Erectile dysfunction (ED) is a condition in which a man is unable to maintain or attain an erection that is satisfactory for sexual activity. It affects men throughout aging, typically starting in their 40s and 50s. Although a man may have a rare episode of difficulty, it’s not considered normal for these issues to worsen or occur frequently, especially during sex activity.

What Is Erectile Dysfunction?

Erectile dysfunction (ED) is the inability to maintain or achieve an erection. It occurs more commonly as men age. Multiple factors can contribute to ED including other health issues, medications, stress and prior surgeries. Erectile dysfunction symptoms include:

• Ability to get an erection, but not firm enough for sex
• An erection that doesn’t last long enough for satisfactory sex
• Unable to get an erection

ED may be an early symptom of an underlying health condition, so it’s essential to get it checked.

What Causes Erectile Dysfunction?

Erectile dysfunction causes may include conditions affecting the vascular, nervous and endocrine systems. Although aging may make a man more likely to develop ED, it does not necessarily cause this condition. As such, ED is treatable at any age. Here are some health conditions that may lead to ED:

• Cardiovascular disease
• High blood pressure
• Diabetes mellitus
• Prostate cancer surgery or other pelvic cancer surgery
• Pelvic radiation
• Injury to the pelvis, bladder, prostate or penis
• Neurologic conditions like multiple sclerosis or spinal cord injuries
• Peyronie's disease

Here are some emotional or psychological factors that may worsen ED:

• Anxiety
• Depression
• Sexual performance anxiety
• Stress

The following are health-related factors that may contribute to ED:

• Obesity
• Excess alcohol consumption
• Physically inactive
• Using illegal drugs
• Smoking

How is Erectile Dysfunction Diagnosed?

A healthcare provider can help diagnose ED and determine its possible causes. Your medical history can reveal whether certain treatments or conditions might have led to ED. On the other hand, your sexual activity history can help your healthcare provider determine possible problems with erection, ejaculation or sexual desire. An erectile dysfunction diagnosis involves learning about your medical and sexual history as well as a physical exam. Laboratory, imaging and other tests may also be ordered to support your doctor’s diagnosis and help them plan a treatment for ED that may include medications, counseling, lifestyle changes or other interventions.

Medical History

Some diagnostic questions may include:

• Do you drink or smoke, and how often?
• What medications and supplements are you currently taking?
• What other conditions have you been diagnosed with?
• What procedures or surgeries have you gone through before?

Sexual History

Your doctor may ask questions related to your sex life such as:

• How long have you been experiencing these symptoms?
• How often are you able to maintain an erection during sexual activities?
• When you have erections, how firm are they?
• Do your erections vary depending on sexual activity?
• How often do you get satisfaction from sexual activity?
• How would you rate your confidence to get and maintain an erection?

How Can You Fix Your Erectile Dysfunction?

Working with a healthcare provider for ED treatment is a personal decision. Your doctor may suggest lifestyle improvements, such as stopping smoking, increasing physical activity and consuming a balanced diet. ED treatment options may include:

• Oral medications – to help achieve and maintain an erection, such as sildenafil, tadalafil, and vardenafil. They work by increasing blood flow in the penis to help erection during sexual stimulation. However, these medications must not be taken if you’re taking nitrates for heart issues or chest pain, as this may result in sudden blood pressure drop.
• Penile injections – a medication injected into the side of the penis to cause an erection.
• Vacuum erection devices – a vacuum that brings blood into the penis to help with erection.
• Penile implant surgery – an artificial device / medical device that is surgically placed within the penis to create an erection.

How To Prevent Erectile Dysfunction?

Committing to a healthy diet and lifestyle may help prevent many ED causes. Here are some steps you can take:

• Quit smoking
• Consume a healthy diet
• Avoid excess alcohol drinking
• Maintain a healthy weight
• Be physically active
• Keeping blood sugar under good control