Erectile Dysfunction (ED)Symptoms, Doctors, Treatments, Advances & More
Learn About Erectile Dysfunction (ED)
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at all. Or, you may lose the erection during intercourse before you are ready. Erection problems do not usually affect your sex drive.
Erection problems are common. Almost all adult men have trouble getting or keeping an erection at one time or another. Often the problem goes away with little or no treatment. But for some men, it can be an ongoing problem. This is called erectile dysfunction (ED).
If you have trouble getting or keeping an erection more than 25% of the time, you should see your health care provider.
Erectile dysfunction; ED; Impotence; Sexual dysfunction - male
To get an erection, your brain, nerves, hormones, and blood vessels all need to work together. If something gets in the way of these normal functions, it can lead to erection problems.
An erection problem is usually not "all in your head." In fact, most erection problems have a physical cause. Below are some common physical causes.
Disease:
- Diabetes
- High blood pressure
- Heart or thyroid conditions
- Clogged arteries (atherosclerosis)
- Depression
- Nervous system disorders, such as multiple sclerosis or Parkinson disease
Medicines:
- Antidepressants
- Blood pressure medicines (especially beta-blockers)
- Heart medicines, such as digoxin
- Sleeping pills
- Some peptic ulcer medicines
Other physical causes:
- Low testosterone levels. This can make it difficult to get an erection. It can also reduce a man's sex drive.
- Nerve damage from prostate surgery.
- Nicotine, alcohol, or cocaine use.
- Spinal cord injury.
In some cases, your emotions or relationship problems can lead to ED, such as:
- Poor communication with your partner.
- Feelings of doubt and failure.
- Stress, fear, anxiety, or anger.
- Expecting too much from sex. This can make sex a task instead of a pleasure.
Erection problems can affect men at any age, but are more common as you get older. Physical causes are more common in older men. Emotional causes are more common in younger men.
If you have erections in the morning or at night while you sleep, it is likely not a physical cause. Most men have 3 to 5 erections at night that last about 30 minutes. Talk with your provider about how to find out if you have normal nighttime erections.
Symptoms may include any of the following:
- Trouble getting an erection
- Trouble keeping an erection
- Having an erection that is not firm enough for intercourse
- Less interest in sex
The treatment may depend on what is causing the problem and how healthy you are. Your provider can talk with you about the best treatment for you.
For many men, lifestyle changes can help. These include:
- Getting exercise
- Eating a healthy diet
- Losing extra weight
- Sleeping well
If you and your partner have trouble talking about your relationship, it may cause problems with sex. Counseling can help both you and your partner.
Lifestyle changes alone may not be enough. There are many treatment options.
- Pills you take by mouth, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), avanafil (Stendra), and tadalafil (Adcirca, Cialis). They work only when you are sexually aroused. They usually start to work in 15 to 45 minutes.
- Medicine inserted into the urethra or injected into the penis to improve blood flow. Very small needles are used and cause minimal pain.
- Surgery to place implants in the penis. The implants may be inflatable or semi-rigid.
- A vacuum device. This is used to pull blood into the penis. A special rubber band is then used to keep the erection during intercourse.
- Testosterone replacement if your testosterone level is low. This comes in skin patches, gel, or injections into the muscle.
ED pills can have side effects. These can range from muscle pain and flushing to heart attack. Do not use these medicines with nitroglycerin. The combination can cause your blood pressure to drop.
You may not be able to use these drugs if you have any of the following conditions:
- Recent stroke or heart attack
- Severe heart disease, such as unstable angina or irregular heartbeat (arrhythmia)
- Severe heart failure
- Uncontrolled high blood pressure
- Uncontrolled diabetes
- Very low blood pressure
Other treatments also have possible side effects and complications. Ask your provider to explain the risks and benefits of each treatment.
You may see many herbs and supplements that claim to help sexual performance or desire. However, none have been proven to successfully treat ED. Plus, they may not always be safe. Do not take anything without talking with your provider first.
Johns Hopkins Outpatient Center
Arthur Burnett is a Urologist practicing medicine in Baltimore, Maryland. Dr. Burnett is rated as an Elite provider by MediFind in the treatment of Erectile Dysfunction (ED). He is also highly rated in 20 other conditions, according to our data. His clinical expertise encompasses Priapism, Erectile Dysfunction (ED), Peyronie Disease, Prostatectomy, and Penectomy. Dr. Burnett is board certified in American Board Of Urology.
