Medical Encyclopaedia › Erectile dysfunction (short definition)
In brief: Erectile dysfunction is present when an erection sufficient for satisfactory sexual intercourse cannot be achieved or maintained over a longer period. It is common and increases with age; in most cases it can be treated well.
Causes
Physical causes are usually involved, above all circulatory disorders due to arteriosclerosis, favoured by high blood pressure, diabetes, raised blood lipids, smoking and overweight. Other causes are nerve damage, testosterone deficiency, pelvic surgery, for example on the prostate, and medicines. Psychological factors such as stress, performance pressure, relationship problems or depression often play a part or predominate in younger men.
A warning sign for the heart
Because the blood vessels in the penis are very small, circulatory disorders often show up there earlier than in the heart. Erectile dysfunction can therefore precede a heart attack by several years and is a good reason to have cardiovascular risk factors checked.
Diagnosis
An open conversation, a physical examination and laboratory values such as blood sugar, blood lipids and, if necessary, testosterone are important. Sometimes special urological examinations of blood flow follow.
Treatment
The basis is treating risk factors and a healthy lifestyle: exercise, weight loss and stopping smoking often measurably improve erectile function. The first-choice medicines are PDE-5 inhibitors such as sildenafil or tadalafil, which only work with sexual arousal. They must not be combined with nitrates and are prescription-only; preparations from unsafe internet sources are frequently counterfeit. Other options are injections into the erectile tissue, vacuum pumps and, as a last option, a penile implant. Sex therapy or couples counselling can be a useful addition.
When to see a doctor?
If erection problems last longer than a few weeks or are distressing, an assessment by a urologist or GP is advisable. A painful erection lasting longer than four hours is an emergency.
Related terms in the encyclopaedia
Sildenafil, Arteriosclerosis, Testosterone, Hypogonadism, Diabetes mellitus, Hypertension, Stopping smoking, Urology, Andrology
Sources
- European Association of Urology (EAU): Guidelines on Sexual and Reproductive Health
- Deutsche Gesellschaft für Urologie (DGU): Patienteninformationen, urologenportal.de
- IQWiG: gesundheitsinformation.de – Gesundheitsinformationen des Instituts für Qualität und Wirtschaftlichkeit im Gesundheitswesen
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor or pharmacist. Last updated: October 2026.