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Erectile dysfunction

Dysfunctio erectilis · Porucha erekce

male only

What it is

Usually a blood-vessel problem — and often the first sign of heart disease.

Symptoms & signs

  • Difficulty getting or keeping an erection
  • reduced morning erections
  • low confidence
  • relationship strain

🚩 Get help if…

  • call 112 / 911 now Erection lasting over 4 hours
  • call 112 / 911 now Chest pain during sex or after erection drugs
  • see a doctor soon Erection problems with new chest pain or breathlessness on exertion
  • see a doctor soon Curved or painful erection, or a lump in the penis

Where it strikes

Medical treatment

  • Sildenafil or tadalafil
  • check testosterone, glucose and lipids
  • vacuum device
  • intracavernosal alprostadil
  • penile implant
  • treat the cardiovascular cause

Natural & lifestyle

  • Exercise (strong evidence)
  • weight loss
  • stop smoking
  • pelvic floor training
  • reduce alcohol
  • treat sleep apnoea
  • address anxiety

Emerging & experimental

  • Low-intensity shockwave therapy
  • stem-cell and platelet-rich plasma injections
  • gene therapy for smooth muscle

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • L-arginine and L-citrulline — small trials in mild cases mixed evidence
  • Red ginseng (Panax ginseng) — trials show a modest effect mixed evidence
  • Home acoustic-wave devices — early studies early / small studies
  • Yohimbine — small effects, with anxiety and blood-pressure side effects early / small studies
  • 'Male enhancement' supplements — many contain hidden sildenafil or tadalafil anecdotal / traditional

ICD codes