how to fix erectile dysfunction at 50 naturally

How to Treat Erectile Dysfunction Naturally: 12 Methods

Erectile dysfunction (ED) may feel like an embarrassing condition, but it’s potentially much more than that. Not only can it be a sign of a serious health issue like heart disease, it can easily affect your love life, self-esteem, and sleep — as the stress and anxiety over it keep you up. And when sleep is affected, almost everything else — your energy, your mood, your mental and physical health — takes a hit. 

ED that happens every now and again isn’t usually cause for concern. But when it’s a constant problem or something that’s disrupting your life, it’s worth getting to the bottom of. That, however, is easier said than done. 

Erectile dysfunction can be caused by a range of physical and mental problems, and it often has a mixture of different causes. And while supplements and prescription medications do exist, they don’t treat the root cause of the problem and often come with side effects. Luckily, there are science-back natural treatments for the sexual disorder.

Below, we’ll dive into how to treat erectile dysfunction naturally with a special focus on sleep — a little-known cause and underrated treatment for ED. Plus, we’ll show you how the RISE app can help with many ED treatments. 

What is Erectile Dysfunction?

Erectile dysfunction is the most common sexual disorder in men, affecting about one-third of the male population. 

It’s defined as:

• Trouble getting an erection 
• Trouble keeping an erection 
• Reduced libido, or sexual desire 

What Causes Erectile Dysfunction?

Erectile dysfunction can be caused by limited blood flow to the penis, but this problem itself can be caused by many factors, including physical or physiological problems. It can be difficult to tell what the root cause of the sexual disorder is, and often it’s a mixture of both physical and physiological factors. 

Causes of ED include: 

• Health conditions like diabetes, high blood pressure, high cholesterol, kidney disease, vascular disease, and heart disease
• Medications like antidepressants 
• Mental health issues like stress, anxiety, and depression 
• Relationship problems 
• Sleep deprivation 
• Sleep disorders like sleep apnea 

Seeking medical advice for sexual dysfunction is never easy. But you shouldn’t suffer in silence when it comes to erectile dysfunction. As much as it impacts your sexual health and relationship, it could also be a sign of an underlying condition that needs urgent treatment like cardiovascular disease. Speak to a healthcare professional if it’s an ongoing problem. 

Plus, the stress and anxiety ED causes can easily start affecting your health, relationship, and sleep — all of which can make ED worse and can lead to further health consequences. 

How to Treat Erectile Dysfunction Naturally?

Erectile dysfunction treatments range from prescription ED medications like sildenafil (Viagra) and tadalafil (Cialis) to over-the-counter dietary supplements to herbal remedies like ginkgo, red ginseng, and the aptly named horny goat weed. But these options often don’t treat the underlying cause of poor erectile function.

Plus, prescription medication can come with side effects and over-the-counter supplements aren’t well-researched in clinical trials regulated by the Food and Drug Administration. 

Luckily, there are natural treatment options that have been scientifically proven to help, and depending on what’s causing your erectile dysfunction and how severe it is, you may only need to make some simple lifestyle changes to see an improvement in your sex life. 

Try these natural cures for erectile dysfunction: 

1. Exercise

Regular exercise improves blood vessel health, lowers stress, helps you lose weight, and helps you fall asleep — all of which can help with erectile dysfunction. 

Both aerobic and anaerobic exercise can help with ED, but moderate-to-vigorous aerobic exercise has been shown to be the most effective. But even walking has been shown to improve erectile dysfunction.   

Vigorous exercise may be great for ED, but doing it too close to bedtime can keep you up. Check the RISE app for when you should avoid intense workouts. 

​​ RISE users on iOS 1.202 and above can click here to set up their avoid late workouts reminder.

2. Pelvic Floor Exercises 

One study asked men with erectile dysfunction to either make lifestyle changes only or do pelvic floor exercises as well as make lifestyle changes. Both groups saw an improvement in their ED after three months, but the group who did pelvic floor exercises saw the most improvement. After six months, 40% of the pelvic floor group had cured their erectile dysfunction, and 35.5% had improved it. 

Talking to a professional can help if you’re suffering from stress, anxiety, or depression. A sex therapist may be able to help with problems like performance anxiety. 

Speaking to a professional with your partner can help you work through trust issues or arguments you have that have led to relationship problems. 

4. Reduce Stress

Stress can not only be a cause of erection problems, it can keep you up at night, which can also cause the sexual disorder or other factors that put you at risk like obesity, diabetes, and heart disease. 

You can work on lowering your stress levels through meditation, yoga, and spending time in nature. There are even small studies suggesting acupuncture can help some people with ED. 

Cutting down on your workload, asking for help with childcare or caretaking duties, and speaking with a therapist may also be necessary to reduce stress long term. 

• What is the impact of sleep on mental health?
• What's the connection between anxiety and sleep loss?
• How can I calm anxiety at night?

5. Cut Down on Alcohol 

Men who drink three or more alcoholic drinks a week are more likely to have erectile dysfunction. This is true even when age and smoking are taken into account. 

