You may have erectile dysfunction if you keep finding it hard to get an erection, to keep one, or to get hard enough for sex, again and again rather than once in a while. Many men have erection problems from time to time; if yours are only occasional you might not need medical help, but if they continue or you have any concerns, see your doctor (healthdirect).

What exactly is erectile dysfunction?

Erectile dysfunction, or ED, means not being able to get or keep an erection suitable for sexual activity. It is also called impotence. More than 1 in 10 males cannot have erections, the problem becomes more common with age, and it can come and go. ED does not include difficulties with ejaculation, fertility or sex drive: those are separate problems with their own causes (healthdirect).

What are the signs?

healthdirect lists three:

  • difficulty getting an erection
  • difficulty keeping an erection
  • difficulty having sex because your penis is not hard enough

The pattern matters more than any single night. ED sometimes happens only in certain situations, and its cause is not always clear at first (healthdirect).

Can you test yourself at home?

Not in a way that gives a diagnosis. If you are asking "How can I test myself for erectile dysfunction?", the useful home step is to note how often the problem happens, since when, and whether it happens every time or only in some situations. healthdirect's online Symptom Checker can tell you whether to seek medical help. The diagnosis itself comes from a doctor's questions and examination.

What physical problems can cause it?

Reduced blood flow to the penis from clogged arteries, nerve problems (after a spinal cord injury, or with Parkinson's or Alzheimer's disease), hormone problems such as low testosterone or an underactive thyroid, alcohol, smoking or other drugs, and some medicines for high blood pressure, high cholesterol, depression or prostate cancer. Long-term conditions contribute too: high blood pressure, diabetes, high cholesterol, heart disease, obesity and sleep disorders. Peyronie's disease and prostate disease or its treatment are further causes (healthdirect).

Can stress or anxiety cause it?

Yes. The psychological causes are stress, anxiety, depression, unresolved problems in the relationship and worry about sexual performance, which is most common at the start of a new relationship, especially after earlier problems. The cause can be physical, psychological or a combination of both (healthdirect).

Why is ED worth a visit to the GP?

Because ED is often the first sign of a medical problem: cardiovascular disease, diabetes, high blood pressure or high cholesterol. Diagnosing and treating these early can find the cause of the ED and lower your chance of complications from the conditions themselves (healthdirect). If raising it feels awkward, healthdirect's Question Builder helps you prepare what to ask your GP. Left alone, ED can also lead to low self-esteem, anger, depression or anxiety; MensLine Australia is a free counselling service on 1300 78 99 78, open 24 hours a day, 7 days a week.

How does a doctor diagnose it?

By asking about your sexual history, your general health, your relationships and how you feel about sex. Some doctors offer to talk with your partner as well. A physical examination follows, and you may be sent for blood tests or an ultrasound, or referred to a urologist (healthdirect).

Can erectile dysfunction be treated?

Usually, yes. Your doctor will first treat any underlying condition and may recommend lifestyle changes such as eating a healthy diet and exercising regularly; when the cause is psychological, cognitive behavioural therapy or sex therapy can help (healthdirect). Depending on the cause, your doctor may also suggest medications or other treatments. The tablets used in Australia, sildenafil, tadalafil, vardenafil and avanafil, all need a prescription and must never be taken with nitrates; injections, vacuum erection devices and counselling are the alternatives (healthdirect). Sometimes ED can't be completely cured, but treatment usually allows you to get an erection so you can have sex.