Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for intercourse.Having erection difficulty from time to time isn't always a cause for concern. If erectile dysfunction is an ongoing issue, but it can lead to stress, affect your self-confidence and contribute to relationship problems. Problems getting or maintaining an erection may also be a sign of an underlying health condition that requires treatment and a risk factor for heart disease.If you're worried about erectile dysfunction, speak with your doctor -- even if you are embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.
Erectile dysfunction care at Mayo Clinic Symptoms Erectile dysfunction symptoms may include persistent:Trouble getting an erection Trouble keeping an erection Reduced sexual desire When to see a doctor A family doctor is a good place to start when you have erectile issues. See your doctor if:You have concerns about your erections or you are experiencing other sexual problems like premature or delayed ejaculation You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction You have other symptoms along with erectile dysfunction Causes Male sexual stimulation is a complicated process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these.
Likewise, stress and mental health concerns can worsen or cause erectile dysfunction.Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about keeping an erection. The resulting anxiety can lead to or worsen erectile dysfunction.Physical causes of erectile dysfunction In many cases, erectile dysfunction is caused by something physical.
Common causes include:Heart disease Clogged blood vessels (atherosclerosis)High cholesterolHigh blood pressureDiabetesObesityMetabolic syndrome -- a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol Parkinson's disease Multiple sclerosis Certain prescription medicines Tobacco use eyronie's disease -- growth of scar tissue in the penis Alcoholism and other forms of substance abuse Sleep disorders Treatments for prostate cancer or enlarged prostate Surgeries or injuries that affect the pelvic region or spinal cord Psychological causes of erectile dysfunction The brain plays an integral role in triggering the collection of physical events that lead to an erection, beginning with feelings of sexual excitement.
A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:Depression, anxiety or other mental health conditions Stress Connection problems due to stress, poor communication or other issues Risk factors As you get older, erections may take more time to develop and might not be as business. You might need more direct contact to your penis to get and keep an erection.Various risk factors can contribute to erectile dysfunction, including:Medical conditions, especially diabetes or heart ailments Tobacco use, which restricts blood flow to arteries and veins, can -- over time -- trigger chronic health conditions that lead to erectile dysfunction Being overweight, especially if you're obese Certain medical treatments, like prostate surgery or radiation therapy for cancer Injuries, particularly if they harm the nerves or arteries that control erections Medicines, such as antidepressants, antihistamines and medications to treat high blood pressure, prostate or pain ailments Emotional conditions, like stress, anxiety or depression Drug and alcohol use, especially if you're a long-term drug user or heavy drinker Complications Complications resulting from erectile dysfunction may include: An unsatisfactory sex life Stress or anxiety Embarrassment or low self-esteem Relationship problems The inability to get your partner pregnant Prevention.
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any current health conditions. For example:Work with your doctor to handle diabetes, heart disease or other chronic health conditions. See your doctor for regular checkups and medical screening tests. Stop smoking, limit or avoid alcohol, and don't use illegal drugs. Exercise regularly. Take steps to reduce stress. Get help for anxiety, depression or other mental health issues.
How do I treat erectile dysfunction?You may work with a health care professional to treat an underlying cause of your erectile dysfunction (ED). Selecting an ED treatment is a personal decision. However, you also may benefit from talking with your spouse about which treatment is ideal for you as a couple.Lifestyle changes Your health care professional may recommend that you make lifestyle changes to help reduce or enhance ED. You can You can seek help from a health professional if you have problems making these changes by yourself.
Go to counseling Talk to your doctor about going to a counselor if psychological or emotional issues are impacting your ED. A counselor can teach you how to decrease your anxiety or stress associated with sex. Your counselor may suggest that you bring your spouse to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a physician can concentrate on treating the physical causes of ED.How do doctors treat erectile dysfunction?Change your medicines.
If a medication you need for a different health condition is causing ED, your doctor may suggest a different dose or alternative medicine. Never stop taking a medicine without speaking with your physician first. Read about which medications make it more likely you'll develop ED.Prescribe medications you take by mouth A health care professional may prescribe you an oral medication, or medicine you take by mouth, such as among the following, to help you get and maintain an erection: sildenafil (Viagra) vardenafil (Levitra, Staxyn) tadalafil (Cialis) avanafil (Stendra) All these medications work by relaxing smooth muscles and increasing blood circulation in the penis during sexual stimulation.
You should not take any of these medicines to treat ED if you are taking nitrates to treat a heart condition. Nitrates widen and relax your blood vessels. The combination can result in a sudden drop in blood pressure, which might cause you to become faint or dizzy, or collapse, resulting in possible injuries.Also speak with your health care professional if you're taking alpha-blockers to deal with prostate enlargement. The combination of alpha-blockers and ED medicines also could lead to a sudden drop in blood pressure.A health care professional can prescribe testosterone when you have low levels of the hormone in your blood. Although taking testosterone can help your ED, it is often unhelpful if your ED is due to circulatory or nerve problems.
Taking testosterone can also lead to unwanted effects, including a high red blood cell count and problems urinating.Testosterone treatment also hasn't been demonstrated to help ED related to age-related or late-onset hypogonadism. Do not take testosterone therapy that has not been prescribed by your physician. Testosterone therapy can affect how your other medicines work and can result in serious side effects.Prescribe injectable medications and suppositories. Many men get stronger erections by injecting a medicine called alprostadil to the penis, causing it to become full of blood.
Cosmetic medications can improve your reaction to sexual stimulation, but they do not trigger an automatic erection such as injectable medications do.Instead of injecting a medication, some guys insert a suppository of alprostadil into the urethra. A suppository is a solid piece of medicine that you fit in your body where it dissolves. A healthcare professional will prescribe a prefilled applicator that you insert the pellet about an inch into your urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes.Discuss alternative medicines. Some guys say particular alternative medicines taken by mouth can help them get and keep an erection. But, not all"natural" medicines or nutritional supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health issues. To help ensure coordinated and secure care, talk about your use of alternative medicines, including use of vitamin and mineral supplements, using a medical care professional. Additionally, never order a medication online without speaking with your doctor.How will side effects of erectile dysfunction medicines affect me?
ED medicines that you take by mouth, through an injection, or as a pellet in the urethra can have side effects, including a lasting erection known as priapism. Call a health care professional immediately if an erection lasts 4 hours or more.A few of men have vision or hearing loss after taking oral ED medicines. Call your health care professional right away if you develop these problems.Prescribe a vacuum apparatus A vacuum device causes an erection by pulling blood to the penis. The device has three parts:A plastic tube, which you put around your manhood a pump, which draws air out of the tube, creating a vacuuman elastic ring, which you move from the end of the tube into the base of your penis as you remove the tubeThe elastic ring maintains the erection during intercourse by preventing blood from flowing back into your body.
The elastic ring can stay in place up to thirty minutes. Remove the ring then time to restore normal circulation and to reduce skin irritation.You may find that using a vacuum device requires some alteration or practice. Using the device may make your penis feel cold or numb and have a purple shade. You might also have bruising on your penis. However, the lumps are most often painless and disappear in a couple of days. Vacuum apparatus may weaken ejaculation however, typically, the devices do not affect the pleasure of climax, or orgasm.Recommend SurgeryFor many men, surgery should be a last resort. Talk to your doctor about whether surgery is right for you. A urologist performs surgery at a surgical center or hospital to implant a device to make the penis erect rebuild arteries to boost blood circulation to the penis implanted devices.