Erectile dysfunction (ED) is the inability to get or keep an erection in order to have sexual intercourse, including the inability to get an erection, lack of enough hardness of the erection to allow penetration, and loss of the erection before sex is finished.
- Certain medicines, such as:
- Pain relievers.
- Blood pressure medicines.
- Water pills (diuretics).
- Ulcer medicines.
- Muscle relaxants.
- Excessive drinking.
- Psychological causes, such as:
- Performance fear.
- Physical causes, such as:
- Artery problems. This may include diabetes, smoking, liver disease, or atherosclerosis.
- High blood pressure.
- Hormonal problems, such as low testosterone.
- Nerve problems. This may include back or pelvic injuries, diabetes mellitus, multiple sclerosis, or Parkinson disease.
- Inability to get an erection.
- Lack of enough hardness of the erection to allow penetration.
- Loss of the erection before sex is finished.
- Normal erections at some times, but with frequent unsatisfactory episodes.
- Low sexual satisfaction in either partner due to erection problems.
- A curved penis occurring with erection. The curve may cause pain or the penis may be too curved to allow for intercourse.
- Never having nighttime erections.
- Performing a physical exam to find other diseases or specific problems with the penis.
- Asking you detailed questions about the problem.
- Performing blood tests to check for diabetes mellitus or to measure hormone levels.
- Performing other tests to check for underlying health conditions.
- Performing an ultrasound exam to check for scarring.
- Performing a test to check blood flow to the penis.
- Doing a sleep study at home to measure nighttime erections.
- Medicine taken by mouth to help you achieve an erection.
- Hormone replacement therapy to replace low testosterone levels.
- Medicine that is injected into the penis. Your health care provider may instruct you how to give yourself these injections at home.
- Vacuum pump. This is a pump with a ring on it. The pump and ring are placed on the penis and used to create pressure that helps the penis become erect.
- Penile implant surgery. In this procedure, you may receive:
- An inflatable implant. This consists of cylinders, a pump, and a reservoir. The cylinders can be inflated with a fluid that helps to create an erection, and they can be deflated after intercourse.
- A semi-rigid implant. This consists of two silicone rubber rods. The rods provide some rigidity. They are also flexible, so the penis can both curve downward in its normal position and become straight for sexual intercourse.
- Blood vessel surgery, to improve blood flow to the penis. During this procedure, a blood vessel from a different part of the body is placed into the penis to allow blood to flow around (bypass) damaged or blocked blood vessels.
- Lifestyle changes, such as exercising more, losing weight, and quitting smoking.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider. Do not increase the dosage without first discussing it with your health care provider.
- If you are using self-injections, perform injections as directed by your health care provider. Make sure to avoid any veins that are on the surface of the penis. After giving an injection, apply pressure to the injection site for 5 minutes.
- Exercise regularly, as directed by your health care provider. Work with your health care provider to lose weight, if needed.
- Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
- Before using a vacuum pump, read the instructions that come with the pump and discuss any questions with your health care provider.
- Keep all follow-up visits as told by your health care provider.
Contact a health care provider if:
- You feel nauseous.
- You vomit.
Seek immediate treatment if:
- You are taking oral or injectable medicines and you have an erection that lasts longer than 4 hours. If your health care provider is unavailable, go to the nearest emergency room for evaluation. An erection that lasts much longer than 4 hours can result in permanent damage to your penis.
- You have severe pain in your groin or abdomen.
- You develop redness or severe swelling of your penis.
- You have redness spreading up into your groin or lower abdomen.
- You are unable to urinate.
- You experience chest pain or a rapid heartbeat (palpitations) after taking oral medicines.
This information is not intended to replace advice given to you by your health care provider.