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Erectile dysfunction — illustrative hero

Erectile dysfunction

ICD-10 N52.9

Reviewed by the WeighedHealth Editorial Team against primary clinical sources — FDA labeling, peer-reviewed trials, and specialty-society guidelines.
Content current as of July 2026; updated when guidance or availability changes.
Last verified by WeighedHealth Editorial Team against primary sources
~0M
US men with some degree of ED
0%
prevalence at age 40
0-25%
prevalence at age 65
~0%
respond to first-line PDE5i

What are the symptoms of erectile dysfunction?

  • Difficulty getting an erection sufficient for satisfactory intercourse
  • Difficulty maintaining an erection during intercourse
  • Reduced morning or spontaneous erections (early marker of vascular cause)
  • Reduced libido (suggests possible endocrine contribution — check testosterone)
  • Premature or delayed ejaculation can coexist but is a separate diagnosis

Who is at risk for erectile dysfunction?

  • Cardiovascular disease, hypertension, hyperlipidemia (ED is often the earliest warning)
  • Diabetes (vascular + neuropathic mechanisms)
  • Tobacco use (current or recent — vasoconstriction + endothelial damage)
  • Obesity (low testosterone + vascular contribution)
  • Medications: many antihypertensives, SSRIs, finasteride, beta-blockers, some opioids
  • Pelvic surgery or radiation (prostatectomy is the most common iatrogenic cause)
  • Depression and relationship stress (psychogenic component)

How is erectile dysfunction diagnosed?

Clinical history is sufficient for most cases. The International Index of Erectile Function (IIEF-5) questionnaire validates severity. Workup considers cardiovascular risk, testosterone, prolactin, and glucose. Sudden onset suggests psychogenic; gradual onset suggests organic (vascular, neurogenic, or hormonal) cause.

How is erectile dysfunction treated?

First-line: PDE5 inhibitors (sildenafil/Viagra, tadalafil/Cialis) — effective for 60-80% of men. Lifestyle: cardiovascular fitness, weight loss, smoking cessation. Second-line: alprostadil intracavernosal or intraurethral. Third-line: penile prosthesis. Treat underlying conditions (hypogonadism, depression, vascular disease) when present.

Medications used for erectile dysfunction

Authority reference: www.auanet.org

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Sources

Primary sources cited above. FDA labeling, peer-reviewed trials, and specialty-society guidelines only.

  1. Erectile Dysfunction: AUA Guideline · American Urological Association, 2018
  2. Erectile Dysfunction and Cardiovascular Disease · Journal of the American College of Cardiology, 2018 · PMID 30409258
  3. Massachusetts Male Aging Study — Prevalence of ED · Journal of Urology, 1994 · PMID 8254833

People also ask

  • What's the difference between Viagra and Cialis?

    Viagra (sildenafil) works in 30-60 minutes and lasts about 4 hours — designed for on-demand use. Cialis (tadalafil) works in 30 minutes but lasts up to 36 hours, so the timing window is much wider; it can also be dosed daily for ongoing readiness. Same efficacy class, different time profile.

  • Are there free or low-cost ways to treat ED?

    Generic sildenafil and tadalafil are widely available and cost a fraction of the brand-name versions. Telehealth platforms offer the generics at $1-5 per dose. Insurance coverage of ED treatment is plan-specific and often excludes lifestyle indications.

  • Can ED be a sign of heart disease?

    Yes. ED frequently precedes cardiovascular events by 2-5 years because penile arteries are smaller than coronary arteries and show endothelial dysfunction earlier. New-onset ED in a man over 40 warrants a cardiovascular risk assessment.

  • Can I take PDE5 inhibitors if I'm on heart medication?

    Nitrates (nitroglycerin, isosorbide) are an absolute contraindication — the combination can cause life-threatening hypotension. Alpha-blockers require careful timing and dose. Always disclose every cardiovascular medication you take to the prescriber.

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