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Erectile dysfunction (ED), or impotence, is the inability to get or keep an erection long enough for satisfactory lovemaking. Erectile dysfunction isn’t a disease, but a symptom of some other problem – physical, psychological or a mixture of both.
It is normal to experience the occasional bout of impotence. Unless it persists, there is no reason to be concerned. Ongoing impotence should be investigated by a doctor.
Treatments for erectile dysfunction include medications given orally (by mouth), vacuum devices, counselling, injections directly into the penis or penile prosthetic implants.
Causes of erectile dysfunction
It was once thought that erectile dysfunction was mainly caused by psychological factors, such as anxiety or depression. In fact, most cases of erectile dysfunction are actually caused by physical illness.
The four main causes of erectile dysfunction include:
- Physical illness – there are many diseases that interfere with functioning of the penis by either reducing blood flow or affecting the nerves. Some of these diseases include heart and blood vessel diseases (atherosclerosis), diabetes and multiple sclerosis. Cigarette smoking, drinking too much alcohol and some prescription drugs can also cause erectile dysfunction. High blood pressure and high cholesterol levels increase a man’s risk of developing erectile dysfunction. Major surgery for prostate or bowel cancer may also lead to erectile dysfunction by causing nerve damage. When the impotence is caused by a physical illness it usually develops slowly. Most causes of impotence are physical. Some prescription drugs such as narcotics, sedatives and blood pressure medication can give you impotence as a side effect.
- Psychological factors – a man’s sexual drive or performance can be affected by stress such as problems at work, relationship difficulties or financial worries. Psychiatric conditions and feeling depressed or anxious about poor sexual performance can also result in a failed erection. Only one in ten cases of impotence are caused by psychological factors.
- A combination of physical illness and psychological factors – physical problems with maintaining an erection may cause the man to feel anxious about lovemaking, which makes the problem worse.
- Unknown – in a few cases, neither physical nor psychological causes can explain the loss of sexual functioning.
Occasional impotence is normal
Don’t worry about the occasional failure to get or keep an erection. Occasional impotence is normal. Some of the causes include drinking too much alcohol, anxiety and tiredness. In fact, one of the most common causes of impotence in middle-aged men is lack of sleep.
Ongoing impotence should be investigated by a doctor
While occasional erectile dysfunction is normal, ongoing impotence can be a symptom of a serious physical illness. It is important that any ongoing problems are fully investigated by a doctor to check for any underlying medical cause that may also require treatment. This may include heart and blood vessel diseases, diabetes, high blood pressure or high cholesterol.
Once you find out whether your impotence stems from physical or psychological causes, you can get the proper course of treatment.
Treatment
There are many treatments for erectile dysfunction. These include:
- Changing your prescription drugs if they are the cause
- Psychotherapy and counselling
- Oral medications such as Viagra, Cialis and Levitra
- External vacuum devices to create blood flow
- Injections directly into the penis (penile injections)
- Hormone therapy (rarely given)
- Penile prosthetic implants.
It is usual to start with the least invasive treatment, such as tablets, and to recommend more complicated injection treatments or surgery if the tablets fail.
Treat any products that claim to treat or even cure erectile dysfunction with caution and use only under the supervision of a doctor. Some products are expensive and may not have been adequately tested for either their side effects or results.
Where to get help
Things to remember
- Most cases of impotence are physical in origin.
- It is normal for a man to experience occasional bouts of impotence, perhaps from tiredness or drinking too much alcohol.
- Ongoing erectile dysfunction should be investigated by a doctor.
- Common treatments include counselling, oral medications, vacuum devices, penile injections and implants.
You might also be interested in:
Diabetes and erectile dysfunction.
Erectile dysfunction treatments.
Want to know more?
Go to More information for support groups, related links and references.
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This page has been produced in consultation with, and approved by:
Andrology Australia
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Copyight © 1999/2009 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.
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This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
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Last updated: January 2009
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Erectile dysfunction - Better Health Channel
Erectile dysfunction (ED), or impotence, is the inability to get or keep an erection. It used to be thought that impotence was psychological in origin but now we know that many cases are caused by a physical problem. Occasional erectile dysfunction is normal, but ongoing impotence should be investigated by a doctor...
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Erectile dysfunction - Better Health ChannelErectile dysfunction (ED), or impotence, is the inability to get or keep an erection. It used to be thought that impotence was psychological in origin but now we know that many cases are caused by a physical problem. Occasional erectile dysfunction is normal, but ongoing impotence should be investigated by a doctor...
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The information published here was accurate at the time of publication and is not intended to take the place of medical advice. Please seek advice from a qualified health care professional.
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