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Seventy-two percent 80% and 85% of the patients on 25 mg and 100 mg of . Erectile dysfunction (impotence) Erection problems (impotence) are very common, particularly in men over 40. It's usually nothing to worry about, but you should see a GP if it keeps happening. Most men occasionally fail to get or keep an erection. This is usually caused by stress, tiredness, anxiety or drinking too much alcohol, and it's nothing to worry about.

If it happens more often, it may be caused by physical or emotional problems.

Non-urgent advice: See a GP or go to a sexual health clinic if: erection problems keep happening.

It could be a sign of an underlying health condition. How sexual health clinics can help with erection problems. They can provide the same treatment you would get at your GP surgery. Many sexual health clinics offer a walk-in service, where you do not need an appointment.

They'll often get test results quicker than GP practices. The doctor or nurse will ask about your lifestyle and relationships, and any problems you might be having.

They'll carry out basic health checks, such as taking your blood pressure.

They'll also examine your genitals to rule out any obvious physical cause.

If you have symptoms like needing to pee more often, your doctor may also need to examine your prostate.

Treatment for erection problems depends on the cause. Treatments for erectile dysfunction are much better than they used to be, and the problem often goes away.

There are specific treatments for some of the causes of erectile dysfunction.

Treatments for some causes of erectile dysfunction Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol Medicine to lower blood pressure, statins to lower cholesterol Hormone problems Hormone replacement (for example, testosterone) Side effects of prescribed medication Change to medicine after discussion with GP. Medicine such as sildenafil (sold as Viagra) is also often used by doctors to treat erectile dysfunction. Because of changes in regulations, you no longer need a prescription to get sildenafil.

But you'll have to have a consultation with the pharmacist to make sure it's safe for you to take it.

There are other similar medicines called tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra) that work in a similar way. You'll still need a prescription to get these medicines. It's possible to buy Viagra over the internet, but many sites sell fake (counterfeit) medicines.

The active ingredients in them can vary, causing side effects. Make sure they're prescribed by a doctor or come from a UK pharmacy. Things you can do to help with erectile dysfunction. Healthy lifestyle changes can sometimes help erectile dysfunction. Erectile dysfunction (ED) is commonly called impotence. It’s a condition in which a man can’t achieve or maintain an erection during sexual performance.

Symptoms may also include reduced sexual desire or libido. Your doctor is likely to diagnose you with ED if the condition lasts for more than a few weeks or months. ED affects as many as 30 million men in the United States.

Standard ED treatments include prescription medications, vacuum pumps, implants, and surgery, but many men prefer natural options. Research has found that some natural options can improve ED symptoms. Read on to learn about natural options that have research to back them up. Called the herbal Viagra, Panax ginseng (red ginseng) has solid research behind it. Researchers reviewed seven studies of red ginseng and ED in 2008.

Dosages ranged from 600 to 1,000 milligrams (mg) three times daily.

They concluded there was “suggestive evidence for the effectiveness of red ginseng in the treatment of erectile dysfunction.” More current research is examining how red ginseng influences ED.

Ginsenosides are one element present in Panax ginseng extract that have action at the cellular level to improve erection.

The action of Panax ginseng appears to be most effective for those with high lipids in their blood and metabolic syndrome. This herb is known to have anti-inflammatory action, improve lung function, and improve blood flow in other diseases — all characteristics that may reduce ED. One small study indicated that Rhodiola rosea may be helpful.

Twenty-six out of 35 men were given 150 to 200 mg a day for three months.

They experienced substantially improved sexual function. This herb has been shown to improve energy and reduce fatigue. More studies are needed to understand action and ensure safety.

Dehydroepiandrosterone (DHEA) is a natural hormone produced by your adrenal glands. It can be converted to both estrogen and testosterone in the body. Scientists make the dietary supplement from wild yam and soy. The influential Massachusetts male aging study showed that men with ED were more likely to have low levels of DHEA. In 2009, 40 men with ED participated in another study in which half receiving 50 mg DHEA and half receiving a placebo once a day for six months.

