Key takeaways:
Many men experience erectile dysfunction (ED), and it becomes more common with age. The main ED symptom is a regular difficulty getting and keeping an erection.
There are many causes of erectile dysfunction. Sometimes ED can be a sign of other health problems.
If you have ED symptoms, talk with a healthcare professional about your treatment options.
Save on related medications
Erections are an important part of physical and mental health. Blood vessels, nerves, hormones, and psychological factors all contribute to having erections. When there’s a problem in any of those areas, it can lead to erectile dysfunction (ED).
Erectile dysfunction used to be called “impotency,” but the term was changed to better describe the condition. Basically, these terms mean the same thing. Erectile dysfunction means you can’t regularly have and maintain an erection. This becomes more common as you age. But it can also happen due to health conditions or medications.
Erectile dysfunction symptoms can vary from person to person, and it can sometimes be confused with other sexual health problems. It’s normal to occasionally have some of these issues. But, if these symptoms happen more than half the time, then you may want to talk with a healthcare professional.
Let’s take a closer look at ED symptoms and what you can do about it.
1. Difficulty getting an erection
Under normal circumstances, sexual arousal is followed by achieving an erection. Erections are a result of blood vessels dilating and allowing blood into the penis. At the same time, blood flow out of the penis through veins is reduced. This traps the blood, making the penis hard.
An erection takes coordination between:
The central nervous system
Spinal cord
Peripheral nerves
Hormones
Cardiovascular system
There’s also a psychological piece to getting an erection. A problem in any one of these areas can make it difficult to achieve and maintain an erection.
2. Difficulty maintaining an erection long enough for sexual intimacy
When an erection goes away before you’re ready, it can be frustrating and embarrassing. The complex interplay between hormones, nerves, and the cardiovascular system can affect how well you maintain an erection.
3. Erections that aren’t hard enough for penetration
Penetration occurs when the penis is inserted into a bodily orifice (opening). An erection has to be hard enough to push past the tissues surrounding the opening for penetration to occur. Sometimes an erection can occur but not be hard enough to achieve penetration.
4. Loss of erection after penetration
You can lose an erection at any point in a sexual encounter. Losing an erection after penetration is similar to not being able to maintain one long enough to initiate sexual intercourse. But, in this case, it happens later in sexual intimacy.
5. Unsatisfactory intercourse
The definition of erectile dysfunction is based on your ability to have satisfactory sexual intercourse. If you’re having sex, but don’t find it satisfying, you may be experiencing ED. Even if you don’t have any other symptoms, it’s worth talking with a healthcare professional.
Can ED happen suddenly?
No, ED doesn’t usually happen suddenly. That said, it’s normal to have sudden, unexpected difficulty with erections from time to time. This may happen especially when you’re:
Experiencing stress
Having relationship difficulties
But, when symptoms start to happen regularly over a period of several months, then it may be a sign of ED.
ED symptoms that happen because of underlying medical conditions usually take months or years to develop. This is due to changes in your hormones, blood vessels, and nerve health. As you get older, difficulty getting and keeping an erection will likely happen more often as a result.
What causes erectile dysfunction?
Many health conditions can cause erectile dysfunction. So, it’s important to treat any health condition you may have. Sometimes symptoms of erectile dysfunction can be the first warning sign of health issues you didn’t know you had.
Some of the main causes of erectile dysfunction include:
Health conditions: These include hormonal, cardiovascular, or neurological issues.
Lifestyle factors: These include drinking alcohol, smoking, or using recreational drugs.
Certain medications: These include medications for high blood pressure, heart disease, or depression.
Mental health concerns: Depression, anxiety, and stress can affect your sex life, including contributing to ED.
How do you know if it’s ED or something else?
ED can sometimes be confused with other sexual problems. Other common issues that can affect sexual satisfaction include:
Low libido (decreased interest in sex)
Premature ejaculation (when ejaculation happens too soon after penetration)
Delayed ejaculation (when ejaculation takes a long time after penetration)
Anorgasmia (inability to have an orgasm at all)
ED can sometimes happen at the same time as these other conditions. To get the right diagnosis and ED treatment, it’s important to talk with a healthcare professional about libido changes, erection patterns, and ejaculation issues.
Quiz: Is it erectile dysfunction?
When should you see a doctor for erectile dysfunction symptoms?
You should see a healthcare professional as soon as you have concerns about your sexual performance. The earlier a problem is caught, the easier it may be to treat. Earlier treatment also helps minimize frustration for you and your partner.
If your ED is due to an underlying medical condition or medication, a healthcare professional can make the diagnosis and treat those conditions with medications such as tadalafil (Cialis) or sildenafil (Viagra). Substituting your medication for a different one, or simply changing the dose, may help improve ED symptoms.
