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Erectile and Male Sexual Dysfunction

Erectile dysfunction (ED), or impotence, is the inability to achieve or maintain an erection during sexual performance. ED occurs when not enough blood flows to the penis, preventing an erection. Studies have shown that most cases of ED, which affects nearly 30 million men, are caused by physical health problems.

Potential Causes

Erectile dysfunction is not a disease in and of itself, but rather a symptom of an underlying condition such as diseases that affect blood flow, psychological factors, chronic diseases, and certain medications:

  • Diabetes
  • Atherosclerosis
  • Pituitary tumors
  • Hormonal imbalances
  • Neurological problems (e.g., from surgery to remove the prostate)
  • Psychological issues such as depression or performance anxiety
  • Medication side effects


There are no formal tests to diagnose erectile dysfunction; however, there are tests to determine underlying causes:

  • Blood tests to measure cholesterol levels and to detect anemia
  • Nerve tests to determine if there is sufficient nerve sensation in the penis
  • Tests of nocturnal penile tumescence (the occurrence of an erection during sleep) that may indicate a problem with nerve function and blood supply in the penis
  • Duplex ultrasound to evaluate blood flow and signs of atherosclerosis


A number of treatments for erectile dysfunction exist. New medications, however, have revolutionized the treatment of ED:

  • Drugs like Viagra and Cialis that work by increasing tissue sensitivity to the blood-vessel-dilating substance nitric oxide in the penis
  • Sex therapy or counseling to alleviate stress and other psychological issues
  • Pumps that draw blood into the penis prior to sex
  • Exercise, especially aerobic exercise

Contact Information

Beth Israel Deaconess Hospital-Needham
148 Chestnut Street
Needham, MA 02492