What is Erectile Dysfunction?

Written by the Manual Team · Medically approved by Dr Earim Chaudry - MD

In 30 seconds

What is the definition of erectile dysfunction (ED)? ED is the inability of the penis to become hard and maintain its erection long enough to have sexual intercourse. Partial erections or the loss of erections during sexual activity is also ED.

ED and impotence: what’s the difference? Impotence and erection problems are not exactly the same, although the words are often used interchangeably. Impotence refers to a total lack of desire for sexual activity.

How common is ED? Erection problems are quite common. About 4.5 million or 1 in 5 males in the UK have some degree of sexual dysfunction. This could range from severe impotence to erection issues due to medical causes. In older men compromised blood vessels, nerves or low levels of testosterone are often the cause. In younger men medical conditions, lifestyle circumstances and stress are among ed risk factors.

Erectile Dysfunction: Definition

ED refers to the difficulty or inability to achieve or sustain an erection and engage in sexual intercourse. It includes inability to get an erection spontaneously (by thinking about sexual activity) or not being able to achieve an erection with manual stimulation. The term ED also encompasses being able to achieve erections but losing them before completion of sexual intercourse.

There are numerous treatments available for erection problems. Medical treatments include oral therapies like Viagra (Sildenafil), Tadalafil (Cialis), Vardenafil (Levitra) and Avanafil (Spedra). Other options include the Alprostadil self-injection, Alprostadil urethral suppository or testosterone replacement therapy. Penis pumps – where a vacuum device is used to pump more blood into the penis to help sustain an erection – and surgery to insert implants or repair damaged arteries is another treatment option. 


As men get older they may be more prone to ED.


While testosterone levels do drop as men age, and age-related conditions like heart disease, high blood pressure and Type 2 diabetes become more likely, not all men over the age of 50 develop erection problems. In fact, half of older men never have erection issues.


What is impotence? ED vs. impotence

These two terms are often used interchangeably to describe the inability to get and sustain an erection during sexual activity. Impotence used to be a term more linked to describing the lack of desire for sexual activity strictly speaking – and of course, lack of desire often leads to ED. In most literature on the subject, the two words are used to describe erection problems. 

We used to refer to the inability to gain erections as impotence but this word has fallen into disuse due to confusion about its definition and negative connotations of being non-treatable or permanent.


ED: what does it mean?

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ED results in an inability to achieve an erection spontaneously (for example by seeing something sexual or having sexual thoughts) or with manual stimulation. If you think you have ED you should definitely see a doctor. If necessary, your GP can refer you to a specialist. Specialist endocrinologists (if you have hormonal problems) or urologists (problems with the genitals) will help you uncover the reasons for your erection problems. They will run blood tests, may do an ultrasound and take a full medical history to screen for related conditions like diabetes and thyroid problems. Urologists will try to uncover functional causes. 


Erection problems can be caused by heart or vascular disease. In this case the blood supply to the penis may become blocked or narrowed by the arteries becoming hardened (atherosclerosis ). Another cause of ED is neurological disorders like multiple sclerosis, and Parkinson’s disease. These diseases affect the nerve impulses to the penis. In young men psychological causes were once considered to be a major factor but it is now known that these issues are often linked to health conditions like thyroid disease. However stress, anxiety, depression, lack of stimulus from the brain, and performance anxiety can be factors. Traumatic injury to any of the areas involved in attaining an erection can also cause ED.


The good news is that erection problems are most often treatable and can restore full functionality to the penis.


Treatments include medications, hormone therapy, penis pumps and surgery but options depend on the reason for your ED. Medications like Viagra increase the levels of nitric oxide in the body and relax the muscles in the penis. This increases blood flow and helps you to achieve erections.


Erectile Dysfunction Statistics: Is ED common?

According to statistics from the NHS, about half of all older men between the ages of 40-70 may suffer from erection problems at some time in their lives. This makes it a very common condition. This is about 4.3 million men across the UK. It’s also common in younger men, 40% of men under 40 have experienced erectile dysfunction.


However, about 45% of men with ED have not sought any treatment. The more men report problems with erections the less stigma there will be around this issue.


What we do know is that erection difficulties are common in both young men and older men and are linked to health conditions (not status or virility). That means that the condition is treatable by medical intervention and has little to do with social or sexual prowess. Men should feel comfortable consulting their doctor with any symptoms as prompt treatment can completely restore quality of life and sexual confidence.