Frequently asked questions
While ED can happen at any age, ED is more common in older men. Up to 35% of men have ED symptoms between the ages of 55 and 64, and symptoms increase with age.
You may have ED if you have any of the symptoms listed above. But to find a treatment that works, you’ll need to identify the underlying cause of your symptoms. To diagnose the cause of your symptoms, a healthcare professional may:
Perform blood tests
Perform radiology tests
Look at your medications
Ask you questions about your mental health
Yes, you can cure some causes of erectile dysfunction. For example, you may be able to reverse erectile dysfunction caused by medication side effects, obstructive sleep apnea, and psychological issues like stress or anxiety. Curing or reversing ED means that after addressing the underlying cause, you’ll be able to get an erection without medication.
Depending on the cause, erectile dysfunction can sometimes be permanent. Not all causes of erectile dysfunction have a cure, and there may be multiple causes. ED is usually permanent when the cause is related to structural problems of the penis, nerves, or blood vessels.
Yes, ongoing stress can cause erectile dysfunction. When you experience stress over the long term, your body can release cortisol — a hormone that constricts the blood vessels in your penis. And when blood can’t flow properly to your penis, you may have trouble achieving an erection. Long-term stress can also decrease how much testosterone your body makes. And low testosterone is linked to ED.
Plus, when you’re feeling stressed, you may not feel in the mood for sex. These feelings can also make erections go away if you have one.
Treatment for ED may include lifestyle changes, medications, or psychotherapy. When underlying conditions — like diabetes or high blood pressure — are causing ED, it’s important to treat those. It’s also a good idea to review your medications with a healthcare professional to see if these could be causing ED as a side effect.
While ED can happen at any age, ED is more common in older men. Up to 35% of men have ED symptoms between the ages of 55 and 64, and symptoms increase with age.
You may have ED if you have any of the symptoms listed above. But to find a treatment that works, you’ll need to identify the underlying cause of your symptoms. To diagnose the cause of your symptoms, a healthcare professional may:
Perform blood tests
Perform radiology tests
Look at your medications
Ask you questions about your mental health
Yes, you can cure some causes of erectile dysfunction. For example, you may be able to reverse erectile dysfunction caused by medication side effects, obstructive sleep apnea, and psychological issues like stress or anxiety. Curing or reversing ED means that after addressing the underlying cause, you’ll be able to get an erection without medication.
Depending on the cause, erectile dysfunction can sometimes be permanent. Not all causes of erectile dysfunction have a cure, and there may be multiple causes. ED is usually permanent when the cause is related to structural problems of the penis, nerves, or blood vessels.
Yes, ongoing stress can cause erectile dysfunction. When you experience stress over the long term, your body can release cortisol — a hormone that constricts the blood vessels in your penis. And when blood can’t flow properly to your penis, you may have trouble achieving an erection. Long-term stress can also decrease how much testosterone your body makes. And low testosterone is linked to ED.
Plus, when you’re feeling stressed, you may not feel in the mood for sex. These feelings can also make erections go away if you have one.
Treatment for ED may include lifestyle changes, medications, or psychotherapy. When underlying conditions — like diabetes or high blood pressure — are causing ED, it’s important to treat those. It’s also a good idea to review your medications with a healthcare professional to see if these could be causing ED as a side effect.
The bottom line
Erectile dysfunction (ED) is a common condition and can often overlap with other sexual problems or health conditions. ED symptoms include having recurrent difficulty with getting and keeping an erection. ED can be an early warning sign of other health conditions, like diabetes or heart disease. That’s why it’s important to talk with a healthcare professional about your sexual health concerns.
Why trust our experts?
References
Dean, R. C., et al. (2005). Physiology of penile erection and pathophysiology of erectile dysfunction. Urologic Clinics of North America.
HardFacts.com.au. (n.d.). Understanding ED. Boston Scientific.
Jenkins, L. C., et al. (2015). Delayed orgasm and anorgasmia. Fertility and Sterility.
Leslie, S. W., et al. (2024). Erectile dysfunction. StatPearls.
Mark, K. P., et al. (2024). Erectile dysfunction prevalence in the United States: Report from the 2021 National Survey of Sexual Wellbeing. The Journal of Sexual Medicine.
Mostafaei, H., et al. (2021). Association of erectile dysfunction and cardiovascular disease: an umbrella review of systematic reviews and meta-analyses. BJU International.
National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Diagnosis of erectile dysfunction. National Institutes of Health.
National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Symptoms and causes of erectile dysfunction. National Institutes of Health.
NHS Inform. (2024). Erectile dysfunction (impotence).
Panchatsharam, P. K., et al. (2023). Physiology, erection. StatPearls.
Rivas, A. M., et al. (2014). Diagnosing and managing low serum testosterone. Baylor University Medical Center Proceedings.
Yafi, F. A., et al. (2016). Erectile dysfunction. Nature Reviews Disease Primers.