Those receiving the DHEA were more likely to achieve and maintain an erection.

More recently, DHEA has been identified as an option for treatment of ED for men with concurrent diabetes. ED commonly affects these men because of hormonal issues as well as diabetes complications that interfere with blood flow to organs.

L-arginine is an amino acid naturally present in your body.

Nitric oxide relaxes blood vessels to facilitate a successful erection and is essential for healthy sexual functioning.

Researchers studied the effects of L-arginine on ED.

Thirty-one percent of men with ED taking 5 grams of L-arginine per day experienced significant improvements in sexual function. A second study showed that L-arginine combined with pycnogenol, a plant product from tree bark, restored sexual ability to 80 percent of participants after two months.

Ninety-two percent had restored sexual ability after three months. Another placebo-controlled study found that L-arginine in combination with other medications was well-tolerated, safe, and effective for mild-to-moderate ED.

Though studies are mixed, many show positive results when acupuncture is used to treat ED.

A 1999 study , for example, found that acupuncture improved the quality of erections and restored sexual activity in 39 percent of participants.

A later study published in 2003 reported that 21 percent of ED patients who received acupuncture had improved erections. Other studies have shown conflicting results, but this treatment has potential and may work for you. The risks of acupuncture are low if provided by a licensed acupuncturist.

Acupuncture shows promise for treating ED, but more studies are needed.

This supplement is extracted from the bark of the African yohimbe tree.

Some studies have shown positive effects on sexual performance with use of this drug.

However, the American Urological Association doesn’t recommend yohimbe as an ED treatment. This is because there’s not a lot of evidence proving it works.

These include increased blood pressure and heart rate, irritability, and tremor.

If you decide you want to try yohimbe, be sure to talk to your doctor beforehand. Other alternative therapies thought to help ED include zinc supplements (especially for men who are low in zinc), the herb ashwagandha (also called Indian ginseng), and ginkgo biloba, but more studies are needed to know with certainty. If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.

If other health issues aren’t found to be the cause of your ED, your doctor will likely prescribe some common treatments. However, you may also choose natural options — just be sure to discuss them with your doctor first. Whichever route you take, keep in mind that ED is a common condition that’s very treatable. With some trial and error, you’re likely to find a treatment that works for you and your partner.

Food and Drug Administration doesn’t regulate quality, strength, purity, or packaging of herbs.

If you choose to take herbs, be sure to get them from a reliable source.

In many cases, changes to your lifestyle and diet can help ease ED symptoms.

Lifestyle changes that could help improve your sexual function include exercising and losing weight.

They also include stopping smoking and curbing your alcohol intake. For information on which foods might benefit you, such as cocoa and pistachios, check out this article on diet and ED. Can you run as fast as you did when you were 20 years old? But even as we age, there are still plenty of ways to stay in the game and enjoy it. Erectile dysfunction (ED) can occur for many reasons. Sometimes it is as simple as the side effect of a particular medication.

But for roughly 75% of men, the cause is more complex.

ED may result from vascular disease, neurological disease, diabetes, or prostate-related treatments or surgeries.

Whether you currently suffer from ED or are hoping to sidestep this condition, try these tips to overcome ED for better health and a better sex life. According to one Harvard study, just 30 minutes of walking a day was linked with a 41% drop in risk for ED. Other research suggests that moderate exercise can help restore sexual performance in obese middle-aged men with ED.

In the Massachusetts Male Aging Study, eating a diet rich in natural foods like fruit, vegetables, whole grains, and fish — with fewer red and processed meat and refined grains — decreased the likelihood of ED.

High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist.

Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED.

Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well. Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein.

In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.

For more on diagnosing, treating, and learning how to overcome ED, read What to do about Erectile Dysfunction, a Special Health Report from Harvard Medical School. Share this page: Share this page to Facebook Share this page to Twitter Share this page to Google Plus Email this page.

