How Common Is Erectile Dysfunction?

How Common Is Erectile Dysfunction?

By Katie Wilkinson, MPH, MCHES

Published on September 28, 2021
Medically reviewed by Matthew Wosnitzer, MD

This article is a repost which originally appeared on verywell health

Edited for content.

Erectile dysfunction (ED), or impotence, is the inability to achieve and maintain an erection for sexual activity. While the occasional failure to get an erection is not uncommon, if it happens consistently, or more than 50% of the time, it may be ED. It can be a temporary experience, or develop into a long-term condition that requires treatment.

Prevalence

On a global scale, ED affects 3% to 76.5% of all men. The wide range is due to the different measures used in studies to evaluate ED.

In the United States, it’s estimated that 30 million men experience ED.2 Worldwide, there are about 150 million men living with ED, and by the year 2025, it’s predicted that over 300 million men will have ED.

Common Causes

ED can be caused by a number of factors relating to physical and mental health, including:

  • Physical and health conditions that involve different systems in the body, such as the vascular, neurological, or endocrine systems; can include issues with nerve signals or blood flow to the penis
  • Side effects from medication, which can include antidepressants, medication to manage blood pressure, tranquilizers, sedatives, ulcer medication, and prostate cancer therapy
  • Psychological or emotional causes such as depression, anxiety, fear associated with sexual performance, general stress, or low self-esteem
  • Lifestyle behaviors and health-related factors that are associated with ED include smoking, being overweight, lack of exercise, and substance (alcohol or drug) use

Risk Factors

Certain risk factors have been found to increase the likelihood of experiencing ED. They can include:

    • Age: The chances of developing ED increases with age, particularly in men over 60 years old.
    • Tobacco use: Research has found that smokers are 1.5 times more likely to experience ED than nonsmokers.
    • High blood pressure (hypertension): About 30% to 50% of people living with hypertension also experience ED.
    • Type 2 diabetes: Between 35% and 90% of diabetic men will develop ED.
    • High cholesterol: Statins used to treat high cholesterol showed improved erectile function.
    • Hypogonadism: This is a condition where the body doesn’t produce enough sex hormones, including testosterone. Since testosterone is necessary for the ability to maintain an erection, people with hypogonadism who are treated with testosterone replacement therapy can see improved erectile function.
    • Obesity: Several studies have indicated that men with a body mass index (BMI) greater than 25 begin to experience a 1.5 to three times greater risk of ED than those with lower BMIs.
    • Depression: Men living with depression are two times more likely to experience ED. Treating depression with selective serotonin uptake inhibitors (SSRIs) can also increase risk of ED.

Stress and anxiety, particularly performance-related anxiety, can also cause issues with sexual activity and erectile function.

Associated Conditions

In addition to diabetes, hypertension, and hypogonadism, the National Institute for Diabetes and Digestive and Kidney Diseases also lists the following conditions and diseases as associated with ED:

  • Heart and blood vessel conditions, including atherosclerosis
  • Injuries of the spinal cord, penis, prostate gland, bladder, or pelvic area
  • Prostate or bladder surgery
  • Chronic kidney disease
  • Multiple sclerosis
  • Peyronie’s disease, a condition where scar tissue develops and creates a bend in the penis

Treatment

Treatment for ED can take many forms and depends on the root cause of the individual’s ED. Because of ED’s impact on sexual relationships, it’s worth discussing treatment options with your sexual partner.

Lifestyle

Avoiding or stopping the use of tobacco, alcohol, and other drugs may help with ED.

Increasing physical activity and maintaining a healthy weight can also be a way to improve erectile function.

Mental Health Counseling

Because emotional and psychological concerns can play a role in ED, speaking with a mental health professional can be beneficial. They can help identify ways to manage anxiety and work through stress that may be impacting sexual performance.

Medication

Oral (PDE5 inhibitors), injectable, or suppository medications can be prescribed to help achieve and maintain an erection. For those with low testosterone (hypogonadism), testosterone replacement therapy may be prescribed.

Treatment may also involve adjusting or changing current medications that hinder the ability to get an erection.

Devices and Procedures

The following devices and procedures can be used to treat ED:

  • Penis pump: This device uses vacuum action to pull blood into the penis to create an erection. It has a tube where the penis is placed and a pump that draws air out of the tube and creates suction. Once the blood is pulled into the penis, an elastic band is placed at the base of the penis to prevent the blood from going back into the body and to keep the erection for about 30 minutes.
  • Arterial repair surgery: Procedures to repair clogged blood vessels in the penis may increase blood flow to allow for erections. This treatment is usually reserved for patients under the age of 30.
  • Implantable devices: These include surgically placed devices that either inflate or include semi-rigid rods to help a person achieve an erection.

A Word From Verywell

While many men might feel embarrassed by their erectile dysfunction, it should be a comfort to know that it is a very common condition, affecting at least 150 million men worldwide. It is also a very treatable condition.

