Erectile dysfunction defined, its causes, how common it is, and what the first steps are for finding treatment.
Erectile dysfunction (ED) is the consistent inability to achieve or maintain an erection firm enough for satisfying sexual activity. This definition covers a spectrum of experiences — from being unable to achieve any erection, to achieving erections that are softer than they used to be, to inconsistent erections that vary unpredictably from one occasion to the next.
ED affects roughly one in three men. While it becomes more common with age — affecting an estimated 40% of men at age 40 and 70% of men by age 70 — it is not exclusively an older man's problem. More than 25% of men under 40 experience ED, and a significant proportion of those cases are primarily psychological in origin.
Because an erection is fundamentally a vascular event — requiring healthy blood vessel function, adequate blood flow, and normal nerve signaling — ED is increasingly recognized by cardiologists as an early indicator of cardiovascular disease. The penile arteries are smaller than the coronary arteries, so vascular compromise often appears there first. Men who develop ED in their 40s with no obvious cause should discuss cardiovascular screening with their physician.