Erectile dysfunction (ED), also referred to as "impotence," is characterized by the inability to sustain an erection long enough for sexual intercourse. Erectile dysfunction can be caused by a number of factors including cardiovascular disease, low testosterone levels, diabetes, stress, anxiety, and more. 

What is erectile dysfunction?

Erectile dysfunction (ED), also referred to as “impotence,” is the chronic inability to sustain an erection long enough for intercourse. An erection is manged by two mechanisms: the reflex erection, which is achieved by touching the penile shaft, and the psychogenic erection, which reacts to erotic stimuli. Consequently, adequate testosterone levels as well as a reactive neural system are necessary for sustaining erections.

Many factors can cause erectile dysfunction, including cardiovascular diseases, diabetes, low testosterone levels, anxiety, prescription and recreational drugs, injury, and sleep disorders (among other causes). As there are many different factors that can trigger erectile dysfunction, the first step is diagnosing the root cause with a doctor. 

Erectile dysfunction and male fertility

Erectile dysfunction is the most common sexual problem in people with penises, and can have a significant psychological impact on couples. This condition directly affects male fertility because the inability to sustain an erection — and often the inability to ejaculate — makes conceiving naturally more difficult. Those experiencing erectile dysfunction should consult a doctor to diagnose the root cause and get treatment accordingly.

Symptoms of erectile dysfunction

Common symptoms of erectile dysfunction include trouble maintaining an erection, issues getting an erection, and reduced sexual desire. Beyond these symptoms, erectile dysfunction is often linked with premature or delayed ejaculation, as well as anagorasmia, which is the inability to achieve orgasm despite sustained stimulation.

Treatment of erectile dysfunction

Many treatments exist for erectile dysfunction, including medications, talk therapy to relieve stress and anxiety, as well as vacuum pumps to sustain erections. The first step is to consult a doctor and get a clinical diagnosis before proceeding.

For patients with ED who want to conceive a child, prostate stimulation and/or testicular sperm extraction can allow for sperm to be collected without the need for erection or orgasm. Additionally, sperm freezing may be implemented to ensure that a sample is available prior to IUI or IVF.