Topic Overview

What are erection problems?

A man has erection problems if he cannot get or keep an erection that is firm enough for him to have sex. Erection problems are also called erectile dysfunction or impotence.

Erection problems can occur at any age. But they are more common in older men, who often have other health problems. Treatment can help both older and younger men.

What causes erection problems?

Erection problems may be caused by physical problems, such as injury to nerves or loss of blood supply to the penis.

They can also be linked to other health problems. These include diabetes, high blood pressure, high cholesterol, and atherosclerosis. Erection problems can also be linked to problems with the nervous system, such as multiple sclerosis and Parkinson's disease.

Many medicines for other health problems may cause erection problems, but most do not. If you recently began taking a new medicine and started having erection problems, this could be a side effect of the medicine. Talk with your doctor. He or she may be able to change the dose or type of medicine you take.

Men who drink too much alcohol, smoke, or use illegal drugs also are at risk for erection problems.

Anxiety, stress, or depression can cause erection problems.

Other causes include surgery, such as for prostate cancer, or injury to the pelvic area.

What are the symptoms?

The only symptom of an erection problem is being unable to get and keep an erection that is firm enough to have sex. But even with an erection problem, a man may still have sexual desire and be able to have an orgasm and to ejaculate.

How are erection problems diagnosed?

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 if the problem happens all the time or just from time to time. The exam, lab tests, and sometimes mental health tests can help find out the cause of the problem.

How are they treated?

There are a number of treatments for erection problems. Doctors usually start with lifestyle changes and medicines. They usually don't advise surgery or other treatments unless those first steps don't help.

Treatment can include:

• Making lifestyle changes, such as avoiding tobacco, drugs, and alcohol. It may also help to talk about the issue with your partner, do sensual exercises, and get counseling.
• Finding and then stopping medicines that may be causing the problem. In some cases you can take a different medicine that does not cause erection problems.
• Taking prescription medicine that can help you get erections. These include pills such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). Check with your doctor to see if it is safe for you to take one of these medicines with your other medicines. These can be dangerous if you have heart disease that requires you to take nitroglycerin or other medicines that contain nitrates.
• Taking medicines and getting counseling for depression or anxiety.
• Using vacuum devices or getting shots of medicine into the penis.
• Having surgery to place an implant in the penis.