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Erectile problems
Category: Men's Health · All men's health symptoms
What it can feel like
Erectile problems (erectile dysfunction) mean difficulty getting or keeping an erection firm enough for sex, happening persistently rather than as an occasional one-off. Occasional failure is universal and usually fatigue, alcohol or stress; persistent problems deserve a medical review because erections are a blood-vessel health barometer.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Erectile problems can be associated with blood vessel disease (the penile arteries are small, so they show vessel disease early), diabetes, high blood pressure, testosterone deficiency, medicines including many blood-pressure and antidepressant drugs, alcohol, smoking, and psychological factors such as anxiety and relationship stress.
Other possible causes
Erectile problems can also be associated with nerve damage after pelvic surgery or from spinal disease, Peyronie's disease (curvature from scar tissue), and hormone problems such as raised prolactin.
Red flags — when to seek help promptly
- Erectile problems in a man with chest pain on exertion or breathlessness — heart review first
- Erectile problems with reduced sex drive, shrinking testicles or breast growth
- Erectile problems following pelvic injury or surgery
- A painful, bent erection or a hard lump in the shaft (possible Peyronie's disease)
- An erection lasting beyond four hours (priapism) — emergency care
What a clinician may do
A clinician will take a sexual, medical and medicines history, measure blood pressure and weight, and arrange blood tests — glucose, lipids, and morning testosterone as a baseline — because the consultation doubles as a cardiovascular risk check. Treatment addresses causes first, then erection-specific therapy.
Watch: related videos
Examination and clinical videos from the MedicalVideos.com library relevant to this symptom. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Why do doctors treat erection problems as a heart warning?
The arteries supplying the penis are narrower than the coronary arteries, so the same vessel disease blocks them years earlier — erectile dysfunction often precedes heart symptoms by three to five years. The consultation is a genuine opportunity to catch cardiovascular risk while it is still silent.
Do erection tablets work for everyone?
They help most men with vascular causes by amplifying blood flow signals, but they require sexual stimulation to work, are dangerous with nitrate heart medicines, and do not fix low testosterone or nerve damage. That is why assessment precedes prescription.
Related symptoms — Men's Health
Browse the E section of the A–Z list or return to the Symptoms A–Z hub.