Impotence (Erectile Dysfunction): What You Should Know and Do

Impotence, or erectile dysfunction (ED), is more common than people admit. It can show up suddenly or slowly, and it often signals something else—like heart disease, diabetes, or stress. The good news: many causes are treatable, and small changes often help a lot.

ED means you can’t get or keep an erection firm enough for sex. That’s the basic definition, but the reasons vary. Sometimes it’s mainly physical (blood flow, nerves, hormones). Sometimes it’s mainly psychological (anxiety, depression, relationship issues). And often it’s a mix of both.

Common physical causes include blocked arteries, high blood pressure, diabetes, obesity, low testosterone, nerve damage after surgery, and some prescription drugs. Lifestyle factors—smoking, heavy drinking, poor sleep, and lack of exercise—also matter. Mental stress, performance anxiety, and unresolved relationship problems can make ED worse or even start it.

Quick tests and when to see a doctor

If ED happens more than occasionally, book an appointment. Don’t wait if it starts suddenly, if erections fail completely, or if you have chest pain, shortness of breath, or sudden weakness—those can point to heart trouble. Your doctor will usually start with a few basic checks: blood pressure, blood sugar, cholesterol, and a testosterone level. They may also ask about your meds, sleep, mood, and sexual history.

Simple follow-up tests can include a urine test, blood tests for hormones, and sometimes a vascular test to see blood flow to the penis. If psychological causes look likely, expect questions about stress, mood, and sleep—sometimes a short therapy referral helps more than medicine.

Real treatment options and everyday fixes

First-line medical treatments are oral pills called PDE5 inhibitors—sildenafil, tadalafil, vardenafil, and avanafil. They work for many men but don’t mix with nitrates (heart meds). If pills aren’t right, there are other choices: vacuum pumps, penile injections, urethral suppositories, and, for long-term severe ED, surgical implants.

Don’t ignore lifestyle fixes. Quit smoking, cut back on alcohol, lose excess weight, and get 30 minutes of moderate exercise most days. Controlling blood sugar and blood pressure improves erections and reduces long-term risk. Pelvic floor exercises (Kegels) can help men regain control—try short daily routines for a few months.

Mental health matters. If anxiety or depression is part of the picture, talk therapy or couples counseling often speeds recovery. Communication with your partner reduces pressure and makes treatment work better.

Practical tips: keep a simple journal of when ED happens, what you were taking, and your stress level—this helps your doctor. Be honest about medication use and alcohol. If you’re considering buying ED medicine online, check that the pharmacy is legitimate and ask your doctor first.

ED can feel isolating, but it’s usually treatable. Start with a medical check, focus on one lifestyle change at a time, and use treatments that match your situation. You don’t have to figure it out alone—professional help works.