Erectile Dysfunction: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Erectile Dysfunction?
A urologist, a doctor who treats the male reproductive and urinary systems, often treats erectile dysfunction (ED). ED can be a sign of health problems such as diabetes or heart disease, so a primary care doctor often starts the check-up. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is erectile dysfunction?
Erectile dysfunction (ED) is a common type of male sexual dysfunction. It means a man has trouble getting or keeping an erection that is firm enough for intercourse.
Almost all adult men have trouble with erections at one time or another. Often the problem goes away with little or no treatment. When it keeps happening, it is called ED. ED becomes more common as you get older, but it is not a natural part of aging.
Symptoms
Symptoms of ED may include:
- Trouble getting an erection.
- Trouble keeping an erection.
- An erection that is not firm enough for intercourse.
- Less interest in sex.
Causes and who gets it
An erection needs the brain, nerves, hormones, and blood vessels to work together. If something gets in the way, ED can result. Most erection problems have a physical cause. Common physical causes include:
- Diseases such as diabetes, high blood pressure, heart or thyroid conditions, and clogged arteries.
- Nervous system disorders, such as multiple sclerosis or Parkinson disease.
- Medicines, such as antidepressants, blood pressure medicines, and sleeping pills.
- Low testosterone, a male hormone.
- Nerve damage from prostate surgery, or a spinal cord injury.
- Nicotine, alcohol, or cocaine use.
Emotions and relationship problems can also lead to ED. Examples are stress, fear, anxiety, and anger. ED can affect men at any age. Physical causes are more common in older men. Emotional causes are more common in younger men.
Do not change or stop any medicine without first talking to your doctor.
How doctors diagnose it
Your doctor will do a physical exam. This may include checking your blood pressure and examining your penis and rectum. Your doctor will also ask about your health, your medicines, your lifestyle, and your feelings, such as stress or worry.
Tests can help find the cause. They may include:
- Urine or blood tests to check for diabetes, heart problems, or low testosterone.
- A device you wear at night to check for normal nighttime erections.
- An ultrasound of the penis, which uses sound waves to check for blood flow problems.
- Questionnaires to check for depression and other emotional problems.
Treatment
Treatment depends on the cause and on how healthy you are. For many men, lifestyle changes help. These include exercise, a healthy diet, losing extra weight, and good sleep. Counseling can help a couple who have trouble talking about the problem.
Lifestyle changes alone may not be enough. Other options include:
- Pills such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), avanafil (Stendra), and tadalafil (Cialis). They work only when you are sexually aroused.
- Medicine that is injected into the penis or put into the urethra, the tube that carries urine.
- A vacuum device that pulls blood into the penis. A special rubber band then keeps the erection.
- Surgery to place implants in the penis.
- Testosterone replacement, if your testosterone level is low.
ED pills can have side effects. These range from muscle pain and flushing to heart attack. Do not use them with nitroglycerin, because blood pressure can drop. Men who take nitrates for heart disease should not take ED medicines. Many herbs and supplements claim to help, but none have been proven to treat ED, and they may not be safe.
When to see a doctor
See your doctor if you have trouble getting or keeping an erection more than 25% of the time. Also call if the problem does not go away with lifestyle changes, or if it starts after an injury or prostate surgery. Do not wait, because ED may be a sign of a health problem such as diabetes or heart disease.
Call 911 or go to the emergency room if you have chest pain, trouble breathing, or fainting, especially after you take an ED medicine.
If an ED medicine gives you an erection that lasts more than 4 hours, contact your doctor right away or go to an emergency room. Without treatment, you may suffer lasting damage to your penis.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can do the first exam, review your medicines, and order blood tests. They can also refer you to a urologist if you need one.
Common questions
Is erectile dysfunction a normal part of aging?
No, ED is not a natural part of aging. It does become more common as you get older, so tell your doctor if you have it.
Can ED be a sign of another health problem?
Yes, ED may be a sign of health problems such as diabetes or heart disease. It may mean your blood vessels are clogged.
Is erectile dysfunction all in your head?
Usually not. Most erection problems have a physical cause. Emotions and relationship problems can also lead to ED.
Do herbs and supplements treat erectile dysfunction?
No, none of these remedies have been proven to treat ED. They may not always be safe, so talk with your doctor before you take anything.
Sources
- MedlinePlus - Erection problems
- MedlinePlus - Erectile Dysfunction
- MedlinePlus - Erection problems - aftercare
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
