Overview

What is erectile dysfunction? A Mayo Clinic expert explains

Learn more from Matthew Ziegelmann, M.D.

I'm Dr. Matthew Ziegelmann, a urologist at Mayo Clinic. In this video, we'll cover the basics of erectile dysfunction. What is it? Who gets it? The symptoms, diagnosis, and the treatments. Whether you're looking for answers for yourself or for someone you love, we're here to give you the best information available. Erectile dysfunction, also known as impotence, is defined by difficulty getting and keeping an erection. It can be an embarrassing thing to talk about. It's been reported that more than half of men between the ages of 40 and 70 experience some form of ED. So take comfort in knowing that you are not alone. Experiencing difficulty with erections from time to time is usually no cause for concern. But ongoing issues can cause stress, it can affect self-confidence, and it can contribute to relationship problems. Sometimes it may indicate an underlying condition. The bottom line is that if you experience ED, you should talk about it with your doctor, even if you're embarrassed, because we have a number of ways that we can effectively treat erectile dysfunction. ED can be caused by physical or psychological issues. Sexual arousal is a complicated process. It involves your brain, your hormones, your nerves, your muscles, and your blood vessels. A hiccup in any of these can cause a problem.

The fact is that erectile dysfunction affects men of all ages. However, as you get older, your risk can increase. This is not only because erections take longer to develop, but also that other contributing factors may come into play. Physical issues like heart disease, high cholesterol, high blood pressure, diabetes, obesity, and smoking can all cause erectile dysfunction. On the other hand, depression, anxieties, stress, relationship problems, and other mental health concerns can also interfere with sexual feelings. And this can cause or worsen your erectile problems. Often, it's a bit of both. So it's important to understand one's physical and psychological state to know the underlying cause of one's erectile dysfunction.

Unlike a lot of medical conditions, the symptoms of erectile dysfunction are rather straightforward. If you have persistent trouble getting or keeping an erection, you might have erectile dysfunction. If you're dealing with any of these symptoms, a family doctor or an internist is usually a good place to start.

Usually, the hardest part of diagnosing erectile dysfunction is overcoming that embarrassment that comes with talking about your ED. But once you talk to your doctor, you'll find that it's common, and a diagnosis can happen quickly. For many people, a physical exam and answering some basic questions about your medical history is all that is needed. If you have chronic health conditions or your doctor suspects an underlying condition might be involved, you could need further tests or a consultation with a specialist such as me.

Millions of men are able to successfully treat their erectile dysfunction. Oral prescription medications are one popular route. Taking medications does not automatically produce an erection. These tablets amplify the effects of nitric oxide. This is a chemical that your body produces that relaxes muscles in the penis. Sexual stimulation releases this chemical and these medications enhance its effect, allowing for an erection. Other less common, but effective, medications for ED include self-injections or urethral suppositories. If medications aren't effective, your doctor may recommend a vacuum penis pump. This device uses a hollow tube to create a vacuum that pulls blood into your penis. Penile implants are another option and involve surgically placing a device that allows the penis to achieve an erection. If your ED is impacting your mental health or your relationship, your doctor may also recommend that you and your partner visit a psychologist or a sexual therapist. What your treatment ultimately looks like depends on the cause and severity of your erectile dysfunction, as well as any underlying health condition that may be present. Your doctor will be able to work with you to find the right solution.

Erectile dysfunction can be an uncomfortable topic to discuss with your doctor, with your partner and with your friends. But don't assume that you're alone. Involve your partner, and communicate openly and honestly about your condition. Try to remember that it's very common. And more importantly, it's very treatable. If you'd like to learn more about erectile dysfunction, here are some other related videos. Or you can visit mayoclinic.org. We wish you well.

Erectile dysfunction means not being able to get and keep an erection firm enough for sexual activity. It also is called impotence.

Having erection trouble from time to time isn't always a cause for concern. But if erectile dysfunction is ongoing, it can cause stress, affect self-confidence and add to challenges with a partner. Problems getting or keeping an erection can be a sign of a health condition that needs treatment and a risk factor for heart disease.

