any of the medicines you take may cause ED.

How is it treated?

You may need to stop smoking or using drugs, drink less alcohol, lose weight, reduce stress, and start exercising. There are pills that may help you get an erection. If these do not work, there are other medicines that can be injected or inserted into your penis. Your doctor can teach you how to do this. Vacuum pump or inflatable devices may also help you manage your ED.

Where can I get more information?

Your doctor

American Academy of Family Physicians

American Urological Association Foundation

  • Web site: http://www.urologyhealthorg/adult/index.cfm?cat=11&topic=174

National Institutes of Health

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