Drinking too much alcohol also feeds into several erectile dysfunction risk factors, like obesity, sleep loss, and diabetes. 

Avoid alcohol close to bed as it can fragment your sleep , meaning you wake up during the night. 

Check RISE for when you should have your final drink each day. 

RISE users on iOS 1.202 and above can click here to set up their avoid late alcohol reminder.

6. Quit Smoking

Research suggests smoking may double your risk of developing erectile dysfunction. 

But the good news is the prevalence of erectile dysfunction in former smokers is the same as in those who have never smoked, so the damage may be reversible. 

7. Eat a Healthy Diet  

Research from 2020 found eating a healthy or Mediterranean diet of vegetables, fruits, nuts, legumes, and fish — and avoiding red meat and processed meat — was linked to a lowered risk of developing erectile dysfunction. 

Plus, eating this diet comes with the added health benefit of maintaining a healthy weight, which can also keep ED risk down. 

8. Lose Weight

Carrying excess weight, especially excess belly fat , can increase your odds of developing ED. But losing weight has been shown to improve erectile function. 

Eat in a calorie deficit, get plenty of exercise, and focus on getting enough sleep to aid weight loss. 

You can learn more about the best way to lose weight and what time you should stop eating to lose weight here. 

Let’s dive into the sleep-based treatments in more detail.

Can Sleep Cure Erectile Dysfunction?

Sleep and erectile dysfunction are closely linked. Sleep plays a huge role in your hormone production and blood flow — two things that are essential for an erection. 

Poor sleep can also be the reason for low testosterone levels. Sleeping five hours a night for eight nights reduces your testosterone by 10% to 15% , and even just one night of 4.5 hours can reduce morning testosterone levels. 

You can learn more about testosterone and sleep here.   

But the link between sleep and erectile dysfunction goes beyond just hormones and blood flow. Not getting enough sleep spikes your stress levels, makes you less likely to work out, causes weight gain , leaves you feeling exhausted, and makes you more tense with your partner — all of which can contribute to erectile dysfunction. 

And to make matters worse, not getting enough sleep puts you at higher risk for health problems like obesity, diabetes, and heart disease, and these conditions increase your odds of erectile dysfunction, too. 

And to top it off, stress and anxiety about erectile dysfunction can easily keep you up at night, creating a vicious circle.   

Need proof? A 2022 study looking at the link between erectile dysfunction and sleep found that poor sleep quality was a risk factor for the sexual disorder (although experts don’t have an agreed-upon definition for sleep quality yet).

The results also showed that those with erectile dysfunction had significantly lower: 

• Total sleep time
• Sleep onset latency — the time it takes to fall asleep 
• Deep sleep duration 
• Rapid eye movement (REM) sleep duration 

Beyond erectile dysfunction, sleep can impact your sex life in other ways, too. Sleep deprivation and sleep disorders can cause low libido in both men and women , and even cause relationship problems. One study found when both partners slept less, they were more hostile toward each other.

There is some good news, though. Many of the natural remedies for erectile dysfunction can also improve your sleep. For example, working out, reducing stress, cutting down on alcohol, quitting smoking, and losing weight have all been shown to boost your sleep and help with ED, meaning these lifestyle changes are a win-win. 

You can learn more about how to increase sex drive through sleep here.

Let’s dive into how you can cure erectile dysfunction in the most natural way possible — by getting better sleep. 

Sleep debt is the amount of sleep you owe your body . It’s measured against your sleep need, the genetically determined amount of sleep you need. On the RISE app , we measure sleep debt over your last 14 nights. 

So, if your sleep need is 8 hours 30 minutes, but you’ve only been getting six to seven hours of sleep a night recently, you’ll have built up a lot of sleep debt. 

The RISE app can work out your individual sleep need down to the minute and work out how much sleep debt you’re carrying. We recommend keeping this below five hours to feel and perform your best, both in and out of the bedroom. 

If you find you’ve got high sleep debt, you can pay it down by: 

• Taking naps: Check RISE for the best time to do this. 
• Going to bed a little earlier. 
• Sleeping in a little later: Keep this to an hour or two to avoid messing up your circadian rhythm (more on that soon). 
• Improving your sleep hygiene: Focus on sleep hygiene habits that can cut down the time it takes you to fall asleep and reduce how often you wake up during the night, meaning you get more sleep overall. More on what to do soon. 

RISE users on iOS 1.202 and above can click here to view their sleep need.

RISE users on iOS 1.202 and above can click here to view their sleep debt.

Get in Sync With Your Circadian Rhythm

Your circadian rhythm is your body’s roughly 24-hour biological clock that dictates things like your sleep-wake cycle, your energy levels throughout the day, and your hormone production.  

When you’re out of sync with your circadian rhythm — perhaps from an irregular sleep schedule, jet lag , or shift work — you might struggle to fall asleep and wake up at your desired bedtime and wake time, and suffer from low energy throughout the day. 

Living out of sync can cause high sleep debt, weight gain, and health conditions like high blood pressure, diabetes, and depression — all of which are linked to ED. And circadian misalignment had been linked directly to erectile dysfunction. 

