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You have erection problems if you can't get or keep an erection that is firm enough for you to have sex. Erection problems are also called erectile dysfunction or impotence.
It's common to have erection problems every now and then. This is normal. These problems can occur at any age. But they are more common as you get older, when you are more likely to have other health problems. Treatment can help if you are older or younger.
Erection problems may be caused by physical problems or mental health issues. Examples include injury to the nerves or loss of blood supply to the penis, side effects of some medicines, and some surgeries. Depression, stress, and anxiety can also cause the problem.
Your doctor can find out if you have an erection problem by asking questions about your health and doing a physical exam. Your doctor will want to know how often the problem happens. Lab tests, and sometimes mental health tests, can also help find out the cause of the problem.
Treatment for an erection problem depends on the cause of the problem. The cause may be mental, physical, or a combination. Treatment can include talking about the issue with your partner, taking pills that can help you get an erection, and finding and then stopping medicines that may be causing the problem.
To reduce your risk of having erection problems, lead a healthy lifestyle—eat healthy foods; be active; and don't smoke, drink too much alcohol, or use illegal drugs. You may be able to avoid erection problems related to anxiety and stress by talking with your partner about your concerns. This may help you relax.
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Erection problems may be caused by physical problems related to the blood vessels, nerves, and hormones. Or they may be caused by mental health issues.
Normally, an erection occurs when your imagination or senses (vision, hearing, touch, smell, taste) are stimulated. You then get aroused. Your central nervous system sends nerve impulses that increase blood flow to your penis.
Causes of erection problems may include:
You may be able to avoid erection problems related to anxiety and stress by taking a more relaxed approach to sex. Talk to your partner about your problems and concerns. Sexual intimacy is a form of communication. If you and your partner talk about sex, it will help reduce your stress and anxiety. And you may become more relaxed.
Erections may gradually become more difficult to get and keep as you get older. But foreplay—erotic stimulation before intercourse—and the right environment can help increase your ability to have an erection, regardless of your age.
Here are some other things you can do that may reduce your risk for erection problems.
Even small amounts of alcohol can cause erection problems.
This can help lower your risk of hardening of the arteries (atherosclerosis).
The only symptom of an erection problem is being unable to get and keep an erection that is firm enough or lasts long enough to have sex. But even with an erection problem, you may still have sexual desire and be able to have an orgasm and to ejaculate.
It's common to have erection problems now and then. But when erection problems are lasting, they can affect your self-image, sex life, and relationship. When you have erection problems often, "performance anxiety" can make the problem worse. If you can't keep an erection that is firm enough for intercourse, or if you have an orgasm before or right after entering your partner (premature ejaculation), you may feel frustrated and believe you aren't pleasing your partner. All of these things could affect how you view your relationship.
Fortunately, many of the things that cause erection problems can be treated.
Call your doctor now or seek medical care right away if:
Call a doctor if erection problems occur:
If your erection problem happens just now and then, there's no reason to call your doctor. If it happens often and upsets you or your partner, it's okay to call your doctor. If an erection problem doesn't bother you or your partner, you may choose not to call your doctor.
Watchful waiting is a wait-and-see approach. A single episode of an erection problem is often a temporary problem that is easy to reverse. Don't assume it will happen again. Try to forget about it, and expect a more successful experience the next time. If you or your partner is concerned about it, talk about the problem. Openly discuss your fears and anxieties.
If self-care has not helped after 2 weeks and you are concerned about your erection problem, see a doctor who has experience in dealing with these problems.
To diagnose an erection problem, your doctor may:
Your doctor may start treatment with pills. But you may get more tests if pills don't work or your doctor thinks that testing is needed.
Tests can help your doctor find out whether physical factors are causing your erection problem. These may include lab tests for:
If your doctor thinks you have a mental health issue, a mental health evaluation may be recommended.
Treatment for an erection problem depends on the cause of the problem. The cause may be mental or physical. Or it might be a mix of both.
Many doctors take a step-by-step approach to treating erection problems. They start with treatments that don't put anything in or on your body.
Treatment can include having you:
There are also complementary therapies for erection problems. If you don't want to use medicine, or if medicine doesn't work for you, you may want to talk with your doctor about some of these options. They include acupuncture, ginseng, and zinc. Most of these treatments need more research before doctors can know for sure if they work.footnote 1
It's important to involve your partner in your decision, no matter which treatment you choose.
Medicines that can help produce an erection may be used to treat erection problems that are caused by blood vessel (vascular), hormonal, nervous system, or psychological problems. The medicines also may be used with counseling. Together, they can treat erection problems that have psychological causes.
Commonly used oral medicines include:
Other medicines that may be used include:
Hormones and other medicines may be prescribed if you have low testosterone or high prolactin levels.
PDE-5 inhibitors should never be used if you may need to take a nitrate-containing medicine, such as nitroglycerin. Taking nitroglycerin and a PDE-5 inhibitor within 24 hours of each other may greatly lower your blood pressure. This could lead to a heart attack, stroke, or death.
Burnett AL (2012). Evaluation and management of erectile dysfunction. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 721–748. Philadelphia: Saunders.
Current as of:
February 11, 2021
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineAdam Husney MD - Family MedicineChristopher G. Wood MD, FACS - Urology, Oncology
Current as of: February 11, 2021
E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & Christopher G. Wood MD, FACS - Urology, Oncology
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