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Updated by Umbrella Health Care Systems on Oct 22, 2023
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A Visual Guide to Erectile Dysfunction

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.
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1

What Is Erectile Dysfunction (ED)?

What Is Erectile Dysfunction (ED)?

Erectile dysfunction (ED) happens when a man has ongoing problems getting and keeping an erection. Without treatment, ED can make sex difficult. The problem is reported by 1 in 5 men, and that number gets bigger with age.
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2

Symptoms of ED

Symptoms of ED

Symptoms of ED include:

  • Erections that are too soft for sex.
  • Erections that are don’t last long enough for sex.
  • An inability to get an erection. If you can’t get or keep an erection that lasts long enough or is rigid enough for sex, you have erectile dysfunction.
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The Mechanics of ED

The Mechanics of ED

You get an erection when blood fills two chambers known as the corpora cavernosa. This causes your penis to expand and stiffen, much like a balloon as it is filled with water. Impulses from the brain and genital nerves start the process. Anything that blocks these impulses or restricts blood flow to the penis can cause ED.
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4

Causes of ED: Chronic Disease

Causes of ED: Chronic Disease

The link between chronic disease and ED is most striking for diabetes. Men with diabetes are two to three times more likely to have erectile dysfunction. And it could start 10 to 15 years earlier. But blood sugar control can lower this risk. Any condition that affects the way blood flows through your body could lead to ED. This includes cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis.
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5

Causes of ED: Surgery

Causes of ED: Surgery

Surgery, including treatments for prostate cancer, bladder cancer, or BPH, can sometimes damage nerves and blood vessels near your penis. If the nerve damage is permanent, you’ll need treatment to get an erection. But sometimes surgery causes temporary ED that gets better on its own after 6 to 18 months.
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6

Treating ED: Oral Medications

Treating ED: Oral Medications

You’ve probably heard of sildenafil (Viagra), but it isn’t the only pill for ED. This class of drugs also includes avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn). All work by improving blood flow to the penis during arousal. They're generally taken 30-60 minutes before sexual activity and should not be used more than once a day. You can take tadalafil up to 36 hours before sexual activity. It also comes in a lower, daily dose. All require an OK from your doctor first for safety.
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7

Treating ED: Injections

Treating ED: Injections

Pills are an easy way to treat ED, but you might get a stronger erection from injecting medication directly into your penis. That’s because these drugs widen your blood vessels so your penis fills with blood. Another option: A medicated pellet you put into the opening at the end of your penis. The pellet can trigger an erection within 10 minutes.
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8

Treating ED: Psychotherapy

Treating ED: Psychotherapy

Even when ED has a physical cause, psychotherapy can help. A therapist can teach the man and their partner techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants.
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9

Treating ED: Alternative Therapies

Treating ED: Alternative Therapies

Talk with your doctor before trying supplements for ED. They can contain 10 or more ingredients and could make other health conditions worse. Some men say alternative treatments help them get and keep an erection. Unfortunately, the long-term safety of these products isn’t known, so most doctors don’t recommend them.
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10

Discussing ED With Your Partner

Discussing ED With Your Partner

Though you're the one with ED, your partner is also affected. Talking openly about ED will help your partner understand the diagnosis and treatment options. This can reassure them that you haven't lost interest.
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