As one study puts it: “Convincing evidence shows that a disturbed circadian clock due to shift work, irregular sleep-wake cycle, or inappropriate modern lifestyle impairs human health and contributes to various diseases, including ED.”

More research needs to be done, but the good news is, fixing circadian issues may help to treat erectile dysfunction. 

Here’s how to live in sync with your circadian rhythm: 

• Keep a consistent sleep schedule: Find a sleep schedule that works for you and stick to it, even on weekends. 
• Eat meals at roughly the same times and during the day: Eating can change the timing of your circadian rhythm, and eating too close to bedtime can keep you up. 
• Go to bed during your Melatonin Window: This is what we call the roughly one-hour window of time when your body’s rate of melatonin production is at its highest. As melatonin primes your body for sleep , going to bed during this window can help you fall and stay asleep.

The RISE app predicts your circadian rhythm each day based on factors like your inferred light exposure and last night’s sleep times. You can then see when your body naturally wants to wake up, wind down for bed, and go to sleep, and sync up your daily life to it. 

RISE users on iOS 1.202 and above can click here to see their circadian rhythm on the Energy screen.

Improve Your Sleep Hygiene

Sleep hygiene is the set of habits you can do each day to help you fall asleep faster, wake up less often during the night, and stay in sync with your circadian rhythm. 

Many sleep hygiene habits are also natural erectile dysfunction cures — like working out and limiting alcohol. 

Another bonus? Improving your sleep hygiene can help you fall asleep and stay asleep, meaning you don’t have to turn to sleep aids like benzodiazepines — which have been linked to erectile dysfunction . 

Here’s what to do: 

• Get light first thing and avoid it before bed: Get at least 10 minutes of bright light as soon as possible after waking up to reset your circadian rhythm for the day. And dim the lights and put on blue-light blocking glasses 90 minutes before bed to stop bright light from keeping you up.
• Avoid alcohol, vigorous exercise, large meals, and caffeine too close to bedtime: These common sleep disruptors can keep or wake you up. 
• Do a relaxing bedtime routine: Reduce stress and anxiety and wind down for bed by doing calming activities in the run-up to bedtime. Try reading, listening to music, journaling, or doing yoga. 

Stay on top of your sleep hygiene with RISE. The app can remind you to do 20+ sleep hygiene habits each day and tell you the best time to do them based on your circadian rhythm each day to make them more effective 

RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications. 

Get Tested for and Treat Sleep Apnea

Sleep apnea causes you to temporarily stop breathing during the night. This leads to sleep loss, lowered testosterone levels, and lowered oxygen levels — all of which may contribute to erectile dysfunction. 

Plus, the sleep disorder can lead to weight gain , diabetes, depression, high blood pressure, and heart disease — and all of these health conditions can increase your risk of developing erectile dysfunction, too. 

And that’s not to mention the fact that snoring, gasping for breath, and waking up during the night can easily impact your partner’s sleep — breeding resentment and fatigue, not exactly a recipe for a great sex life, erectile dysfunction aside.

Sleep apnea may be the sleep disorder most associated with an increased risk of erectile dysfunction , and research shows the more severe your sleep apnea is, the more severe your erectile dysfunction. 

Treating the sleep disorder can not only improve your overall health and quality of life, but it can help your sex life, too. 

A common sleep apnea treatment involves sleeping with a continuous positive airway pressure (CPAP) machine, which pushes air into your airways, keeping them open at night. This treatment has been shown to improve erectile dysfunction in those with the sleep disorder.

It may not take long to see results, either. Research suggests one month of CPAP therapy may help up to 75% of patients with erectile dysfunction.

You can learn more about how to know if you have sleep apnea here and how to get rid of sleep apnea here. Can you take testosterone if you have sleep apnea ? We summarize the science here.

Improve Your Sleep, Improve Your Sex Life 

There are many natural cures for erectile dysfunction, including exercise, lowering stress, and pelvic floor exercises, but one under-appreciated treatment is sleep. 

High sleep debt and being out of sync with your circadian rhythm can cause erectile dysfunction, and lead to many other problems — weight gain, stress, fatigue, relationship problems — which can tank your sex life further.

Sleep has a huge impact on sexual function, and it’s something we can work on improving. You can use the RISE app to keep track of your sleep debt and sync up with your circadian rhythm. RISE can also guide you through 20+ sleep hygiene habits to make this easy.

You should start sleeping more soundly and performing better — both in and out of the bedroom. 

What is the main cause of erectile dysfunction?

Erectile dysfunction can have many causes including sleep deprivation, sleep disorders, obesity, smoking, alcohol, relationship problems, medication, stress, anxiety, depression, and health conditions like diabetes, high blood pressure, and heart disease.

Can a lack of sleep cause erectile dysfunction?

Yes, a lack of sleep can cause erectile dysfunction. Less sleep time, taking longer to fall asleep, and getting less deep sleep and REM sleep have been linked to erectile dysfunction. Lack of sleep can also cause problems that put you at more risk of developing erectile dysfunction like relationship problems, stress, and heart disease.

