Erectile dysfunction : cause and symptoms

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Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Symptoms

Erectile dysfunction symptoms might include persistent:

Trouble getting an erection

Trouble keeping an erection

Reduced sexual desire

When to see a doctor

A family doctor is a good place to start when you have erectile problems. See your doctor if:

You have concerns about your erections or you’re experiencing other sexual problems such as premature or delayed ejaculation

You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction

You have other symptoms along with erectile dysfunction

Causes

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

Heart disease

Clogged blood vessels (atherosclerosis)

High cholesterol

High blood pressure

Diabetes

Obesity

Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol

Parkinson’s disease

Multiple sclerosis

Certain prescription medications

Tobacco use

Peyronie’s disease — development of scar tissue inside the penis

Alcoholism and other forms of substance abuse

Sleep disorders

Treatments for prostate cancer or enlarged prostate

Surgeries or injuries that affect the pelvic area or spinal cord

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

Depression, anxiety or other mental health conditions

Stress

Relationship problems due to stress, poor communication or other concerns

Risk factors

As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.

Various risk factors can contribute to erectile dysfunction, including:

Medical conditions, particularly diabetes or heart conditions

Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction

Being overweight, especially if you’re obese

Certain medical treatments, such as prostate surgery or radiation treatment for cancer

Injuries, particularly if they damage the nerves or arteries that control erections

Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions

Psychological conditions, such as stress, anxiety or depression

Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker

Complications

Complications resulting from erectile dysfunction can include:

An unsatisfactory sex life

Stress or anxiety

Embarrassment or low self-esteem

Relationship problems

The inability to get your partner pregnant

Prevention

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:

Work with your doctor to manage diabetes, heart disease or other chronic health conditions.

See your doctor for regular checkups and medical screening tests.

Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.

Exercise regularly.

Take steps to reduce stress.

Get help for anxiety, depression or other mental health concerns.

By Mayo Clinic

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