What is erectile dysfunction (ED)?

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s sometimes referred to as impotence, although this term is now used less often.

Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED, however, can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.

What causes an erection?

ED can occur because of problems at any stage of the erection process. An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.

When a man is sexually excited, muscles in the penis relax. This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. As the chambers fill with blood, the penis grows rigid.

An erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.

There are many possible causes of ED, and they can include both emotional and physical conditions. Common causes include:

• cardiovascular disease
• diabetes
• hypertension, or high blood pressure
• high cholesterol
• obesity
• low testosterone levels or other hormone imbalances
• kidney disease
• increased age
• stress
• anxiety
• depression
• relationship problems
• certain prescription medications, such as those used to treat high blood pressure or depression
• sleep disorders
• drug use
• consuming too much alcohol
• using tobacco products
• certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS)
• damage to the pelvic area through injury or surgery
• Peyronie’s disease, which causes scar tissue to develop in the penis

ED can be caused by only one of these factors or by several of them. That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions.