Erectile Dysfunction

Erectile dysfunction is the inability to get or sustain a good enough erection to have sexual intercourse. Erectile dysfunction may involve:

  • Inability to get an erection.

  • Lack of enough hardness to allow penetration.

  • Loss of the erection before sex is finished.

  • Premature ejaculation.

CAUSES

  • Certain drugs, such as:

  • Pain relievers.

  • Antihistamines.

  • Antidepressants.

  • Blood pressure medicines.

  • Water pills (diuretics).

  • Ulcer medicines.

  • Muscle relaxants.

  • Illegal drugs.

  • Excessive drinking.

  • Psychological causes, such as:

  • Anxiety.

  • Depression.

  • Sadness.

  • Exhaustion.

  • Performance fear.

  • Stress.

  • Physical causes, such as:

  • Artery problems. This may include diabetes, smoking, liver disease, or atherosclerosis.

  • High blood pressure.

  • Hormonal problems, such as low testosterone.

  • Obesity.

  • Nerve problems. This may include back or pelvic injuries, diabetes mellitus, multiple sclerosis, or Parkinson disease.

SYMPTOMS

  • Inability to get an erection.

  • Lack of enough hardness to allow penetration.

  • Loss of the erection before sex is finished.

  • Premature ejaculation.

  • Normal erections at some times, but with frequent unsatisfactory episodes.

  • Orgasms that are not satisfactory in sensation or frequency.

  • Low sexual satisfaction in either partner because of erection problems.

  • A curved penis occurring with erection. The curve may cause pain or may be too curved to allow for intercourse.

  • Never having nighttime erections.

DIAGNOSIS

Your caregiver can often diagnose this condition by:

  • Performing a physical exam to find other diseases or specific problems with the penis.

  • Asking you detailed questions about the problem.

  • Performing blood tests to check for diabetes mellitus or to measure hormone levels.

  • Performing urine tests to find other underlying health conditions.

  • Performing an ultrasound exam to check for scarring.

  • Performing a test to check blood flow to the penis.

  • Doing a sleep study at home to measure nighttime erections.

TREATMENT

  • You may be prescribed medicines by mouth.

  • You may be given medicine injections into the penis.

  • You may be prescribed a vacuum pump with a ring.

  • Penile implant surgery may be performed. You may receive:

  • An inflatable implant.

  • A semirigid implant.

  • Blood vessel surgery may be performed.

HOME CARE INSTRUCTIONS

  • If you are prescribed oral medicine, you should take the medicine as prescribed. Do not increase the dosage without first discussing it with your physician.

  • If you are using self-injections, be careful to avoid any veins that are on the surface of the penis. Apply pressure to the injection site for 5 minutes.

  • If you are using a vacuum pump, make sure you have read the instructions before using it. Discuss any questions with your physician before taking the pump home.

SEEK MEDICAL CARE IF:

  • You experience pain that is not responsive to the pain medicine you have been prescribed.

  • You experience nausea or vomiting.

SEEK IMMEDIATE MEDICAL CARE IF:

  • When taking oral or injectable medications, you experience an erection that lasts longer than 4 hours. If your physician is unavailable, go to the nearest emergency room for evaluation. An erection that lasts much longer than 4 hours can result in permanent damage to your penis.

  • You have pain that is severe.

  • You develop redness, severe pain, or severe swelling of your penis.

  • You have redness spreading up into your groin or lower abdomen.

  • You are unable to pass your urine.