Erectile dysfunction (ED), or impotence, is the inability to achieve and maintain an erection for sexual activity. While the occasional failure to get an erection is not uncommon, if it happens consistently, or more than 50% of the time, it may be ED. It can be a temporary experience, or develop into a long-term condition that requires treatment.
Learn more about the prevalence of ED and its causes, risk factors, and treatment options.
On a global scale, ED affects 3% to 76.5% of all men. The wide range is due to the different measures used in studies to evaluate ED.
In the United States, it’s estimated that 30 million men experience ED. Worldwide, there are about 150 million men living with ED, and by the year 2025, it’s predicted that over 300 million men will have ED.
ED can be caused by a number of factors relating to physical and mental health, including:
- Physical and health conditions that involve different systems in the body, such as the vascular, neurological, or endocrine systems; can include issues with nerve signals or blood flow to the penis
- Side effects from medication, which can include antidepressants, medication to manage blood pressure, tranquilizers, sedatives, ulcer medication, and prostate cancer therapy
- Psychological or emotional causes such as depression, anxiety, fear associated with sexual performance, general stress, or low self-esteem
- Lifestyle behaviors and health-related factors that are associated with ED include smoking, being overweight, lack of exercise, and substance (alcohol or drug) use
Certain risk factors have been found to increase the likelihood of experiencing ED. They can include:
- Age: The chances of developing ED increases with age, particularly in men over 60 years old.
- Tobacco use: Research has found that smokers are 1.5 times more likely to experience ED than nonsmokers.
- High blood pressure (hypertension): About 30% to 50% of people living with hypertension also experience ED.
- Type 2 diabetes: Between 35% and 90% of diabetic men will develop ED.
- High cholesterol: Statins used to treat high cholesterol showed improved erectile function.
- Hypogonadism: This is a condition where the body doesn’t produce 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 can see improved erectile function.
- Obesity: Several studies have indicated that men with a body mass index (BMI) greater than 25 begin to experience a 1.5 to three times greater risk of ED than those with lower BMIs.
- Depression: Men living with depression are two times more likely to experience ED. Treating depression with selective serotonin uptake inhibitors (SSRIs) can also increase risk of ED.
Stress and anxiety, particularly performance-related anxiety, can also cause issues with sexual activity and erectile function.
In addition to diabetes, hypertension, and hypogonadism, the National Institute for Diabetes and Digestive and Kidney Diseases also lists the following conditions and diseases as associated with ED:
Treatment for ED can take many forms and depends on the root cause of the individual’s ED. Because of ED’s impact on sexual relationships, it’s worth discussing treatment options with your sexual partner.
Avoiding or stopping the use of tobacco, alcohol, and other drugs may help with ED.
Increasing physical activity and maintaining a healthy weight can also be a way to improve erectile function.
Mental Health Counseling
Because emotional and psychological concerns can play a role in ED, speaking with a mental health professional can be beneficial. They can help identify ways to manage anxiety and work through stress that may be impacting sexual performance.
Oral (PDE5 inhibitors), injectable, or suppository medications can be prescribed to help achieve and maintain an erection. For those with low testosterone (hypogonadism), testosterone replacement therapy may be prescribed.
Treatment may also involve adjusting or changing current medications that hinder the ability to get an erection.
Devices and Procedures
The following devices and procedures can be used to treat ED:
- Penis pump: This device uses vacuum action to pull blood into the penis to create an erection. It has a tube where the penis is placed and a pump that draws air out of the tube and creates suction. Once the blood is pulled into the penis, an elastic band is placed at the base of the penis to prevent the blood from going back into the body and to keep the erection for about 30 minutes.
- Arterial repair surgery: Procedures to repair clogged blood vessels in the penis may increase blood flow to allow for erections. This treatment is usually reserved for patients under the age of 30.
- Implantable devices: These include surgically placed devices that either inflate or include semi-rigid rods to help a person achieve an erection.
A Word From Verywell
While many men might feel embarrassed by their erectile dysfunction, it should be a comfort 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 healthcare provider if you experience issues achieving and maintaining an erection. Even though it may be uncomfortable to talk about, proper sexual functioning is a key part of your overall health and well-being.
Frequently Asked Questions
How common is erectile dysfunction for men under 40?
Estimates from a number of large studies have found that around 30% of men under the age of 40 experience erectile dysfunction.
How common is erectile dysfunction after a vasectomy?
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) following hernia surgery. However, there is some variation based on the type of procedure. Laparoscopic or minimally invasive hernia surgeries result in higher rates of sexual dysfunction than open surgeries.
Why is erectile dysfunction so common?
The ability to maintain an erection can be impacted by many issues of the vascular, nervous, or endocrine systems. Researchers have also noted the global aging population as a reason for growing ED rates, as the likelihood of experiencing ED increases with age.