Erection Problems

Written by Darla Burke
Medically Reviewed by George Krucik, MD

What Are Erection Problems?

When men become sexually aroused, a number of hormones, muscles, nerves, and blood vessels all work in conjunction with one another to signal an erection. Nerve signals, sent from the brain to the penis, stimulate muscles to relax. This, in turn, allows blood to flow to the tissue in the penis. Once the blood fills the penis and an erection is achieved, the blood vessels to the penis close off so that the erection can be maintained. Following sexual arousal, the veins in the penis again open up allowing the blood to leave.

At some point in a man’s life, he may have difficulty achieving or maintaining an erection. Erectile problems occur when you cannot achieve an erection that is firm enough to have sexual intercourse. For most men, this problem occurs occasionally and is not a serious issue. However, if you are unable to achieve an erection 25 percent of the time or more, you may have a health problem that requires medical attention. Erection problems are also known as:

  • erectile dysfunction (ED)
  • impotence
  • sexual dysfunction

What Are the Common Underlying Causes of Erection Problems?

The causes of erection problems can be both physical and psychological. Physical causes of erection problems are more common in older men. They occur because of disorders that can affect the nerves and blood vessels responsible for causing an erection.

Physical causes of erectile problems include:

  • heart disease
  • atherosclerosis (hardening of the arteries)
  • high blood pressure
  • diabetes
  • obesity
  • high cholesterol
  • Parkinson’s disease
  • multiple sclerosis
  • Peyronie’s disease(development of scar tissue in the penis, causing painful erections)
  • use of certain medications, including diuretics, muscle relaxers, or antidepressants
  • alcoholism or substance abuse
  • tobacco use
  • trauma or injury to the spinal cord or genital region
  • congenital problems, such as hypospadias or epispadias
  • circumcision complications
  • liver or kidney disease
  • treatment for prostate problems

Psychological causes of erection problems occur in 40 percent of cases and are more common in younger men. Psychological issues can distract a man from becoming aroused and include:

  • anxiety over not being able to achieve or maintain an erection
  • prolonged emotional distress related to economic, professional, or social issues
  • relationship problems
  • depression

When Should You Call Your Doctor?

If you develop erection problems that get worse over time, you should call your doctor. You should also call your doctor if erectile problems develop or get worse after injury or prostate surgery. If you experience erectile problems along with other symptoms, such as lower back pain or abdominal pain, make a doctor’s appointment.

You should also talk to your doctor if you believe a new medication is causing your erectile problems. Do not stop taking your medication before talking to your doctor.

How Can Erectile Problems Be Treated?

If you experience erectile problems, you may want to try homecare options to reduce your symptoms. Many of the physical causes of erectile problems are related to lifestyle choices.

As such, you may want to consider the following:

  • cutting down or stopping tobacco use
  • reducing alcohol consumption
  • getting plenty of rest
  • eating a healthy diet
  • exercising regularly
  • talking with your partner about sexual issues

If changes in your lifestyle do not reduce your symptoms, you will need to contact your doctor to identify the cause of your erectile problems. Your doctor will examine your penis and rectum as well as your nervous system function. Your doctor will also ask you about current health problems and when your symptoms began.

In an effort to accurately diagnose the cause of your erection problems, your doctor may also order tests, including:

  • complete blood count (CBC)­—a set of blood tests that checks for anemia (low red blood cell count)
  • hormone profile—measures the levels of sex hormones (testosterone and prolactin)
  • nocturnal penile tumescence (NPT)—measures erectile functionality while a man is sleeping
  • duplex ultrasound—high-frequency sound waves are used to take pictures of the body’s tissues
  • urinalysis—analyzes urine to measure protein and testosterone levels

Once your doctor determines the cause of your erection problem, he or she will provide appropriate treatment. Treatment options may include addressing the underlying health problem and providing intervention to reduce erection problems.

Options for treating erection problems may include:

  • medications injected into the penis, including prostaglandin E1 (alprostadil) and papaverine
  • medication (alprostadil (MUSE)) injected into the urethra
  • erectile dysfunction medications taken by mouth, such as Viagra
  • surgery
  • vacuum devices

What Are the Complications of Erection Problems?

The complications associated with erection problems are significant and can impact your quality of life. If you experience erection problems, you may also experience:

  • stress or anxiety
  • embarrassment
  • low self-esteem
  • relationship problems
  • dissatisfaction with your sex life

How Can You Prevent Erection Problems?

To prevent erection problems, you should engage in healthy lifestyle behaviors, such as eating a healthy diet, maintaining a healthy weight, and exercising regularly. If you have chronic health conditions, such as diabetes or heart disease, you should also work with your doctor to manage your symptoms. If you experience mental health problems, such as anxiety or depression, you should also seek treatment.

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