Erectile dysfunction and sleep apnea

Erectile dysfunction and sleep apnea are linked. Sleep apnea can cause sleep deprivation, lowered testosterone, and lowered oxygen levels, which can contribute to erectile dysfunction. Treating sleep apnea with CPAP therapy has been shown to improve erectile dysfunction.

How do you fix erectile dysfunction?

You can fix erectile dysfunction by keeping your sleep debt low, living in sync with your circadian rhythm, treating sleep apnea, exercising, doing pelvic floor exercises, losing weight, cutting down on alcohol, quitting smoking, and reducing stress.

How can I solve erectile dysfunction naturally?

You can solve erectile dysfunction naturally by keeping your sleep debt low, living in sync with your circadian rhythm, treating sleep apnea, exercising, doing pelvic floor exercises, losing weight, cutting down on alcohol, quitting smoking, and reducing stress.

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Best Natural Treatments For Erectile Dysfunction

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Table of Contents

• What Is Erectile Dysfunction?

Best Natural Treatments and Remedies for Erectile Dysfunction

Erectile dysfunction treatments or remedies to avoid, when to see a doctor.

While most men occasionally struggle to get or keep an erection, erectile dysfunction (ED) that happens routinely isn’t normal and should be treated.

Many factors can affect a person’s likelihood of experiencing ED, including age, high blood pressure, diabetes, obesity, smoking, certain medications, depression and anxiety.

ED is often treated with prescription medication, but there are also several natural treatments and remedies available. Read on to learn about natural treatments for ED, including which treatments and remedies to avoid, as well as when to speak to a health care provider.

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Erectile dysfunction (ED) is the inability to achieve or maintain an erection for satisfactory sexual performance, according to the National Health Service (NHS). While not typically a serious medical condition in and of itself, ED can have a significant impact on the quality of life of a person and their partners.

It’s estimated that by 2025, ED will affect almost 322 million people, according to a review published in Materials Today Bio [1] Ren Y, Yuan J, Xue Y, et al. Advanced hydrogels: New expectation for the repair of organic erectile dysfunction . Mater Today Bio. 2023;20:19:100588. .

Symptoms of Erectile Dysfunction

The main symptoms of ED include:

• An inability to get an erection
• An inability to keep an erection for long enough to have intercourse

In some cases, ED is also associated with low sex drive ( low libido ).

Common Erectile Dysfunction Causes

ED is caused by either psychological or organic (physical) factors but is most often due to a combination of the two. Some common risk factors for ED include:

• Age (it’s estimated that by the time a man reaches his 40s, he has about a 40% chance of having some form of ED. This prevalence increases about 10% for each additional decade) [2] Ferrini MG, Gonzalez-Cadavid NF, Rajfer J. Aging related erectile dysfunction-potential mechanism to halt or delay its onset . Transl Androl Urol. 2017;6(1):20-27.
• High blood pressure 
• High cholesterol
• Cardiovascular disease
• Lack of exercise
• Major pelvic surgery
• Degenerative disorders (such as multiple sclerosis and Parkinson’s disease )
• Spinal cord trauma
• Central nervous system tumors
• Certain medications

People experiencing ED who don’t want to try prescription medication just yet have several alternative options. ED can often be successfully treated by making certain lifestyle changes, says David Samadi, M.D., a prostate cancer surgeon and urologist in New York.

According to Dr. Samadi, some of the most effective natural treatments and remedies for ED include:

• Losing weight
• Quitting smoking
• Reducing alcohol consumption
• Ceasing illegal drug use
• Exercising regularly
• Reducing stress

Lose Weight

A 2022 meta-analysis in Andrologi a combined the results of five studies including a total of 619 participants to investigate the effects of weight loss on ED. The analysis found that weight loss could improve erectile function symptoms in men with overweight and obesity [3] Li H, Xu W, Wang T, Wang S, Liu J, Jiang H. Effect of weight loss on erectile function in men with overweight or obesity: A meta-analysis of randomised controlled trials . Andrologia. 2022;54(1):e14250. .

While losing weight can be challenging, a registered dietitian nutritionist or obesity medicine physician can provide valuable insight into a person’s eating habits and help them make sustainable changes.

Quit Smoking

According to a 2023 review in Sexual Medicine Reviews , cigarette smoking is heavily associated with ED. The review found the more a person smoked, the more likely they were to experience ED. Cigarette smoke contains several harmful compounds, including nicotine, carbon monoxide and heavy metals, that can damage the inner layer of blood vessels and disrupt the erection process. Furthermore, the review found smoking cessation programs to be effective treatments for ED in active smokers [4] Allen MS, Tostes RC. Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation . Sexual Medicine Reviews. 2023;11(1):61-73. .

There are many resources available online to help kick the cigarette habit, including these expert-backed tips .