Print this page: Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Everything You Need to Know About Erectile Dysfunction (ED) What is erectile dysfunction (ED)? Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s sometimes referred to as impotence, although this term is now used less often.

Frequent ED, however, can be a sign of health problems that need treatment.

It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.

ED can occur because of problems at any stage of the erection process. An erection is the result of increased blood flow into your penis.

Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis. When a man is sexually excited, muscles in the penis relax.

This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. As the chambers fill with blood, the penis grows rigid. An erection ends when the muscles contract and the accumulated blood can flow out through the penile veins. There are many possible causes of ED, and they can include both emotional and physical conditions.

Common causes include: cardiovascular disease diabetes hypertension, or high blood pressure high cholesterol obesity low testosterone levels or other hormone imbalances kidney disease increased age stress anxiety depression relationship problems certain prescription medications, such as those used to treat high blood pressure or depression sleep disorders drug use consuming too much alcohol using tobacco products certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS) damage to the pelvic area through injury or surgery Peyronie’s disease, which causes scar tissue to develop in the penis.

ED can be caused by only one of these factors or by several of them.

That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions.

Treatment for ED will depend on the underlying cause.

You may need to use a combination of treatments, including medication or talk therapy.

Your doctor may prescribe medication to help you manage the symptoms of ED. You may need to try several medications before you find one that works. The following oral medications stimulate blood flow to your penis to help treat ED: avanafil (Stendra) sildenafil (Viagra) tadalafil (Cialis) vardenafil (Levitra, Staxyn) Alprostadil (Caverject, Edex, MUSE) is another medication that can be used to treat ED. It can be administered in two ways: as a penile suppository or as a self-injection at the base or side of the penis.

Testosterone therapy (TRT) may also be recommended if you have low levels of testosterone.

Medications used for other conditions may cause ED. Talk to your doctor about your medications and whether they could be causing your symptoms.

Never stop taking medications without first talking to your doctor.

If you’re experiencing unpleasant side effects, talk to your doctor.

They may be able to recommend a different medication.

Get more information on the medications used to treat ED. A number of psychological factors can cause ED, including: stress anxiety post-traumatic stress disorder (PTSD) depression. If you’re experiencing psychological ED, you may benefit from talk therapy.

Over several sessions, you and your therapist will discuss: major stress or anxiety factors your feelings around sex subconscious conflicts that could be affecting your sexual well-being. If ED is affecting your relationship, consider speaking with a relationship counselor as well.

Relationship counseling can help you and you partner reconnect emotionally, which may also help your ED.

This treatment uses the creation of a vacuum to stimulate an erection. Blood is drawn into the penis as the device is used, leading to an erection. A vacuum pump device consists of a few different components: a plastic tube, which you place over your penis a pump, which works to create the vacuum by drawing air out of the plastic tube an elastic ring, which you’ll move to the base of your penis as you remove the plastic tube. The elastic ring functions to maintain the erection, holding the blood in the penis and preventing it from returning to circulation. You may have ED if you regularly have: trouble getting an erection difficulty maintaining an erection during sexual activities reduced interest in sex.

Other sexual disorders related to ED include: premature ejaculation delayed ejaculation anorgasmia, or the inability to achieve orgasm after ample stimulation. Speak with your doctor if you have any of these symptoms, especially if they’ve lasted for 3 or more months.

They can help determine whether your symptoms are caused by an underlying condition that requires treatment. Testing for ED can involve a variety of steps, including a physical examination and taking your health and sexual history. Additional tests may be performed to determine if your symptoms are caused by an underlying condition.

You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine

your

testicles and penis. They may also recommend a rectal exam to check your prostate.

Your doctor will ask you questions or request that you fill out a questionnaire about your symptoms, health history, and sexual history. The responses can help them evaluate the severity of your ED.

