Erectile Dysfunction
(ED, Impotence)

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Erectile dysfunction (impotence) facts

  • Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity.
  • Symptoms of erectile dysfunction include the inability to have or to sustain a penile erection to complete satisfactory sexual activity.
  • Erectile dysfunction is common; experts have estimated that erectile dysfunction affects 30 million men in the United States.
  • The causes of erectile dysfunction include aging, high blood pressure, diabetes mellitus, cigarette smoking, atherosclerosis, depression, nerve or spinal cord damage, medication side effects, alcoholism or other substance abuse, and low testosterone levels.
  • Erectile dysfunction is treatable in all age groups.
  • Treatments include psychotherapy, adopting a healthy lifestyle, oral PDE5 inhibitors (Viagra, Levitra, Cialis, Stendra, and Staxyn), intraurethral medications (MUSE), intracavernosal injections, vacuum devices, surgery, and working with doctors to avoid medications that can impair erectile function.
  • Before using over-the-counter and/or supplements, a discussion with a doctor is strongly recommended.
  • New research is ongoing in the field of erectile dysfunction to find more improved and effective therapies.

What is erectile dysfunction (ED)?

Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. Erectile dysfunction is different from other conditions that interfere with male sexual intercourse, such as lack of sexual desire (decreased libido) and problems with ejaculation and orgasm (ejaculatory dysfunction). This article focuses on the evaluation and treatment of erectile dysfunction.

What are erectile dysfunction symptoms and signs?

Symptoms of erectile dysfunction may include the following:

  • Penile erection occurs but it is not maintained for the length of sexual activity
  • Penile erection that is not firm enough to penetrate the vagina
  • Inability to obtain a penile erection

What is normal penis anatomy?

The penis contains two chambers, called the corpora cavernosa, which run the length of the upper side of the penis (see figure 1 below). The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa. Filling the corpora cavernosa is a spongy tissue consisting of smooth muscles, fibrous tissues, veins, and arteries. A membrane, called the tunica albuginea, surrounds the corpora cavernosa. Veins located in the tunica albuginea drain blood out of the penis. The corpus spongiosum helps maintain the urethra open during an erection for passage of the ejaculate (sperm and prostatic fluid).

Picture of arteries and veins involved in erectile dysfunction (ED)
Picture of arteries and veins involved in erectile dysfunction (ED); SOURCE: NIH
Medically Reviewed by a Doctor on 4/23/2015

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Erectile Dysfunction Causes and Symptoms

There are many causes of erectile dysfunction (impotence) and some include:

  • blood vessel diseases (such as peripheral vascular disease and others),
  • systemic disease,
  • hormonal imbalance, and
  • medications (such as blood pressure and heart medications).