UCI Health Newport - Birch Street
Dr. Faysal A. Yafi is board-certified urologist and medical director of the Men's Health Center at the UCI Health Center for Urological Care.He specializes in erectile dysfunction, hypogonadism, Peyronie’s disease, prosthetic surgery, male voiding dysfunction, male infertility and other men's health conditions.Yafi earned his medical degree from the American University of Beirut, followed by an internship in general surgery at the Mayo Clinic in Rochester, Minn. He then completed a residency in urology at McGill University in Montreal, Quebec, followed by a two-year fellowship in andrology, sexual medicine and prosthetics at Tulane University in New Orleans, La.He has an avid interest in both basic and clinical research. He has written more than 70 peer-reviewed publications and book chapters, and has received multiple national and international awards and recognitions. He is a fellow of the Royal College of Surgeons of Canada and an active member of the Sexual Medicine Society of North America (SMSNA), the International Society for Sexual Medicine (ISSM), the American Society of Andrology, the American Urological Association (AUA) and the Société Internationale d’Urologie (SIU).Yafi sees patients in Newport Beach and Orange. Dr. Yafi is rated as an Elite provider by MediFind in the treatment of Erectile Dysfunction (ED). He is also highly rated in 27 other conditions, according to our data. His clinical expertise encompasses Peyronie Disease, Erectile Dysfunction (ED), Priapism, Hormone Replacement Therapy (HRT), and Aquablation. Dr. Yafi is board certified in American Board Of Urology - Urology.
Baylor Medicine At McNair - Urology
Mohit Khera, M.D., M.B.A., M.P.H., Associate Professor, is the Director of the Laboratory for Andrology Research at McNair Medical Institute, Baylor College of Medicine. He is also the Medical Director of the Executive Health Program at Baylor. Dr. Khera is a Board-certified urologist specializing in male infertility, male and female sexual dysfunction, and declining testosterone levels in aging men. Dr. Khera's research focuses on the efficacy of botulinum toxin type A in treating Peyronie's disease as well as genetic and epigenetic studies on post-finasteride syndrome patients and testosterone replacement therapy. Dr. Khera is rated as an Elite provider by MediFind in the treatment of Erectile Dysfunction (ED). He is also highly rated in 20 other conditions, according to our data. His clinical expertise encompasses Hypogonadism, Peyronie Disease, Erectile Dysfunction (ED), Hormone Replacement Therapy (HRT), and Prostatectomy. Dr. Khera is currently accepting new patients.
Many men overcome erection problems with lifestyle changes, treatment, or both. For more severe cases, you and your partner may have to adjust to how ED affects your sex life. Even with treatment, counseling can help you and your partner overcome the stress ED may put on your relationship.
An erection problem that does not go away can make you feel bad about yourself. It can also harm your relationship with your partner. ED may be a sign of health problems such as diabetes or heart disease. So if you have an erection problem, do not wait to seek help.
Contact your provider if:
- The problem does not go away with lifestyle changes
- The problem begins after an injury or prostate surgery
- You have other symptoms, such as low back pain, abdominal pain, or a change in urination
If you think any medicine you are taking may be causing erection problems, talk with your provider. You may need to lower the dose or change to another medicine. Do not change or stop taking any medicine without first talking to your provider.
Talk to your provider if your erection problems have to do with a fear of heart problems. Sexual intercourse is usually safe for men with heart problems.
Contact your provider right away or go to an emergency room if you are taking ED medicine and it gives you an erection that lasts for more than 4 hours.
To help prevent erection problems:
- Quit smoking.
- Cut back on alcohol (no more than 2 drinks per day).
- Do not use illegal drugs.
- Get plenty of sleep and take time to relax.
- Stay at a healthy weight for your height.
- Exercise and eat a healthy diet to keep good blood circulation.
- If you have diabetes, keep blood sugar well-controlled.
- Talk openly with your partner about your relationship and sex life. Seek counseling if you and your partner have trouble communicating.
Summary: Erectile dysfunction is a common male sexual health problem that may affect quality of life and sexual relationships. Tadalafil 5 mg once daily is an established oral treatment for erectile dysfunction. L-citrulline is an oral nitric oxide pathway supplement that may improve erectile function by increasing L-arginine availability. This randomized trial will compare three oral treatment regimens in...
Summary: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a condition with several causes of which some remain unknown. It is believed that some types of CP may be genetic or passed down (inherited) from one generation to the next. In this study, we are collecting genetic material and medical information to try to determine if genetic factors play a role in CP/CPPS. We will be collecting DNA (...
Published Date: October 01, 2025
Published By: Linda J. Vorvick, MD, Clinical Professor Emeritus, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
American Urological Association: Urology Care Foundation website. Erectile dysfunction (ED): what is erectile dysfunction? www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed). Updated June 2018. Accessed October 13, 2025.
Anele UA, Burnett AL. Evaluation and management of erectile dysfunction. In: Dmochowski RR, Kavoussi LR, Peters CA, et al, eds. Campbell-Walsh-Wein Urology. 13th ed. Philadelphia, PA: Elsevier; 2026:chap 72.
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Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 216.