Erectile dysfunction (ED), or impotence, is the inability to get and maintain an erection for sexual activity. While the occasional failure to get an erection is not uncommon, if it occurs regularly, or more than 50% of the time, it could be erectile dysfunction. It may be a temporary experience or a long-term illness that requires treatment.
Learn more about the prevalence of erectile dysfunction and its causes, risk factors, and treatment options.
Globally, ED affects 3% to 76.5% of all men. The wide range is due to the different measures used in studies to assess ED.
In the United States, an estimated 30 million men suffer from ED. Globally, around 150 million men are living with erectile dysfunction and by 2025, it is predicted that over 300 million men will be affected by erectile dysfunction.
Erectile dysfunction can be caused by a number of factors related to physical and mental health, including:
- Physical and health conditions which involve different systems of the body, such as the vascular, neurological or endocrine systems; may include problems with nerve signals or blood flow to the penis
- Medication side effects, which may include antidepressants, medicines to manage blood pressure, tranquilizers, sedatives, medicines for ulcers, and treatment for prostate cancer
- Psychological or emotional causes such as depression, anxiety, fear associated with sexual performance, general stress, or low self-esteem
- Lifestyle behaviors and health factors that are associated with erectile dysfunction include smoking, being overweight, lack of exercise, and substance use (alcohol or drugs)
Certain risk factors increase the likelihood of suffering from ED. They may include:
- Age: The chances of developing erectile dysfunction increase with age, especially in men over 60.
- Smoking: Research has shown that smokers are 1.5 times more likely to suffer from ED than non-smokers.
- High blood pressure (hypertension): About 30-50% of people with hypertension also have ED.
- Type 2 diabetes: Between 35% and 90% of men with diabetes will develop erectile dysfunction.
- High cholesterol: Statins used to treat high cholesterol have been shown to improve erectile function.
- Hypogonadism: It is a condition where the body does not make enough sex hormones, including testosterone. Since testosterone is necessary for the ability to maintain an erection, people with hypogonadism who are treated with testosterone replacement therapy may see improvement in erectile function.
- Obesity: Several studies have indicated that men with a body mass index (BMI) greater than 25 start to have a 1.5 to three times higher risk of ED than those with a lower BMI.
- Depression: Men living with depression are twice as likely to have ED. Treating depression with selective serotonin absorption inhibitors (SSRIs) may also increase the risk of erectile dysfunction.
Stress and anxiety, especially performance anxiety, can also cause problems with sexual activity and erectile function.
In addition to diabetes, hypertension, and hypogonadism, the National Institute of Diabetes and Digestive and Kidney Diseases also lists the following conditions and diseases associated with erectile dysfunction:
Treatment for erectile dysfunction can take many forms and depends on the root cause of the individual’s erectile dysfunction. Due to the impact of erectile dysfunction on sex, it is worth discussing treatment options with your sexual partner.
Way of life
Avoiding or stopping the use of tobacco, alcohol, and other drugs can help with erectile dysfunction.
Increasing physical activity and maintaining a healthy weight can also be a way to improve erectile function.
Mental health counseling
Since emotional and psychological concerns can play a role in erectile dysfunction, talking to a mental health professional can be of benefit. They can help identify ways to manage anxiety and overcome stress that can impact sexual performance.
Oral (PDE5 inhibitors), injectable, or suppository medications may be prescribed to help get and maintain an erection. For those who have low testosterone (hypogonadism), testosterone replacement therapy may be prescribed.
Treatment may also involve adjusting or modifying current medications that interfere with the ability to have an erection.
Devices and procedures
The following devices and procedures can be used to treat erectile dysfunction:
- Penis pump: This device uses the action of vacuum to draw blood into the penis to create an erection. It has a tube where the penis is placed and a pump that sucks air from the tube and creates suction. After the blood is drawn into the penis, an elastic band is placed at the base of the penis to prevent blood from returning to the body and maintain the erection for about 30 minutes.
- Arterial repair surgery: Procedures to repair blocked blood vessels in the penis can increase blood flow to allow erections. This treatment is generally reserved for patients under the age of 30.
- Implantable devices: These include surgically placed devices that swell or include semi-rigid rods to help a person achieve an erection.
A word from Verywell
Although many men can feel self-conscious about their erectile dysfunction, it should be comforting to know that it is a very common condition, affecting at least 150 million men worldwide. It is also a very treatable condition.
Talk to your health care provider if you’re having trouble getting and maintaining an erection. While it can be uncomfortable to talk about it, healthy sexual functioning is a key part of your overall health and well-being.
Frequently Asked Questions
How common is erectile dysfunction in men under 40?
Estimates from a number of large studies have found that around 30% of men under the age of 40 suffer from erectile dysfunction.
How common is erectile dysfunction after vasectomy?
A vasectomy is a procedure used to cut the path of sperm outside the body (the vas deferens) to reduce the risk of pregnancy. It does not change the structures of the penis that allow an erection.
How common is erectile dysfunction after hernia surgery?
Research has shown that 5.3% of people experience sexual dysfunction (including the ability to maintain an erection) after hernia surgery. However, there are variations depending on the type of procedure. Laparoscopic or minimally invasive hernia surgeries cause higher rates of sexual dysfunction than open surgeries.
Why is erectile dysfunction so common?
The ability to maintain an erection can be affected by many problems with the vascular, nervous, or endocrine systems. The researchers also noted the aging of the world’s population as a reason for the increase in ED rates, as the likelihood of suffering from ED increases with age.