What is erectile dysfunction?

Erectile dysfunction (ED) is when a man has ongoing trouble getting or keeping an erection firm enough for sexual activity. It can happen occasionally, but when it becomes frequent, it may signal an underlying health concern. ED is common and often treatable.

This condition is usually related to how blood flows to the penis, but it can also involve nerves, hormones, or emotional health.

Possible causes and risk factors include:

• Reduced blood flow due to heart or vascular conditions
• Diabetes affecting nerves and circulation
• Hormone changes, including low testosterone
• Side effects from certain medications
• Stress, anxiety, or depression
• Smoking, alcohol use, or lack of physical activity
• Chronic conditions like high blood pressure or kidney disease

Often, ED is linked to a combination of physical and emotional factors.

Symptoms

Erectile dysfunction can have many different causes, and symptoms may vary from person to person.

Common symptoms include:

• Trouble getting an erection
• Difficulty keeping an erection during sex
• Erections that don’t last long enough

How is it diagnosed?

Your provider will start by discussing your health history and symptoms. This helps identify possible causes and guides next steps.

A physical exam may be done, along with blood or urine tests to check for conditions like diabetes, hormone imbalances, or heart disease. In some cases, imaging, such as ultrasound, is used to evaluate blood flow. Emotional health may also be part of the assessment.

How is it treated?

Treatment depends on the cause of the problem, and many men benefit from a combination of approaches.

Common treatment options include:

• Healthy lifestyle changes, such as exercise, weight loss, and quitting smoking
• Adjusting medications that may be contributing
• Oral medications that improve blood flow
• Counseling or therapy for stress or relationship concerns
• Hormone therapy when levels are low

If these options aren’t effective, other treatments may include:

• Vacuum devices to help create an erection
• Medications delivered directly to the penis
• Surgical implants for long-term solutions

Many men see improvement with treatment, especially when underlying health conditions are addressed.