Talk to your healthcare provider if you experience issues achieving and maintaining an erection. Even though it may be uncomfortable to talk about, proper sexual functioning is a key part of your overall health and well-being.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Erectile dysfunction. Updated October 14, 2019.
  2. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts for erectile dysfunction. Updated July 2017.
  3. Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU International. 2019;124(4):587-599. doi:10.1111/bju.14813
  4. Kalsi J, Muneer A. Erectile dysfunction – an update of current practice and future strategies. J Clinic Urol. 2013;6(4):210-219. doi:10.1177/2051415813491862
  5. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of erectile dysfunction. Updated July 2017.
  6. DeLay KJ, Haney N, Hellstrom WJ. Modifying risk factors in the management of erectile dysfunction: a review. World J Mens Health. 2016;34(2):89-100. doi:10.5534/wjmh.2016.34.2.89
  7. Mourikis I, Antoniou M, Matsouka E, et al. Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation. Ann Gen Psychiatry. 2015;14(1):34. doi:10.1186/s12991-015-0074-y
  8. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for erectile dysfunction. Updated July 2017.
  9. Urology Care Foundation. What is erectile dysfunction? Updated June 2018.
  10. Nguyen HM, Gabrielson AT, Hellstrom WJG. Erectile dysfunction in young men—a review of the prevalence and risk factors. Sexual Medicine Reviews. 2017;5(4):508-520. doi:10.1016/j.sxmr.2017.05.004
  11. International Society for Sexual Medicine. Can a vasectomy cause erectile dysfunction (ED)?
  12. Ssentongo AE, Kwon EG, Zhou S, Ssentongo P, Soybel DI. Pain and dysfunction with sexual activity after inguinal hernia repair: systematic review and meta-analysis. J Am Coll Surg. 2020;230(2). doi:10.1016/j.jamcollsurg.2019.10.010

Two Phase Approach To Eliminating Fear/Hesitation And Developing Efficiency

Two Phase Approach To Eliminating Fear/Hesitation And Developing Efficiency

A Jimmy Bond article

A good amount of credit goes to Al for this article. He worked with me on putting this together.

* * *

There are two very powerful methods to help master fears. These methods are desensitization and counterconditioning.

Desensitization deals with the negative phase where the main goal is to reduce anxiety. During this phase, exposure is attempted. This is where to you attempt to approach the scenario of your anxieties in a progressive manner.

Here’s a good example of this at work: If you have performance anxiety for certain sexual acts (for example: penetration) you would engage in nonthreatening foreplay activities only for the time being. As you get more comfortable and allow your libido to build to the point to where it begins to effectively counteract potential anxieties, then attempts are made to engage in activities which have previously caused anxiety.

It’s important during this phase to work with a trusted partner so you have confidence with the process.

An effective tactic to use when you begin to feel anxiety is to reroute your mind to focus on your breathing. This will allow you to center yourself emotionally. A great exercise which incorporates this is the Emotional Visualizations movement.

Counterconditioning deals with the positive phase where the goal is maximizing efficiency. For this phase, more challenging movements/activities are undertaking to increase sexual ability. These include targets of greater hardness, stamina and ejaculatory control. At this stage, Emotional Visualizations are used only as needed (for when you feel distracted or begin to get pangs of anxiety).

The focus of this phase should be on deepening the level of emotional comfort to the point to where you become completely uninhibited and are able to fully enjoy the experience with all of your senses. This also allows a deep connection with your sexual partner, resulting in a much more intense experience.

The essence of how both of these phases are done can apply for a lot of life’s activities where you might feel inhibited due to anxiety.

Fear Is Not The Enemy

Fear Is Not The Enemy

Very often I read about how fear is a negative emotion. Many take that the wrong way and think it means fear is “bad” or “evil”. Fear is actually a very useful and powerfully motivating emotion. It resides on the negative polarity scale of emotions, but this doesn’t mean it’s wrong or evil in itself. In the proper context, fear will save your life or give you the added adrenaline to escape a dangerous situation or deal with it more effectively. This is also known as the fight or flight response.

Problems happen when fear takes over and panic is allowed to set in. Allowing yourself to suffer at the whims of your emotions can cause a freeze instead of effective fight or flight. This applies to situations where fear is unwarranted or unwanted, like sexual performance anxiety. Left unchecked, it can drag you down and make you ineffective at many things. It also allows you permission to admit and even encourage weakness in yourself. This can be a bad thing if you allow it to fester and cause you to give up or give in, instead of transcending it.

Learning to control and eventually master your fears is a difficult but very rewarding thing to do. Instead of looking at fear as your enemy, look at it like a powerful servant. Use it to motivate you on to higher goals physical, mental and emotional. Learn to recognize it in others or even in writing to be of assistance or to prevent misinformation.

There are plenty of resources on PEGym on how to deal with fear, like Emotional Visualizations. If your fears are out of your ability to manage on your own then professional help would be needed. Don’t be afraid to ask for this help if you need it!