Erectile dysfunction (ED), also known as impotence, is a common condition affecting an estimated 20 to 30 million men in the United States and over 150 million men worldwide. ED is defined as a man's inability to achieve and maintain an erection that is sufficient for satisfactory sexual intercourse. The ability to have an erection requires the normal, integrative functions of the nerves, blood vessels, muscles and brain.
ED may result from a variety of factors or a combination of factors. These may include psychological, neurological, hormonal and vascular disorders. Certain drugs and chronic diseases, as well as the natural aging process, also may contribute to ED. For more information, please see Erectile Dysfunction Causes.
The hallmark symptom of erectile dysfunction is the inability to achieve and maintain an erection for satisfactory sexual intercourse. This condition also may involve problems with emission, ejaculation and orgasm.
In making a diagnosis of erectile dysfunction (ED), your doctor will start by taking a detailed medical and psychosexual history and conducting a thorough physical examination. If possible, interviewing your partner also is very helpful in obtaining an accurate history, planning treatment and a successful outcome.
ED is often associated with various medical conditions, such as diabetes mellitus, coronary artery disease, hypertension, hyperlipidemia, spinal cord compression and pituitary tumors. Therefore, your doctor may conduct a variety of laboratory tests to determine the cause of your ED. These tests may include the following:
There are a variety of treatment options available for erectile dysfunction, which will be explained to you by your doctor. Your therapy will depend on the cause of ED, your age, your health and you and your doctor's preferences.
In most cases, an oral medication, such as Viagra, Levitra or Cialis, will be recommended first. Depending on its effectiveness and your tolerance to the medication, other approaches may be tried. In patients who have blood vessel blockage or leakage, microvascular surgery may be recommended. For those who do not respond to non-surgical treatments or are not candidates for surgery, penile prosthesis is an excellent alternative.
It is important to note that it is not necessary to have an erection to have an orgasm. A vibrator or creative and attentive partner can be helpful.
Reviewed by health care specialists at UCSF Medical Center.