Erectile Dysfunction: What is it? Know the Facts

Erectile dysfunction (ED) is something many men aren’t comfortable talking about, but it’s an issue that affects more of us than you might think. The good news is that there are a number of safe and effective treatments available for the millions of men who experience ED in some form. ED is when the penis doesn’t get hard enough to allow for complete sexual intercourse. ED can be mild, moderate or severe, but it’s considered to be present anytime a man’s erections are consistently unsatisfactory for normal sexual activity. It’s normal for ED to bring up feelings of embarrassment, guilt or even inadequacy. It’s worth knowing the facts, though — the better informed you are about ED, the better equipped you’ll be to reach a solution.

How do Erections Happen?

For an erection to take place, the body has to do a number of complex things. When a man is sexually stimulated, the brain sends chemicals to the nerve endings in the penis. Muscles in the penis then relax, causing an increase in blood flow. The tissues inside the penis (corpus cavernosum) then become full of blood and rigid, forming an erection.

What Causes  ED?

A complex combination of nerves, blood vessels, hormones and psychology produces a normal erection. Anything that interferes with these interactions can cause ED. There are three types of factors that contribute to ED: physical, mental and lifestyle factors.

Mental Factors

  • Stress
  • Clinical depression
  • Anxiety
  • Antidepressant medication

Lifestyle Factors

  • Smoking
  • Alcohol
  • Inactive lifestyle
  • Drug abuse

Physical Factors

  • High blood pressure
  • Diabetes
  • Nerve damage
  • Atherosclerosis
  • Blood clots
  • Prostate surgery
  • Spinal disease
  • Stroke
  • Neurological disorders
illustration of man holding pencil next to a survey

How Can I Tell If I Have ED?

Try this Quiz

Each question below has several possible responses. Select the number of the response that best describes your own situation and at the end of the questions use Quiz Results to check your likelihood of ED. Remember, always check with a doctor before seeking treatment.

How do you rate your confidence that you could get and keep an erection?
When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?
During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
When you attempted sexual intercourse, how often was it satisfactory to you?
If you were to spend the rest of your life with your erectile condition the way it is now, how would you feel about that?

It’s More Common than You Might Think

If you’re concerned about ED, you should know that you’re not alone. About 40% of men over 40 have some degree of ED and as you might imagine, ED symptoms often increase with age.

ED Can Affect Your Whole Life

ED is an issue that affects both partners. Since fulfilling sexual activity is an important part of an intimate relationship, ED can cause feelings of anger, embarrassment, anxiety or depression. It’s normal to have feelings like these. Talking openly about ED with your partner can help.

Get Treatment

Explore Your Options

It all starts with modifying your lifestyle. Often, making lifestyle changes like quitting smoking, getting more exercise and eating a healthier diet can contribute to the quality of your erections.

In addition to lifestyle changes, there’s a range of treatment options available to men with ED. Talk to a doctor about the best treatment option for you. Different treatments suit different people.

These are some of the treatment options that your doctor might recommend. Each one has specific side effects that you should be fully aware of — ask a doctor about possible complications of each treatment you’re considering.

Oral Treatments

Oral treatments (pills) for ED are known as PDE5 inhibitors. They improve erections by helping the blood vessels in the penis to relax, allowing more blood to flow in. Viagra, Levitra and Cialis are three well-known drugs, each with their own characteristics — ask a doctor which one may be right for you. They all require sexual stimulation to work; there’s no need to worry about getting an immediate erection after taking the pill. Your erections will still go away after sex.

Injections, Vacuum Therapy & Transurethral Inserts


Medication injected into the penis right before intercourse relaxes its smooth muscle and allows more blood flow. With injections, it takes between 5 and 20 minutes to get an erection; the erection can last up to an hour.

Vacuum Therapy

This involves drawing blood into the penis using a vacuum device and a ring at the base of the penis to trap the blood in the penis and maintain the erection. Vacuum therapy produces an erection almost immediately; the ring must be removed after 30 minutes.

Transurethral Inserts

A small pellet medicated with alprostadil is inserted into the urethra to stimulate the blood flow needed for an erection. This method produces an erection after 5 to 10 minutes that lasts between 30 minutes and an hour.

Surgical Treatments

Penile Implant Surgery

A prosthesis is inserted into the penis. The prosthesis is either semi-rigid malleable implant, or an inflatable (hydraulic) device. Erections can be achieved immediately and last until the implant is “deactivated”. Most 3-piece inflatable implants are still functional 5 years after surgery.

Striking Up a Conversation About ED

Talking About ED with Your Partner

Having an open, honest conversation about ED with your partner isn’t easy. Many men say their experience with ED causes feelings of embarrassment, frustration and nervousness. It may seem easier to avoid the problem, but good communication about ED is the first step towards finding a solution. Here are some conversation tips.

  1. Remember that you and your partner are not alone — more than 150 million men around the world experience similar symptoms and emotions.
  2. ED is nobody’s fault. Both partners may feel a sense of responsibility — men may fear that their masculinity is in question; partners may feel that they’re no longer attractive.
  3. If it seems like both partners are waiting for the other to begin the conversation, consider dropping hints or giving cues that you’re ready to begin.
  4. Use simple, matter-of-fact language. Be careful not to over-dramatize the situation.
  5. Focus on possible solutions, like the ones outlined on this page. Plan a visit to a doctor together.

Sex Has Many Benefits for Your Health & Well Being

Five things you might not have known about the benefits of sex:

  1. Having sex at least once a week can boost your immune system.
  2. Having sex regularly can reduce your risk of a heart attack, stroke or prostate cancer.
  3. Sex can cure a bad mood — endorphins are released into the body during sex, producing feelings of wellbeing.
  4. It’s a great workout! You burn calories in a fun way while you’re having sex.
  5. Sex improves your outlook on life — couples have reported that having regular sex increases their happiness just as much as a boost in income would.