The inability to achieve or maintain an erection, commonly known as impotence. Heart disease, atherosclerosis, high blood pressure, and diabetes all can cause erectile dysfunction (ED). Certain lifestyle factors also may contribute, including smoking, excess weight, inactivity, alcoholism, or other substance abuse, anxiety, and depression. Anyone with ED should be evaluated by a physician to determine its underlying causes.
Oral medications such as sildenafil (Viagra) and tadalafil (Cialis) may help alleviate ED, but they may not be the best option for men who take nitrate drugs, such as nitroglycerin for angina, or have blood pressure abnormalities or liver or kidney disease. Some drugs such as alprostadil may be injected directly into the penis or inserted as a suppository into the tip of the penis to produce an erection. Testosterone replacement may be beneficial in men who have a documented testosterone deficiency. Vacuum devices, also known as penis pumps, can be placed over the penis to draw blood into it, and then a band is placed around the penis to maintain the erection during intercourse. If the man suffers from leaking or blocked blood vessels, surgical repair of the blood vessels may be needed. If stress, anxiety, or depression are contributing to the ED, it may be helpful for the man, and perhaps his partner, to undergo psychological counseling.