If you're worried about erectile dysfunction, talk to your healthcare professional, even if it's awkward. Sometimes, treating an underlying condition can fix erectile dysfunction. Or you might need medicines or other direct treatments.

Symptoms

Having trouble getting an erection once in a while is common. Erectile dysfunction symptoms are ongoing and often get worse over time. They might include:

  • Trouble getting an erection.
  • Trouble keeping an erection.
  • Wanting sex less.

When to see a doctor

Your main healthcare professional is a good place to start when you have erectile issues. See your healthcare professional if:

  • You worry about your erections or you have other sexual problems, such as ejaculating sooner than you want. This is called premature ejaculation. Ejaculating later than you want is called delayed ejaculation.
  • You have diabetes, heart disease or another health condition that might be linked to erectile dysfunction.
  • You have other symptoms with erectile dysfunction.
Erectile dysfunction care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started.

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Causes

Male sexual arousal is complex. It involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Also, stress and mental health concerns can cause erectile dysfunction or make it worse.

Sometimes the cause of erectile dysfunction is both physical and mental. For instance, a minor physical condition that slows your sexual response might cause worry about keeping an erection. The anxiety can add to erectile dysfunction.

Physical causes of erectile dysfunction

Common physical causes of erectile dysfunction include:

  • Heart disease.
  • Clogged blood vessels, also called atherosclerosis.
  • High cholesterol.
  • High blood pressure.
  • Diabetes.
  • Obesity.
  • Metabolic syndrome, which involves higher blood pressure, high insulin levels, body fat around the waist and high cholesterol.
  • Parkinson's disease.
  • Multiple sclerosis.
  • Certain prescription medicines
  • Tobacco use.
  • Peyronie's disease, which can cause pain during sex, a bent penis to bend, a penis that gets shorter with erection or a lump or bump in the penis.
  • Overuse of alcohol and use of illicit drugs.
  • Sleep conditions.
  • Treatments for prostate cancer or enlarged prostate.
  • Surgeries or injuries that affect the pelvic area or spinal cord.
  • Low levels of the hormone testosterone.

Mental health causes of erectile dysfunction

The brain plays a key role in getting sexually excited, which starts an erection. Things that can get in the way of sexual feelings and cause or add to erectile dysfunction include:

  • Depression, anxiety or other mental health conditions.
  • Stress.
  • Issues with a partner.

Risk factors

As you get older, erections might take longer to start and might not be as firm. You might need more direct touch to your penis to get and keep an erection. But erectile dysfunction is not a typical part of aging.

Risk factors that can add to erectile dysfunction include:

  • Medical conditions. Diabetes or heart conditions are big risk factors.
  • Tobacco use. This lowers blood flow to veins and arteries. Over time, tobacco use can cause ongoing health conditions that lead to erectile dysfunction.
  • Being overweight. Being obese, especially, can lead to erectile dysfunction.
  • Certain medical treatments. These include prostate surgery or radiation treatment for cancer.
  • Injuries. This is especially true if injuries damage the nerves or arteries that control erections.
  • Medicines. These include antidepressants, antihistamines, and medicines to treat high blood pressure, pain or prostate conditions.
  • Mental health conditions. These include stress, anxiety and depression.
  • Illicit drug and alcohol use. This is especially true for long-term drug use or heavy drinking.

Complications

Complications from erectile dysfunction can include:

  • A poor sex life.
  • Depression, stress or anxiety.
  • Embarrassment or low self-esteem.
  • Relationship issues.
  • Not being able to get your partner pregnant.

Prevention

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any health conditions. For instance:

  • Work with your healthcare professional to manage diabetes, heart disease or other ongoing health conditions.
  • Get regular checkups and medical screening tests.
  • Stop smoking, limit or don't drink alcohol, and don't use illicit drugs.
  • Exercise regularly.
  • Find ways to ease stress.
  • Get help for anxiety, depression or other mental health issues.
Erectile dysfunction care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started.

Get the process started

March 01, 2025
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