What it is
Erectile dysfunction (ED) means having trouble getting or keeping an erection firm enough for sex. It's common, especially with age, and it can usually be treated.[1] Because erections depend on healthy blood flow, ED can be a sign of another health problem.[2]
An erection happens when the two corpora cavernosa — spongy tissue along the shaft — fill with blood from the deep arteries of the penis. Anything that affects the arteries, nerves, hormones, or mood can interfere, which is why ED is linked to atherosclerosis, high blood pressure, diabetes, some medicines and depression.[2]
Vasculogenic ED shares risk factors and pathophysiology (endothelial dysfunction) with coronary artery disease. In an observational study reported by the American Heart Association, men with ED had heart attacks, cardiac arrest or stroke at more than twice the rate of men without ED, independent of other risk factors — supporting cardiovascular risk assessment in men presenting with ED.[3]
See the erectile tissue and its arteries in 3D.
See it in 3DHow common it is
Causes and risk factors
Things you can't change
- Getting older, which makes ED more common.[1]
Things you can change
- Heart and blood-vessel disease, high blood pressure, diabetes, obesity, chronic kidney disease.[2]
- Smoking, drinking too much alcohol, too little physical activity and recreational drug use.[2]
- Some medicines, such as certain antidepressants and blood pressure medicines — don't stop them yourself; talk to your clinician.[2][4]
- Anxiety, depression, stress and relationship problems.[2]
Symptoms worth reporting to a doctor
- Trouble getting an erection
- Trouble keeping an erection long enough for sex
- A change that keeps happening, rather than an occasional off night
ED may be a symptom of another health problem, so it's worth raising with a clinician.[2]
Get urgent care if…
How it's diagnosed
Types of treatment
- Treating the cause and lifestyle changes. Quitting smoking, limiting alcohol, more activity, a healthy weight and diet, and stopping illicit drugs.[4]
- Counselling. Helpful when stress, anxiety or relationship issues contribute; a partner can join.[4]
- Reviewing medicines. A clinician may change a dose or switch a medicine that may be causing ED.[4]
- Medicines. Pills called PDE-5 inhibitors improve blood flow to the penis; injections and urethral suppositories are other options. Testosterone is added only when ED comes with low testosterone.[4]
- Devices and surgery. Vacuum erection devices, and — usually as a last resort — a penile implant.[4]
Which option fits depends on the details of each person’s situation. Your care team decides with you.
What you can do
Questions to ask your doctor
- What might be causing my ED?
- Should my heart health be checked?
- Could one of my medicines be responsible?
- Is a PDE-5 inhibitor safe with my other medicines?
- What are the options if pills don't work?
Myth vs. fact
Related topics
Depression and suicide prevention
Depression is common, real and treatable. In men it can look like anger or irritability. If you're in crisis, call or text 988 now.
Heart disease and heart attack
The leading cause of death for men in the US. Most of it comes from narrowed coronary arteries — and much of it can be prevented.
High blood pressure
Half of US men have it, and most people feel nothing. A simple check finds it; habits and medicines control it.
Low testosterone (hypogonadism)
Testosterone falls only slowly with age. Real hypogonadism needs symptoms plus two low morning blood tests — and treatment isn't right for everyone.
Type 2 diabetes and prediabetes
Blood sugar that stays too high. Millions have it without knowing — and prediabetes can often be stopped from progressing.
Sources
- NIH National Institute of Diabetes and Digestive and Kidney Diseases. Definition & Facts for Erectile Dysfunction. Checked 23 October 2026.
- NIH National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Erectile Dysfunction. Checked 23 October 2026.
- American Heart Association News. Erectile dysfunction may be warning sign for more serious health problems (2018). Checked 23 October 2026.
- NIH National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for Erectile Dysfunction. Checked 23 October 2026.
The owner of this website is not a doctor. Human Atlas provides educational anatomy information and does not diagnose, stage, or treat disease. Talk to a qualified clinician about anything concerning your own health.