WebMD Medical Reference
For a healthy young man, erectile dysfunction is typically not a problem. As you age, however, you may notice some changes. Maybe it takes more coaxing to get erect than it used to. Sometimes it may take more direct stimulation of the penis, whereas merely a daydream or the suggestion of sex was once enough. Or perhaps your erection isn't quite as firm as it once was, but it's still good enough. These are normal changes.
So, when is it erectile dysfunction and when should you seek help? Let's consider a few scenarios:
1. You come home one evening after a long and stressful day at work. Your partner wants to have sex. You think you'd like to also, but you have a problem getting an erection. The next time you try, everything is fine.
In this case, your problem probably doesn't need medical treatment, as long as it happens rarely. If it starts to happen more often, you may want to talk to your doctor about it.
2. Sometimes when you try to have sex, you get only partially erect. Your erection isn't rigid enough to enter your partner.
In the most severe cases of erectile dysfunction, a man isn't able to get even slightly erect. But there are degrees of this condition. Even mild erectile dysfunction is worth discussing with your doctor.
3. You can get a good erection during foreplay, but after you start to have intercourse you lose it.
This can be very frustrating for you and your partner. Even though you are able to get an erection, if it doesn't last long enough to complete sexual intercourse you may have erectile dysfuncton.
An estimated 80% of erectile dysfunction is due to physical causes. High blood pressure is often the cause.
The other 20% is psychological. For a long time, doctors thought that erectile dysfunction was mostly in one's head. Now they know that is not true. Still, the mind plays a big role in getting an erection. Maybe you're losing your erection due to anxiety or other issues between you and your partner. Your doctor can help you determine the cause.
4. Your doctor prescribes a new medication, and you notice that it's now more difficult to get an erection than it was before you started taking it.
Side effects of drugs cause up to 25% of erectile dysfunction cases. Blood pressure medicines are lifesavers, but erection problems are sometimes a side effect. Other medications that can cause erectile dysfunction include:
- Antipsychotic drugs
- Seizure medication
Talk to your doctor about switching to a different drug that's less likely to cause problems. Also ask about treatment options specifically for erectile dysfunction.
5. You typically have several alcoholic drinks every night. It's difficult for you to get an erection when you've been drinking.
Drinking too much alcohol can lead to erectile dysfunction. While a glass of wine may help you and your partner get in the mood, heavy drinking can really hamper your sexual performance.
Alcohol depresses the nervous system, which may cause erection problems if you've had too much to drink. If it only happens when you drink and the effect is temporary, you should limit your drinking and avoid treating the problem with erectile dysfunction medication.
Keep in mind that alcohol also has long-term toxic effects on the nerves that can cause erectile dysfunction, even at times when you're not drinking.
SOURCES: American Urological Association, "AUA Guideline on the Management of Erectile Dysfunction: Diagnosis and Treatment Recommendations," 2005. Barksdale, J. Pharmacotherapy, May 1999; vol 19: pp 573-581. Cappelleri, J. International Journal of Impotence Research, July 2005; vol 17: pp 307-319. The Mayo Clinic, "Erectile Dysfunction." Miller, T. American Family Physician, January 2000; vol 61: pp 95-104, 109-10. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), National Institutes of Health (NIH), "Erectile Dysfunction."
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