Erectile Dysfunction Facts

June 26, 2024

This page was reviewed under our medical and editorial policy by Humberto Villarreal, M.D., urologic surgeon and assistant clinical professor, Division of Urology and Urologic Oncology, Department of Surgery, City of Hope^® Cancer Center Duarte.

Erectile dysfunction (ED) is a relatively common condition, affecting approximately 30 million U.S. men. It may also be referred to as impotence.

What Is ED?

Erectile dysfunction occurs when a man can’t get or keep an erection firm enough to have intercourse. It affects approximately half of all men between the ages of 40 and 70.

Erections require sexual stimulation, which promotes blood flow into the penis. As the erection continues, the penis should fill enough to trap the blood in the penis and maintain rigidity for sexual activity. When any of these factors are impacted, erectile dysfunction may occur.

(Courtesy: National Cancer Institute)

What Causes Erectile Dysfunction?

A variety of physical and psychological or emotional issues may cause ED. Physical causes include damage to the nerves, arteries, smooth muscles and fibrous tissues in the penis.

Diseases and disorders that cause damage and may lead to ED include:

• High blood pressure
• Diabetes, a complex group of diseases characterized by high blood glucose, also called high blood sugar or hyperglycemia
• Atherosclerosis, the buildup of a substance called plaque on the inside of arteries
• Heart and blood vessel disease
• Chronic kidney disease
• Multiple sclerosis, an autoimmune disease that attacks the nerves
• Injury from treatments for prostate cancer, including radiation therapy and prostate surgery
• Injury to the penis, spinal cord, prostate, bladder, or pelvis
• Surgery for bladder cancer
• Peyronie’s disease, a disorder in which scar tissue, called a plaque, forms in the penis
• Lifestyle choices, such as smoking, drinking too much alcohol, using illegal drugs, being overweight, and not exercising

Psychological or emotional issues, such as the following, may also contribute to ED:

• Anxiety
• Depression
• Fear of sexual failure
• Guilt
• Low self-esteem
• Stress

Symptoms of Erectile Dysfunction

When the patient has any of the following symptoms consistently or frequently, it may signal an ED diagnosis:

•  The inability to get an erection during some sexual encounters
•  The inability to maintain an erection long enough for intercourse
•  The inability to get an erection at all

Who Is Likely to Develop ED?

Men with an underlying disease that may cause ED are more likely to develop the condition. ED affects men of all races and in all regions. 

While the likelihood of developing ED increases with age, the aging process does not cause ED. Approximately 40% of men who are 40 years old are affected by ED, while about 70% of men are affected by the condition by age 70.