Erectile dysfunction
Key facts
- Erectile dysfunction (also known as ED or impotence) is when you can't get or keep an erection, leading to problems with sexual intercourse.
- Erectile dysfunction is very common, affecting more than 1 in 10 males.
- Erectile dysfunction can have a range of causes, both physical and psychological.
- There are medicines and other therapies that help males get and keep an erection.
- Your doctor can do a health check and prescribe an ED medicine if suitable.
- Other ED treatment options include lifestyle changes, counselling, injections or medical devices.
What is erectile dysfunction?
Erectile dysfunction (ED) means not being able to get or keep an erection — this may cause problems for sexual intercourse.
Erectile dysfunction is also known as ED or impotence.
Many people have ED at some time in their lives. It can come and go. More than 1 in every 10 males cannot have erections. The problem is more common as you get older. There may be underlying causes contributing to erectile dysfunction.
What are the symptoms of erectile dysfunction?
Symptoms of erectile dysfunction include difficulty:
- getting an erection
- keeping an erection
- having sexual intercourse, due to your penis not being hard enough
Erectile dysfunction does not include problems with:
CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.
What causes erectile dysfunction?
Erectile dysfunction can have a range of causes — physical, psychological or a combination. Sometimes it only happens in certain situations. The cause may not always be clear.
Problems with the male reproductive system that can cause erectile dysfunction include:
- Peyronie's disease (scar tissue inside the penis that results in a curved penis)
- prostate disease, and treatments for prostate cancer or an enlarged prostate
- hypogonadism, where the testicles cannot make enough testosterone
Physical factors that can cause erectile dysfunction include:
- health problems that affect the nerves, like spinal cord injury, Parkinson's disease and Alzheimer's disease
- reduced blood flow to the penis, caused by atherosclerosis (clogging of the arteries)
- hormonal problems, including underactive thyroid (hypothyroidism), growth hormone conditions and having too much cortisol
- alcohol, smoking or substance abuse
- some medicines used to treat high blood pressure, high cholesterol, depression or prostate cancer
Chronic health conditions that can contribute to erectile dysfunction include:
- high blood pressure
- diabetes
- high cholesterol
- cardiovascular disease
- obesity or metabolic syndrome
- sleep disorders
Psychological factors that can cause erectile dysfunction include:
- unresolved problems, conflicts or issues within a sexual and emotional relationship
- anxiety about sexual performance (this is most common at the start of a new relationship, especially if you have had previous problems with sexual performance)
- stress
- mental health conditions such as depression or anxiety
When should I see my doctor?
Many people experience erection problems from time to time. If you only have occasional erection problems, you might not need to get medical help. But if the problems continue or you have any concerns, see your doctor.
Often, erectile dysfunction is the first sign of certain medical problems such as:
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How is erectile dysfunction diagnosed?
To diagnose erectile dysfunction, your doctor will ask about your:
- sexual history
- general health
- relationships (current and previous)
- psychological relationship with sex
Sometimes your doctor will also offer to talk to your sexual partner to consider other possible causes. They will then do a physical examination. They may refer you for blood tests or imaging scans, such as ultrasound.
Your doctor may also refer you to a specialist, such as a urologist, for assessment or treatment.
Diagnosing and treating these problems early can help identify underlying causes for ED and treat your symptoms. It can also reduce your chance of complications from the conditions themselves.
ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.
How is erectile dysfunction treated?
Your doctor will first treat any underlying conditions that may be causing ED.
They may also recommend lifestyle changes such as eating a healthy diet and exercising regularly.
More than one treatment may be needed to fix the problem. You may need treatment for both the physical and psychological causes.
Sometimes, ED can't be completely cured. Usually, treatments will allow you to get an erection so you can have sexual intercourse. It is important to understand that treatment cannot fix things that have always been an issue, such as problems with ejaculation or sensation.
Psychological treatments
Your doctor may recommend therapy if your erectile dysfunction is caused or triggered by psychological factors. Examples include cognitive behavioural therapy, or sex therapy, and may also include your partner.
Your GP, psychologist or a mental health professional may be able to provide some form of therapy. Trained sex therapists can offer specialised education and counselling.
Medicines
Erectile dysfunction is most often treated with erection medicines such as:
- sildenafil (for example, Viagra)
- tadalafil (for example, Cialis)
- avanafil (Spedra)
You will need to take these medicines a couple hours before having sex. They work by helping to relax the blood vessels in the penis. This allows blood to flow into the penis, making it easier to get an erection. They do not cause you to have an erection without sexual stimulation or activity.
Medicines can increase both the number and duration of erections, but they do not increase libido (interest in sex). They do not work for everyone.
Make sure to check with your GP before using any erectile medicines, as they may interact with other medicines. Do not take these medicines if you are also taking other nitrate medicines, used to treat chest pain. Ask your pharmacist if you're not sure.
Read more on erectile dysfunction medicines.
Buying medicines for erectile dysfunction
You need a prescription from your doctor to buy medicines for erectile dysfunction. You can buy these medicines from a store-based pharmacy or reputable online pharmacy with a prescription.
Medicines bought on the internet without a prescription may be of poor quality or not contain the ingredients they claim to. They may contain ingredients that are not safe to take with other medicines you take, or because of certain medical conditions.
If you're concerned about a counterfeit medicine, report it to the Therapeutic Goods Administration.
Injections
Your doctor might suggest a medicine that you can inject into your penis when you want an erection. Once you learn how to do this from a health professional, you will be able to inject this yourself.
Other physical treatments
There are devices and therapies that you can use to create an erection, including:
- penile rings to help maintain an erection
- a penis implant
- a penis pump or vacuum
- low-intensity shockwave therapy
Some of these involve surgery to fit the device.
Psychological treatments
Your doctor may recommend therapy if your erectile dysfunction is caused or triggered by psychological factors. Examples include cognitive behavioural therapy, or sex therapy, and may also include your partner.
Your GP, psychologist or a mental health professional may be able to provide some form of therapy. Trained sex therapists can offer specialised education and counselling.
What are the complications of erectile dysfunction?
If you or your partner are unable to achieve or maintain an erection, it can impact your ability to perform sexually and may lead to:
- low self-esteem and confidence
- anger
- depression or anxiety
Some medicines and treatment option for erectile dysfunction can cause complications such as:
- adverse effects (headache, flushing, dizziness)
- painful erections (priapism)
- local pain or bruising
Can erectile dysfunction be prevented?
There is evidence that some causes of erectile dysfunction can be prevented if you:
- stop smoking
- increase exercise
- lose weight
- eat healthy food
Resources and support
- The Healthy Male website has more information about erectile dysfunction and other sexual health issues for males.
- Mensline is a free telephone and online counselling service. Call 1300 78 99 78 for help 24 hours a day, 7 days a week, or chat online.
- Relationships Australia has resources for couples and individuals to help support healthy relationships.
Do you prefer to read in languages other than English?
True provides multilingual information on men's sexual and reproductive health.
Looking for information for Aboriginal and/or Torres Strait Islander people?
The Australian Indigenous HealthInfoNet has sexual health information and resources.
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Last reviewed: February 2025
