Erectile dysfunction (ED)

Overview

Occasional difficulty with erections is common and not usually a concern. ED refers to a persistent pattern that affects sexual activity or wellbeing. Because erections depend on blood flow, nerves, hormones, and psychological factors, ED can have several contributing causes at once.

Common causes and risk factors

Contributors include cardiovascular disease, diabetes, high blood pressure, obesity, smoking, some medicines, hormonal issues, nerve or pelvic conditions, and psychological factors such as stress, anxiety, or relationship difficulties. Because ED shares risk factors with heart disease, a new diagnosis can be a useful prompt to review overall health.

When to seek medical care

Speak with a clinician if ED is persistent, is affecting your wellbeing or relationship, or comes with other symptoms such as chest pain on exertion. It is worth assessing rather than assuming it is untreatable.

How it is assessed

Assessment usually involves a history (including medicines and lifestyle), a physical examination, and sometimes blood tests to check for diabetes, cholesterol, or hormone levels. The aim is to identify treatable contributors, not just the symptom.

Treatment options

Options depend on the cause and may include addressing lifestyle and cardiovascular risk factors, reviewing medicines, psychological support, oral medicines, and other treatments discussed with a clinician. Do not buy prescription medicines from unverified sources.

Questions to ask a clinician

• Could a health condition or medicine be contributing to my ED?
• Should I have my heart and metabolic health checked?
• What lifestyle changes might help?
• What are the options if oral medicines are not suitable or do not work?