Erectile Dysfunction

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

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:

• Problems with the blood vessels. These problems may prevent blood from filling the penis or from staying there long enough to keep an erection.
• Problems with the nerves. These may prevent arousal signals from traveling from the brain and spinal cord to the penis.
• Other health problems, such as low testosterone levels, diabetes, or high blood pressure.
• Side effects of certain medicines.
• Drinking too much alcohol or smoking.
• Surgery, such as for prostate cancer.
• Mental health issues, such as depression, anxiety, stress, or grief.

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.

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.

Treatment can include having you:

• Avoid tobacco and drugs and limit alcohol.
• Talk about the issue with your partner, do sensual exercises, and get counseling.
• Ask your doctor about changing any medicines that may be causing the problem. In some cases, you may be able to use a different medicine.
• Take testosterone or another treatment to fix a hormone problem, such as low testosterone, if tests show that you have one.
• Take pills that help you get an erection. These pills are called PDE-5 inhibitors. They include sildenafil (such as Viagra), tadalafil (such as Cialis), and vardenafil (such as Levitra). Check with your doctor to see if it's safe for you to take one of these medicines with your other medicines. These pills can be dangerous if you take nitroglycerin or other medicines that contain nitrates (for heart disease).
• Use medicines that are injected or inserted into the penis.
• Use vacuum devices. These devices have a tube that you place around the penis. You pump the device to create a vacuum that leads to an erection.
• Have surgery to place an implant in the penis.

It's important to involve your partner in your decision, no matter which treatment you choose.

Sometimes you can treat occasional erection problems at home. Look at relationships and events that may be causing sexual problems. Talk with your partner outside of the bedroom about your sex life. Sensual exercises may help. Not smoking and drinking less alcohol may also help. Seek professional help if you keep having problems.