Some questions that you may be asked include: How long have you been experiencing ED? Are you having any problems with feeling sexual desire, ejaculating, or reaching orgasm? Is this affected by particular situations or types of stimulation? Do you wake up in the morning or in the middle of the night with erections? What expectations do you and your partner have for each other? Have you recently been experiencing a lot of stress? Do you use tobacco, alcohol, or nonprescription drugs? Do you have any underlying conditions or have you had any surgery on or injury to your pelvic area? Your doctor may perform additional testing to help diagnose your ED. An ultrasound can be used to examine the blood vessels of the penis to determine if there’s a problem with penile blood flow. A portable, battery-powered device, worn on the thigh, is used to evaluate the quality of your nocturnal erections. Data is stored in the device, which your doctor can access later. During this test, a medication is injected into your penis to stimulate an erection.

This allows your doctor to evaluate the firmness of the erection and how long it lasts.

Urine tests can be used to check for diabetes or other underlying health conditions.

Blood tests can be used to check for conditions such as diabetes, heart disease, thyroid issues, and low levels of testosterone.

These tests can help your doctor guide your treatment as well as determine if an underlying condition may be causing your ED.

Find out more about how blood tests can be used to diagnose ED.

Kegel exercises are simple movements you can do to strengthen your pelvic floor muscles. The muscles you use to do this are your pelvic floor muscles. Now that you know where these muscles are, contract them for 3 seconds.

Repeat this exercise 10 to 20 times in a row, three times a day.

A small 2005 study compared two groups of men with ED. The first group of men performed regular pelvic floor muscle exercises with a physiotherapist.

They also received biofeedback and advice on lifestyle changes.

The second group only received advice on lifestyle changes. Men in the first group saw their penile function improve significantly after 3 months of regular pelvic floor muscles exercises.

Men in the second group saw little improvement after 3 months.

For the next 3 months, all participants were given at-home exercises to perform.

After 6 months in total had elapsed, 40 percent of all participants (including some men who had belonged to the second group) had regained normal erectile function.

A 2019 literature review also concluded that pelvic floor exercises were effective at treating both ED and premature ejaculation.

However, the ideal exercise plan (in terms of conditions such as frequency and intensity) wasn’t identified. You may find that it’s easier initially to do Kegels while lying down. Eventually, you can start trying them when you’re sitting or standing.

Moderate to vigorous exercise is not only good for your overall health, but also can increase blood flow, possibly helping with ED. A review of 10 studies examined the effect of aerobic exercise on ED.

From their review, investigators concluded that 160 minutes of weekly exercise for 6 months could lead to a decrease in erectile problems.

Another study examined physical fitness and testosterone levels in 87 men with ED.

Researchers found that testosterone levels were negatively correlated with levels of body fat and abdominal fat. This suggests that exercise may increase testosterone in addition to reducing body fat.

Before you start a new exercise plan, you should always discuss it with your doctor.

This is particularly important for people with heart disease or another underlying condition that could be aggravated by vigorous activity.

Since stress or anxiety can viagra pharmacy cost cause or contribute to ED, practicing yoga may be an effective way to ease ED symptoms.

In fact, a 2010 study of 65 men between 24 and 60 years old found that sexual function increased significantly after a 12-week program of yoga sessions. Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor. ED is defined as trouble getting or keeping an erection that's firm enough for sex. Though it's not rare for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated.

Most often when blood flow in the penis is limited or nerves are harmed With stress or emotional reasons As an early warning of a more serious illness, like: atherosclerosis (hardening or blocked arteries), heart disease, high blood pressure or high blood sugar from Diabetes. Finding the cause(s) of your ED will help treat the problem and help with your overall well-being.

As a rule, what's good for your heart health is good for your sex health. During sexual arousal, nerves release chemicals that increase blood flow into the penis. Blood flows into two erection chambers in the penis, made of spongy muscle tissue (the corpus cavernosum).

During erection, the spongy tissues relax and trap blood.

The blood pressure in the chambers makes the penis firm, causing an erection.

When a man has an orgasm, a second set of nerve signals reach the penis and cause the muscular tissues in the penis to contract and blood is released back into a man's circulation and the erection comes down.



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