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Cut Back on Alcohol

A 2020 study in the Scandinavian Journal of Primary Health Care found a significant association between alcohol consumption and reported ED. The population-based study, which observed 22,198 Danish men, found that compared to men with an weekly alcohol intake of one to seven units, men who consumed no alcohol and men who consumed at least eight units of alcohol weekly had significantly higher odds of reporting ED [5] Paulsen LH, Sørensen Bakke L, Jarbøl DE, Balasubramaniam K, Hansen DG. Associations between lifestyle, erectile dysfunction and healthcare seeking: a population-based study . Scand J Prim Health Care. 2020;38(2):176-183. . It’s unclear why complete alcohol abstinence was associated with a higher incidence of ED in this study. Another study published in 2022 in The Journal of Sexual Medicine found that of the 104 men with alcohol use disorder studied, 88.5% showed improvements in ED after three months of abstinence from alcohol. Overall, it appears that drinking less alcohol is associated with a decreased risk of ED [6] Karunakaran A, Michael JP. The Impact of Abstinence From Alcohol on Erectile Dysfunction: A Prospective Follow up in Patients With Alcohol Use Disorder . J Sex Med. 2022;19(4):581-589. .

Avoid Illegal Drugs

A 2019 review in the Journal of Psychosexual Health found ED to be correlated with illicit drug use. Opioids, cocaine, amphetamine and MDMA in particular may all lead to ED with long-term use. Chronic opioid use is associated with changes in hormones, leading to decreased testosterone and reduced sex hormone production by the adrenal glands. This is associated with reduced sexual desire, erectile dysfunction and infertility. With cocaine, prolonged use decreases sexual desire and causes erectile dysfunction and delayed orgasm/ejaculation. This effect appears to be worse when cocaine is used alongside other psychoactive substances, including alcohol [7] Ghadigaonkar DS, Murthy P. Sexual Dysfunction in Persons With Substance Use Disorders . J Psychosexual Health. 2019;1(2):117-121. .

For people who want help with a substance use disorder, drug and alcohol addiction hotlines can be a valuable resource.

Exercise Regularly

A 2016 systematic review and meta-analysis in the British Journal of Sports Medicine found that physical activity and exercise interventions improved patient-reported ED by 3.85 points on the scale the study used to measure ED. The review, which assessed the combined results of seven studies including 478 participants, also found that moderate-to-vigorous intensity aerobic exercise specifically proved best in its ability to alleviate ED symptoms. The study authors hypothesized that this was due to the cardiovascular effects of aerobic activity. They noted that aerobic exercises have been shown to increase cardiac output, decrease oxidative stress and increase the availability of nitric oxide , which is needed to get and maintain an erection [8] Silva AB, Sousa N, Azevedo LF, Martins C. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis . Br J Sports Med. 2017;51(19):1419-1424. .

Reduce Stress

Chronic stress may worsen ED symptoms because stress and anxiety affect how the brain sends signals about your body’s responses.

In a small 2014 study in Andrologia , researchers investigated the effects of an eight-week stress management program on 31 men between the ages of 20 and 55 with ED. They found that the stress management program was just as effective as tadalafil (a common prescription medication used to treat ED) in reducing ED symptoms. While larger trials with longer follow-up times are needed, the results of this study successfully indicate that stress management can play a key role in ED [9] Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C. Stress management and erectile dysfunction: a pilot comparative study . Andrologia. 2014;46(6):698-702. .

While there are many effective natural treatments and remedies for ED, not all of them are safe, explains Dr. Samadi. “The FDA warns men not to purchase or use medications from unapproved and/or unlicensed sources that may be dangerous,” he says. Avoid anything sold on the internet or via television ad, or products that over-promise to fix ED without FDA approval, he says.

Unapproved medications are dangerous for several reasons, including the possibility of counterfeit ingredients, contamination, improper storage and transportation, or inefficacy, says Dr. Samadi.

Many herbal supplements are also concerning, according to Dr. Samadi. “If a man wants to use an herbal supplement for treating ED, he’s taking a chance that there could be unpleasant side effects, and its efficacy may not be as successful as a prescribed ED medication,” he says. Anyone interested in taking herbal supplements for ED should consult with their health care provider prior to doing so, says Dr. Samadi.

Men may be hesitant to discuss ED with their doctor, as this area of men’s health is often ignored, says Dr. Samadi. However, anyone experiencing symptoms for at least a couple of weeks should speak with a doctor, he explains. Beyond more obvious symptoms, ED can be a predictor of serious chronic health conditions, such as type 2 diabetes, cardiovascular disease, gum disease or osteoporosis .

Men experiencing any of the following symptoms for more than a couple of weeks should see a health care provider or urologist, says Dr. Samadi:

• Trouble getting an erection when desired
• Having an erection too soft for intercourse
• Difficulty maintaining an erection long enough for satisfactory sexual performance

Questions to Ask Your Doctor

Dr. Samadi recommends asking the following questions during an appointment with a health care provider:

• What is the underlying cause of my ED?
• What treatment option is best for me?
• When can I expect to regain normal erectile function?

ED is incredibly common, but that doesn’t mean it should be ignored. It can be a predictor of several serious chronic health conditions, so don’t hesitate to seek treatment or speak with a qualified health care professional about it.

