You have seen your doctor for erection problems. You may be unable to get an erection at all. Or you may prematurely lose the erection during intercourse. If the condition persists, the medical term for this problem is erectile dysfunction (ED).
Erection problems are common in adult men. In fact, almost all men have a problem getting or maintaining an erection at times.
For many men, lifestyle changes can help with ED. For example, alcohol and illegal drugs may make you feel more relaxed. But they can cause ED or make it worse. Avoid illegal drugs, and consider limiting the amount of alcohol you drink.
Smoking and smokeless tobacco can cause narrowing of blood vessels all over the body, including those that supply blood to the penis. Talk to your doctor about quitting.
Other lifestyle tips include:
Get plenty of rest and take time to relax.
Exercise and eat healthy foods to maintain good circulation.
Use safe sex practices. Reducing your worry about STDs may help prevent negative emotions that can affect your erection.
Talking with your partner
Having ED can make you feel bad about yourself. This can make it even more difficult to seek treatment and enjoy sexual activity.
ED can be a troubling issue for couples, because it can be difficult for you or your partner to discuss the problem with each other. Couples who do not openly talk to each other are more likely to have problems with sexual intimacy. Likewise, men who have trouble talking about their feelings may be unable to share their sexual concerns with their partners.
If you have trouble communicating, counseling can be very helpful for you and your partner. Finding a way for both of you to express your feelings and desires, and then work on the issues together, can make a big difference.
Medicines, herbs, and supplements
Sildenafil (Viagra), vardenafil (Levitra, Staxyn), and tadalafil (Cialis) are medicines prescribed for ED. They work only when you are sexually aroused.
The effect is usually seen within 15 to 45 minutes. The effects of these drugs may last for several hours. Tadalafil (Cialis) may last for up to 36 hours.
Sildenafil (Viagra) should be taken on an empty stomach. (Levitra) and tadalafil (Cialis) may be taken with or without food.
These drugs should not be used more than once a day.
Common side effects of these medicines include flushing, upset stomach, headache, nasal congestion, back pain, and dizziness.
If you have heart disease, talk with your doctor before using these medicines. Men who take nitrates for heart disease should not take ED medications.
Many herbs and dietary supplements are marketed to help sexual performance or desire. None of these remedies have been proven effective for treating ED. Talk to your doctor to see if any of these treatments is right for you.
When to call your doctor
Call your doctor right away or go to an emergency room if any ED medicine gives you an erection that lasts more than 4 hours. If this problem is not treated, you may suffer lasting damage to your penis.
To end an erection you may try to repeat climax and apply a cold pack to your genitalia (wrap the pack in a cloth first). Never go to sleep with an erection.
Burnett AL. Evaluation and management of erectile dysfunction. In: Wein AJ, Kavoussi LR, Novick AC, et al., eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 24.
Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010 Feb 1;81(3):305-12.
Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.