What is erectile dysfunction (ED)?

ED, or impotence, is when you cannot get or keep an erection for sexual activity.

What causes ED?

• Conditions that lead to nerve problems, such as a spinal cord injury, diabetes, or stroke
• Hormone imbalances, such as low testosterone, high prolactin, or a thyroid disorder
• Medical conditions that decrease blood flow, such as high blood pressure and arteriosclerosis
• Multiple sclerosis or Parkinson disease
• Medicines, such as those used to treat depression and high blood pressure
• Injury to the testicles from radiation therapy to the testicles

What increases my risk for ED?

• Obesity
• Diabetes that is not controlled or heart disease
• Smoking, or drug or alcohol abuse
• An enlarged prostate
• Increasing age
• Spine or groin surgeries
• Stress, depression, relationship problems, and anxiety

How is ED diagnosed?

Your healthcare provider will ask about your symptoms, medical history, and medicines. He or she will examine your abdomen, penis, and testicles. A rectal exam may also be done to check for an enlarged prostate. Blood and urine tests are done to check for medical conditions that may have caused your ED. You may also need tests to check your blood flow and nerve function.

How is ED treated?

Treatment depends on the cause of your ED. You may need any of the following:

• ED medicines help you have an erection. These medicines are taken before you have sex. Follow instructions on how to use these medicines. You may have a life-threatening reaction if you mix ED medicines with medicines that contain nitrates. Medicines with nitrates include nitroglycerin and other heart medicines.
• Testosterone may be given to increase the levels in your blood and improve your ED. You may need to use a skin cream or wear a patch. Testosterone is also given as an injection.
• Penis injections may be done to help improve your blood flow.
• A vacuum device is a tube that is placed over the penis. A hand pump is connected to the tube and acts as a vacuum. This may help increase blood flow to the penis.
• Therapy may be needed to treat emotional or relationship problems that may be causing your ED.
• Surgery may be recommended if other treatments do not work. Surgery includes a penile implant or prosthesis. Surgery may also be done to improve blood flow. Ask for more information about surgeries for ED.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

• Cialis
• Viagra
• sildenafil
• Caverject Impulse
• Edex

View more treatment options

How can I decrease my risk for ED?

• Do not smoke. Smoking can increase your risk for ED. Nicotine and other chemicals in cigarettes and cigars can also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine.
• Control your blood sugar levels if you have diabetes. Over time, high blood sugar levels can increase your risk for ED.
• Limit alcohol. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
• Manage your medical conditions. Eat a variety of healthy foods and stay physically active. Take your medicines as directed. They can help control conditions that may cause ED.
• Manage stress. Learn ways to relax, such as deep breathing, meditation, and listening to music.
• Do not use illegal drugs. They increase your risk for ED.

When should I call my doctor?

• You have chest pain, dizziness, or nausea after you take ED medicines or during or after sex.
• You have an erection for more than 4 hours after you take your ED medicine.
• You see blood in your urine.
• You have changes in your vision, headaches, or back pain after you take ED medicine.
• You have a painful erection.
• You have questions or concerns about your condition or care.

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