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• Ren Y, Yuan J, Xue Y, et al. Advanced hydrogels: New expectation for the repair of organic erectile dysfunction. Mater Today Bio. 2023;20:19:100588.
• Ferrini MG, Gonzalez-Cadavid NF, Rajfer J. Aging related erectile dysfunction-potential mechanism to halt or delay its onset. Transl Androl Urol. 2017;6(1):20-27.
• Li H, Xu W, Wang T, Wang S, Liu J, Jiang H. Effect of weight loss on erectile function in men with overweight or obesity: A meta-analysis of randomised controlled trials. Andrologia. 2022;54(1):e14250.
• Allen MS, Tostes RC. Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation. Sexual Medicine Reviews. 2023;11(1):61-73.
• Paulsen LH, Sørensen Bakke L, Jarbøl DE, Balasubramaniam K, Hansen DG. Associations between lifestyle, erectile dysfunction and healthcare seeking: a population-based study. Scand J Prim Health Care. 2020;38(2):176-183.
• Karunakaran A, Michael JP. The Impact of Abstinence From Alcohol on Erectile Dysfunction: A Prospective Follow up in Patients With Alcohol Use Disorder. J Sex Med. 2022;19(4):581-589.
• Ghadigaonkar DS, Murthy P. Sexual Dysfunction in Persons With Substance Use Disorders. J Psychosexual Health. 2019;1(2):117-121.
• Silva AB, Sousa N, Azevedo LF, Martins C. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. Br J Sports Med. 2017;51(19):1419-1424.
• Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C. Stress management and erectile dysfunction: a pilot comparative study. Andrologia. 2014;46(6):698-702.
• Erectile dysfunction (impotence). NHS. Accessed 3/23/2023.
• Management of Erectile Dysfunction. European Association of Urologists. Accessed 3/23/2023.
• Can Stress Cause Erectile Dysfunction?. Golden State Urology. Accessed 4/17/2023..
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Sarah is a registered dietitian and freelance writer passionate about connecting people to information that will help them improve their mental and physical health. She’s a big believer that food is more than just nutrients and acknowledges the power that food can have to heal and build community. Prior to becoming a freelance writer, Sarah provided patient care in many clinical areas, including weight management, diabetes, kidney disease, oncology, gastrointestinal disorders, and intuitive eating. When she isn’t writing, you can find Sarah with her nose in a fantasy or sci-fi book or crocheting in the company of her husband and two cats, Barney and Mochi.

Dr. Myles Spar is a double board-certified medical expert in personalized and performance medicine, men’s health, advanced testing and integrative medicine. He’s also an author, teacher, clinician and researcher. As a specialist in integrative men’s health, Dr. Spar has advised NBA players, celebrities and executives on maximizing performance through optimizing health. He has contributed articles to the L.A. Times and Men’s Journal and has appeared on multiple national media outlets, and he serves as a clinical faculty member of the University of Arizona School of Medicine. Dr. Spar is also the chair of the American Board of Integrative Medicine and a veteran of Doctors Without Borders—both as a field worker and board member. He practices medicine in person in New York City and virtually across the U.S.

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• Erectile dysfunction FAQs

Urologist Tobias Kohler, M.D., answers the most frequently asked questions about erectile dysfunction.

Hi. I'm Dr. Kohler, a urologist at Mayo Clinic. I'm here to answer some of the important questions you may have about erectile dysfunction.

Problems with erectile dysfunction are super common. If you look at the decade of life, that predicts what percent of men will have problems. So, for example, 50% of 50-year-olds, 60% of 60-year-olds, so on and so forth, will have problems with erections. But that does not necessarily mean that as you get older, you have to have problems of the penis. There are plenty of men in their 60s, 70s and 80s and 90s with great sex lives. In other words, if you take great care your penis, your penis will take great care of you.

So the things that you can do to take care of yourself to help with erections include exercising, eating well, including a diet high in fruits and vegetables, having a slimmer waistline, sleeping well, quitting smoking. A lot of these things I mentioned are as powerful as medications in helping with erections and improving your sex life.

The penis and overall health is so strongly connected, it's really important to remember that the penis is one of the most powerful predictors we have, especially in young men, for heart attacks. The blood vessels that feed the penis are relatively small. Blood vessels in the heart and the neck are a little bit bigger. So therefore, the penis can predict heart attacks or strokes years in advance when they may occur.

Yes and no. So when we talk about what truly is a problem with erectile dysfunction, the definition is a problem that lasts greater than three months and is a consistent inability to obtain or maintain an erection adequate for intercourse. So when young men get problems with erections, which is very, very common because it's normal to have bad nights here and there. And so, if it happens occasionally, you don't need to be as worried about that. But if you have consistent problems, you absolutely should and must get checked out by a doctor to figure out what's going on, not only because there are great treatments available, but because we may discover underlying medical problems.

When young men have problems with erections, most of the time it's a confidence issue. And so, there are different ways to deal with that. One way is to give medications to get the confidence back. Another way is to use specialists trained in behavioral techniques to get confidence back, so sexual counselors or therapists can really help with this problem.

