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What Is Erectile Dysfunction? Understanding ED

Medically Reviewed by Carolin Schneider, MD

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Erectile dysfunction (ED) means being unable to get or keep an erection hard enough for sex. If you have symptoms of ED, you're not alone. As many as 30 million men in the United States are living with this health condition. The good news is that there are effective treatments to help you get and keep an erection.

What Are the Symptoms of Erectile Dysfunction?

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Symptoms of ED can be different from person to person. You may:

• Not be able to get an erection at all
• Be able to get an erection sometimes, but not each time you want to have sex
• Not be able to keep your erection long enough for satisfying sex

What's the Main Cause of Erectile Dysfunction?

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ED is often related to an underlying health issue. Conditions that can cause ED include:

• Diabetes
• High blood pressure
• Atherosclerosis (hardening of the arteries)
• Multiple sclerosis
• Chronic kidney or liver diseases

Mental health can also play a role in ED. You may experience ED if you have:

• Depression
• Anxiety
• Stress — especially stress related to sexual performance

Injuries to the penis and treatments for other health conditions may also cause ED. Treatments that can cause ED include:

• Radiation treatments or surgery on the prostate or bladder
• Certain prescription drugs, including some antidepressants and blood pressure medicines

ED is also more common as you get older. But it's not necessarily a natural part of aging — so if you're experiencing ED, talk with your doctor about potential causes and treatments.

Does COVID-19 Cause Erectile Dysfunction?

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Yes — new data shows that ED is more common in men who've had COVID-19. Researchers are still figuring out exactly why COVID-19 may lead to ED. But for now, it's yet another reason why it's so important to get a COVID-19 vaccine.

Can Low Testosterone Cause Erectile Dysfunction?

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Low testosterone can lead to erectile dysfunction in some cases. If you have low testosterone levels in your blood, your doctor may prescribe testosterone therapy. But taking testosterone probably won't help if your ED has another cause, like aging or problems with nerves or blood circulation.

Taking testosterone can also have severe side effects, including a high red blood cell count. Never take testosterone therapy without a prescription from your doctor.

Can Erectile Dysfunction Be Cured? What's the Best ED Treatment?

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If your ED is related to another health condition, like diabetes, the first step is to treat that condition. You and your doctor can make a plan to find and manage your health conditions and get your ED under control.

If your ED is related to your mental health, your doctor can refer you to a mental health professional. Talk therapy can help with conditions like anxiety and depression. Your doctor may also recommend medicines to treat your mental health conditions.

If your ED is caused by a medicine you're taking, your doctor may be able to switch your medicine to a similar drug that doesn't cause ED.

There are also several effective treatments just for ED, including:

• Prescription pills
• Injections of medicine directly into the penis
• Suppositories (medicine pellets) you place inside the urethra
• Vacuum devices that pull blood into the penis to make it hard
• Penis implants or surgery (only in rare cases when other treatments haven't worked)

Which Erectile Dysfunction Drug Is Best for Me?

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There are several effective drugs to treat ED — but it's very important to talk with your doctor before you try any of these medicines. Some of these drugs interact with other medicines you might be taking and can cause serious side effects. Your doctor can recommend the drug or other ED treatment that's best for you.

The best-known medication for ED is Viagra, also called sildenafil. It works by relaxing the smooth muscles and increasing blood flow in the penis. There are also similar drugs in the same group that your doctor may prescribe to treat ED, like vardenafil, avanafil or tadalafil.

If you take nitrates for a heart condition or alpha-blockers for an enlarged prostate, never take Viagra or any similar ED drugs. Mixing these drugs with your other medicines may lead to dizziness, fainting and severe injuries.

How Can I Cure Erectile Dysfunction Naturally?

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Beware of so-called "natural" products that claim to cure ED — these products often contain prescription medicines or other ingredients that could be harmful to you. Always ask your doctor before taking any supplements, medicines or other products for ED (or any health problem).

But there are very effective steps you can take in your daily life to prevent ED and improve your symptoms. Try these tips:

• Be active. Regular exercise can improve ED, so try fitting some more physical activity into your routine.
• Eat healthy. A balanced diet can help prevent health problems that cause ED. Eat more whole grains, fruits, veggies and lean proteins. And cut down on salt and saturated fat.
• Drink only in moderation.Drinking too much alcohol can affect your sexual function. Try limiting alcohol to no more than two drinks in a day — or even less.
• Quit smoking. Smoking is linked to higher risk of ED. So if you smoke, make a plan to quit.
• Avoid taking recreational drugs. Some drugs, including opioids, can lead to ED. To lower your risk of ED, don't take any drugs without a prescription from your doctor.
• Get help managing stress. When you're feeling stressed, it can be harder to get and keep an erection. Talk with your doctor or a mental health professional about ways to lower your stress.

Resource Links:

• "Erectile Dysfunction" via Mayo Clinic
• "Erectile Dysfunction (ED)" via NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases)
• "'All Natural' Alternatives for Erectile Dysfunction: A Risky Proposition" via FDA (Food and Drug Administration)
• "Yes, COVID-19 Can Cause Erectile Dysfunction" via Cleveland Clinic

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