Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex. Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

In many cases, erectile dysfunction is caused by something physical. Common causes include:

• Heart disease.
• Clogged blood vessels (atherosclerosis)
• High cholesterol
• Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
• Parkinson's disease
• High blood pressure
• Diabetes

Erectile dysfunction symptoms might include persistent:

• Trouble getting an erection
• Trouble keeping an erection.
• Reduced sexual desire