Modern day, we have several new, exciting, experimental things, such as shockwave therapy of the penis or platelet-rich plasma or stem cell therapy. These are not ready for prime time, and so you should not, as a patient, have to spend your hard-earned money to see whether or not this works for you. It's better to be part of a clinical trial to see if that works or to go with more traditional therapies at this point.

If you want to be a great partner for your medical team to help solve problems with erections, the number one thing you can do is book an appointment. Just like anything else in life, you have to take the initiative, set up an appointment for your physician, say, "Doc, I have a problem with sex." Never hesitate to ask your medical team any questions or concerns you have. Being informed makes all the difference. Thanks for your time and we wish you well.

For many people, a physical exam and answering questions (medical history) are all that's needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

• Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
• Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
• Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.

Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.

This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.

• Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.
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Erectile dysfunction care at Mayo Clinic

The first thing your doctor will do is to make sure you're getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner's preferences also might play a role in your treatment choices.

Oral medications

Oral medications are a successful erectile dysfunction treatment for many men. They include:

• Sildenafil (Viagra)
• Tadalafil (Adcirca, Cialis)
• Vardenafil (Levitra, Staxyn)
• Avanafil (Stendra)

All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing normal penile function in some people. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in people who get normal erections.

The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.

Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in everyone and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

• Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Isordil, Bidil)
• Have heart disease or heart failure
• Have very low blood pressure (hypotension)

Other medications

Other medications for erectile dysfunction include:

Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).

Each injection is dosed to create an erection lasting no longer than an hour. Because the needle used is very fine, pain from the injection site is usually minor.

Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.

Alprostadil urethral suppository. Alprostadil (Muse) intraurethral therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra.

The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include a burning feeling in the penis, minor bleeding in the urethra and formation of fibrous tissue inside your penis.

• Testosterone replacement. Some people have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.

Penis pumps, surgery and implants

Battery-powered penis pump for erectile dysfunction

A penis pump is used to draw blood into the penis to create an erection. You then place a rubber ring around the base of the penis to maintain the erection.

If medications aren't effective or appropriate in your case, your doctor might recommend a different treatment. Other treatments include:

Penis pumps. A penis pump (vacuum erection device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis.

Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device.

The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse. Bruising of the penis is a possible side effect, and ejaculation will be restricted by the band. Your penis might feel cold to the touch.

If a penis pump is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it's made by a reputable manufacturer.

Penile implants. This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable.

Penile implants are usually not recommended until other methods have been tried first. Implants have a high degree of satisfaction among those who have tried and failed more-conservative therapies. As with any surgery, there's a risk of complications, such as infection. Penile implant surgery is not recommended if you currently have a urinary tract infection.

Recent studies have found that exercise, especially moderate to vigorous aerobic activity, can improve erectile dysfunction.

Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. Increasing your level of activity might also further reduce your risk.

Discuss an exercise plan with your doctor.

Psychological counseling

If your erectile dysfunction is caused by stress, anxiety or depression — or the condition is creating stress and relationship tension — your doctor might suggest that you, or you and your partner, visit a psychologist or counselor.

• Erectile dysfunction and diabetes
• Erectile dysfunction medications
• Erectile dysfunction: Nonoral treatments
• Acupuncture
• Penile implants

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Lifestyle and home remedies

For many people, erectile dysfunction is caused or worsened by lifestyle choices. Here are some steps that might help:

• If you smoke, quit. If you have trouble quitting, get help. Try nicotine replacement, such as over-the-counter gum or lozenges, or ask your doctor about a prescription medication that can help you quit.
• Lose excess pounds. Being overweight can cause — or worsen — erectile dysfunction.
• Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
• Get treatment for alcohol or drug problems. Drinking too much or taking certain illegal drugs can worsen erectile dysfunction directly or by causing long-term health problems.
• Work through relationship issues. Consider couples counseling if you're having trouble improving communication with your partner or working through problems on your own.

Alternative medicine

Before using any supplement, check with your doctor to make sure it's safe for you — especially if you have chronic health conditions. Some alternative products that claim to work for erectile dysfunction can be dangerous.

The Food and Drug Administration (FDA) has issued warnings about several types of "herbal viagra" because they contain potentially harmful drugs not listed on the label. The dosages might also be unknown, or they might have been contaminated during formulation.

Some of these drugs can interact with prescription drugs and cause dangerously low blood pressure. These products are especially dangerous for anyone who takes nitrates.

• Erectile dysfunction dietary supplements

Coping and support

Whether the cause is physical, psychological or a combination of both, erectile dysfunction can become a source of mental and emotional stress for you and your partner. Here are some steps you can take:

• Don't assume you have a long-term problem. Don't view occasional erection problems as a reflection on your health or masculinity, and don't automatically expect to have erection trouble again during your next sexual encounter. This can cause anxiety, which might make erectile dysfunction worse.
• Involve your sexual partner. Your partner might see your inability to have an erection as a sign of diminished sexual interest. Your reassurance that this isn't the case can help. Communicate openly and honestly about your condition. Treatment can be more successful for you when you involve your partner.
• Don't ignore stress, anxiety or other mental health concerns. Talk to your doctor or consult a mental health provider to address these issues.

