Erectile dysfunction (ED) is difficulty getting or maintaining an erection firm enough for sexual activity. Occasional erection difficulties can happen, but recurring problems warrant medical attention.

ED is common and often treatable. Although it becomes more prevalent with age, it is not an inevitable part of aging.

Common Erectile Dysfunction Symptoms

Signs of ED include:

• Difficulty getting an erection
• Difficulty maintaining an erection long enough for sex
• Erections that are not consistently firm enough for sexual activity

Changes in sexual desire may occur alongside ED, but low desire and erection difficulties are separate concerns. Tell your provider about both.

What Causes Erectile Dysfunction?

Erections depend on coordinated signals among the brain, nerves, hormones, and blood vessels. Physical and emotional factors can interfere with this process, sometimes together.

Common causes and contributing factors include:

• Blood vessel conditions: Heart disease, high blood pressure and narrowing of the arteries
• Diabetes: Can damage nerves and blood vessels
• Hormonal conditions: Including low testosterone
• Nerve damage: From certain illnesses, injuries or pelvic surgery
• Medications: Including some antidepressants and blood pressure medicines
• Emotional factors: Stress, anxiety, depression or relationship concerns
• Lifestyle factors: Smoking, excessive alcohol use, limited physical activity and obesity

ED can be a sign of another health condition—not just a sexual health issue. Do not stop prescribed medication on your own if you suspect it is contributing.

How Is Erectile Dysfunction Diagnosed?

Your provider will review your symptoms, medical history, medications, and emotional health. They may ask when the problem began and whether erections occur during sleep or in other situations.

Evaluation may include:

• A physical examination
• Blood tests for conditions such as diabetes or low testosterone
• Additional testing or a urology referral when needed

Not everyone needs specialized testing. The evaluation depends on your symptoms and medical history.

Erectile Dysfunction Treatment Options

Treatment focuses on underlying causes and improving sexual function. Options may include:

• Prescription medication: Oral medications such as sildenafil or tadalafil help improve blood flow during sexual stimulation
• Counseling: Can help address anxiety, stress or relationship concerns
• Vacuum erection devices: Use suction to draw blood into the penis
• Prescription injections or urethral medication: May be appropriate when oral treatment is unsuitable or ineffective
• Testosterone therapy: May help selected patients with confirmed low testosterone; it is not a general treatment for ED
• Penile implants: A surgical option when other approaches fail to yield satisfactory results

Your provider can explain benefits, side effects and which options fit your health needs.

Important Medication Safety

Do not combine sildenafil, tadalafil, or similar ED medications with nitrates, such as nitroglycerin. This combination can dangerously lower blood pressure. Review all medications with your provider before starting treatment.

Avoid unverified “male enhancement” products. Some contain hidden drugs that can cause serious interactions.

Healthy Habits That May Help

• Quit smoking.
• Limit alcohol and avoid recreational drugs.
• Stay physically active.
• Follow a balanced eating plan.
• Work toward a healthy weight.
• Manage stress and ongoing health conditions.

These habits may improve symptoms, but they do not replace treatment when needed.

When to Seek Care

Schedule a visit if erection difficulties recur, cause distress, or develop alongside other health changes.

Go to a hospital emergency room for an erection lasting four hours or more—even if it is not painful. Prolonged erections can cause permanent damage.

Take the First Step Toward Better Sexual Health

You do not have to manage ED on your own. Schedule a visit with tru Primary & Urgent Care to discuss your symptoms, possible causes, and treatment options, including specialist care when appropriate.