Erectile Dysfunction (Impotence)

Erectile dysfunction is the inability to get a firm enough erection — or to keep it throughout intercourse. It is common, usually treatable, and assessment is important to understand the underlying cause.

An erection is a complex process involving nerves, blood vessels, hormones and psychological factors. A problem in any link of this chain can affect erections. Erectile dysfunction, unlike occasional difficulty, is the persistent or recurrent inability to achieve adequate firmness.

Often it is not a stand-alone disease but the first sign of an underlying vascular, hormonal or metabolic condition. For this reason, assessment concerns not only sexual function but general health too.

Symptoms

• Inability to get a firm enough erection for intercourse
• Inability to maintain the erection throughout intercourse
• Reduced sexual desire (not in every case)
• A marked decrease in morning erections
• Performance anxiety and avoidance of intimacy

Causes

• Vascular causes (hypertension, atherosclerosis, penile venous leak)
• Diabetes and metabolic syndrome
• Hormonal causes (low testosterone, etc.)
• Smoking, alcohol and a sedentary lifestyle
• Side effects of certain medications
• Psychological factors: stress, anxiety, relationship issues

When Should You Seek Help?

If the problem lasts more than a few weeks, recurs, or affects your relationship or self-confidence, assessment is recommended. Because erectile dysfunction can also indicate cardiovascular health, early assessment is valuable for general health too.