Preparing for your appointment

You're likely to start by seeing your family doctor. Depending on your particular health concerns, you might go directly to a specialist — such as a doctor who specializes in male genital problems (urologist) or a doctor who specializes in the hormonal systems (endocrinologist).

Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready and know what to expect from your doctor.

What you can do

Take these steps to prepare for your appointment:

• Ask what you need to do ahead of time. When you make the appointment, be sure to ask if there's anything you need to do in advance. For example, your doctor might ask you not to eat before having a blood test.
• Write down any symptoms you've had, including any that might seem unrelated to erectile dysfunction.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins, herbal remedies and supplements you take.
• Take your partner along, if possible. Your partner can help you remember something that you missed or forgot during the appointment.
• Write down questions to ask your doctor.

For erectile dysfunction, some basic questions to ask your doctor include:

• What's the most likely cause of my erection problems?
• What are other possible causes?
• What kinds of tests do I need?
• Is my erectile dysfunction most likely temporary or chronic?
• What's the best treatment?
• What are the alternatives to the primary approach that you're suggesting?
• How can I best manage other health conditions with my erectile dysfunction?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will that cost, and will the visit be covered by my insurance?
• If medication is prescribed, is there a generic alternative?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

In addition to your prepared questions, don't hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Be prepared for questions such as these:

• What other health concerns or chronic conditions do you have?
• Have you had any other sexual problems?
• Have you had any changes in sexual desire?
• Do you get erections during masturbation, with a partner or while you sleep?
• Are there any problems in your relationship with your sexual partner?
• Does your partner have any sexual problems?
• Are you anxious, depressed or under stress?
• Have you ever been diagnosed with a mental health condition? If so, do you currently take any medications or get psychological counseling (psychotherapy) for it?
• When did you first begin noticing sexual problems?
• Do your erectile problems occur only sometimes, often or all of the time?
• What medications do you take, including any herbal remedies or supplements?
• Do you drink alcohol? If so, how much?
• Do you use any illegal drugs?
• What, if anything, seems to improve your symptoms?
• What, if anything, seems to worsen your symptoms?

Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started.

• AskMayoExpert. Erectile dysfunction (adult). Mayo Clinic; 2019.
• What is erectile dysfunction? Urology Care Foundation. https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction. Accessed Nov. 3, 2019.
• Cunningham GR, et al. Overview of male sexual dysfunction. https://www.uptodate.com/contents/search. Accessed Nov. 3, 2019.
• Erectile dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/all-content. Accessed Nov. 3, 2019.
• Sidawy AN, et al., eds. Erectile dysfunction. In: Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Oct. 16, 2019.
• Parkinson's and sex. American Parkinson Disease Association. https://www.apdaparkinson.org/what-is-parkinsons/symptoms/sexual-effects/. Accessed Nov. 3, 2019.
• Rew KT, et al. Erectile dysfunction. American Family Physician. 2016; https://www.aafp.org/afp/2016/1115/p820.html. Accessed Oct. 16, 2019.
• Hidden risks of erectile dysfunction "treatments" sold online. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/hidden-risks-erectile-dysfunction-treatments-sold-online. Accessed Nov. 3, 2019.
• Burnett AL, et al. Erectile dysfunction: AUA guideline. The Journal of Urology. 2018; doi:10.1016/j.juro.2018.05.004.
• Wecker L, et al., eds. Drug therapy for myocardial ischemia and angina pectoris. In: Brody's Human Pharmacology: Mechanism-Based Therapeutics. 6th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Oct. 16, 2019.
• Ferri FF. Erectile dysfunction. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 3, 2019.
• Jensen NA. Allscripts EPSi. Mayo Clinic. Nov. 1, 2021.
• Silva AB, et al. Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. British Journal of Sports Medicine. 2017; doi:10.1136/bjsports- 2016-096418 .
• Allen MS. Physical activity as an adjunct treatment for erectile dysfunction. Nature Reviews Urology. 2019; doi:10.1038/s41585-019-0210-6.
• Erectile dysfunction: A sign of heart disease?
• Flaccid and erect penis
• What is erectile dysfunction? A Mayo Clinic expert explains

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Lifestyle Changes and Treatments for Managing Erectile Dysfunction

Men out there: if you have erectile dysfunction or ED, there's probably one thing on your mind – how to treat it.

Download the MP3 audio file (MP3, 1.91 MB)

Men out there: if you have erectile dysfunction or ED, there's probably one thing on your mind — how to treat it.

Hi, I’m Dr. Griffin Rodgers, Director of the National Institute of Diabetes, Digestive and Kidney Diseases at NIH.

While medical conditions such as diabetes, kidney disease, and heart disease can cause ED, making healthy lifestyle changes may help you regain sexual function. You should quit smoking, drink less alcohol, increase physical activity, and lose weight.

Your doctor may also recommend treatments for ED, such as medications or devices to increase blood flow, counseling to help reduce stress, or surgery to reconstruct arteries or to implant a device.

To learn more about ED and other urinary conditions affecting men, follow us @NIDDKgov . This is Dr. Griffin Rodgers.

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• Treatment for Erectile Dysfunction