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 also can be a sign of an underlying health condition that needs treatment and a risk factor for heart disease down the road.
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.
Erectile dysfunction symptoms might include persistent:
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection. This might indicate underlying health conditions or be a result of taking medications
Various risk factors can contribute to erectile dysfunction, including:
For many men, a physical exam and answering questions (medical history) are all that’s needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.
Tests for underlying conditions might include:
The first thing your doctor will do is to make sure you’re getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.
Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner’s preferences also might play a role in your treatment choices.
Oral medications are a successful erectile dysfunction treatment for many men. They include:
All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.
Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.
The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.
Your doctor will consider your particular situation to determine which medication might work best. These medications might not fix your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor’s OK. Medications for erectile dysfunction might not work or might be dangerous if you:
Other medications for erectile dysfunction include:
Penis pumps, surgery and implants
If medications aren’t effective or appropriate in your case, your doctor might recommend a different treatment. Other treatments include:
If your erectile dysfunction is caused by stress, anxiety or depression — or the condition is creating stress and relationship tension — your doctor might suggest that you, or you and your partner, visit a psychologist or counselor.