Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.
Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.
Erectile dysfunction symptoms might include persistent:
Trouble getting an erection
Trouble keeping an erection
Reduced sexual desire
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
Common causes include:
Clogged blood vessels (atherosclerosis)
High blood pressure
Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
Certain prescription medications
Peyronie's disease — development of scar tissue inside the penis
Alcoholism and other forms of substance abuse
Treatments for prostate cancer or enlarged prostate
Surgeries or injuries that affect the pelvic area or spinal cord
As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.
Various risk factors can contribute to erectile dysfunction, including:
Medical conditions, particularly diabetes or heart conditions
Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
Being overweight, especially if you're obese
Certain medical treatments, such as prostate surgery or radiation treatment for cancer
Injuries, particularly if they damage the nerves or arteries that control erections
Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
Psychological conditions, such as stress, anxiety or depression
Drug and alcohol use, especially if you're a long-term drug user or heavy drinker
Complications resulting from erectile dysfunction can include:
An unsatisfactory sex life
Stress or anxiety
Embarrassment or low self-esteem
The inability to get your partner pregnant
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