Most men, at some point in their lives, will experience some form of erectile dysfunction. According to the “Merck Manual for Healthcare Professionals,” at least 10 to 20 million men in the United States suffer from erectile dysfunction.

Experts believe that the number may actually be higher because men sometimes may not be comfortable speaking to their doctors about sexual issues.

What is impotence and erectile dysfunction?

Impotence refers to a man’s inability to get or maintain an erection long enough to have sexual intercourse. Occasionally having trouble getting or keeping an erection is quite common. And it’s not generally a cause for concern.

If it happens more than just occasionally, then it needs to be addressed with your doctor. Erectile dysfunction can be a sign of an underlying health condition like diabetes or heart disease. Regardless of the cause of impotence, left untreated it can take a toll on your relationships and your self-confidence.


Experiencing problems with erections once in a while is something that happens to most men at some point. It is when the following symptoms are persistent, or become a problem for you and your partner, they may be cause for concern:

  • difficulty getting erect
  • difficulty keeping a strong erection
  • reduced sex drive

Causes of erectile dysfunction

There are several factors that play a role in a man’s sexual arousal, and can be both physical and emotional. The causes of erectile dysfunction can be as simple as a side effect from a medication, stress, relationship issues, or the result of an illness.

Some common physical causes include:

  • certain prescription medications
  • heart disease
  • diabetes
  • high blood pressure
  • high cholesterol
  • low testosterone levels
  • metabolic syndrome
  • obesity
  • multiple sclerosis
  • Parkinson’s disease
  • cancer treatments
  • Peyronie’s disease
  • certain surgeries
  • drug and tobacco use
  • excessive alcohol consumption

Common psychological causes include:

  • depression
  • anxiety
  • stress
  • mental health issues
  • relationship issues stemming from resentment, anger, or lack of trust

Risk factors

There are many factors that can cause erectile dysfunction. In addition to many physical or psychological causes, there are also other factors that could put you at risk for developing an ongoing problem of getting or maintaining an erection, or getting aroused.

The most common factor is aging. As men get older, it becomes more difficult for them to get an erection. In some cases, a little bit of extra touching and stimulation may help, while others may require treatment.

And a rarely discussed risk factor is prolonged cycling, which affects the flow of blood to the penis and can compress nerves, leading to temporary erectile dysfunction.


The first step in treating erectile dysfunction is an examination by a doctor. They’ll want to know your symptoms and about any stressors in your life. Your doctor will want to know when your symptoms started, and whether you have spontaneous nighttime erections. Your doctor may also speak with your partner.

A complete physical examination, including blood and urine tests and possibly an ultrasound, will also be used to determine what could be causing the issue. It’s not easy to talk to someone about your sexual health or your relationship, but the more candid you are about what’s going on, the easier it will be for your doctor to help you.

Your treatment will depend on what is found during your examination. If a medical condition like high blood pressure or heart disease is deemed to be the cause, then treating those conditions is likely to improve your condition.

If the cause is psychological, then counseling may be part of your treatment. This may include couples counseling if problems in your relationship are an issue.

There are several treatment options available for erectile dysfunction that can help you to achieve and maintain an erection, including:

  • oral medications (Viagra)
  • vardenafil (Levitra, Staxyn)
  • tadalafil (Cialis)
  • self-injections of alprostadil (Caverject Impulse, Edex)
  • alprostadil intraurethral penis suppositories (Muse)
  • penis pumps

Testosterone may also be used to treat low testosterone levels. Antianxiety and antidepressants could also be prescribed to treat psychological issues. And high blood pressure medication, blood thinners, or insulin can treat underlying medical conditions.

Surgical options are also available in rare cases. Blood vessel surgery will repair damaged or blocked blood vessels that may be causing impotence or erectile dysfunction. Or penile implant surgery may help if all other treatment options have been exhausted.

Lifestyle changes to improve erectile dysfunction

There are lifestyle changes that you can make to help improve erectile dysfunction. Losing weight if you are overweight will greatly improve your overall health. A healthier diet and regular exercise will help you to achieve and maintain a healthy weight, which can impact your sexual health. It also improves circulation and can help keep heart problems and diabetes under control.

Smoking and alcohol or drug use can all be contributing factors in erectile dysfunction, and also wreak havoc on your physical and mental health. If these substances are used in excess, you might consider cutting back on your consumption, or seeking help for treatment of an addiction.

There are also relaxation techniques that help people deal with stress and anxiety. These include:

  • yoga
  • meditation
  • deep breathing
  • massage

Exercise also has a relaxing effect, as does engaging in activities that you enjoy, such as walking, painting, or anything else that brings you pleasure and allows you to decompress.