Erectile dysfunction or “ED” means trouble getting or keeping an erection firm enough for sex. It is common and treatable. Many men improve with simple steps and safe treatments.

Quick facts

• ED can be a sign of heart and blood vessel problems.

• Care usually starts with lifestyle changes and pills, and can move to other options if needed.

• We use shared decision‑making. You choose the option that fits your goals, with our guidance.

What causes ED?

ED can have many causes, like blood flow issues, nerve problems, hormone changes, stress, or side effects from medicines. Often, more than one factor is involved.

Is ED linked to my overall health?

Yes. ED can be a warning sign for heart disease, diabetes, high blood pressure, and other conditions. Treating these can help your erections and your health.

How we diagnose ED

At your visit, we will:

• Ask about your medical history, sexual health, and goals.

• Sometimes use short questionnaires to understand your symptoms and track progress.

Family doctors often start the first steps. Urologists get involved if first treatments don’t work or if you want other options.

First steps you can take

These healthy habits can improve erections and overall health:

• Be active most days.

• Quit smoking.

• Cut back on alcohol and cannabis.

• Eat well (follow Canada’s food guide) and work toward a healthy weight.

• Consider sexual counselling (alone or with your partner) to reduce stress and improve satisfaction.

Treatment choices

We’ll review options with you and your partner. Most men start with the least invasive choice.

1) Pills (PDE5 inhibitors)

Common brands include sildenafil, tadalafil, and vardenafil. They help blood flow to the penis when you are sexually stimulated. Many men do well with these medicines. Your clinician will show you how to take them and adjust the dose for best results.

Side effects may include headache, facial flushing, stomach upset, and a stuffy nose. Do not use these pills if you take nitroglycerin or any nitrate medicine for chest pain. Mixing them can cause a dangerous drop in blood pressure.

Pills are the first‑line treatment for most men with ED.

2) Vacuum erection device (VED)

A clear tube and a small pump pull blood into the penis. A ring at the base keeps the erection. The ring should be removed within 30 minutes. With teaching and practice, many men can get a firm erection. Possible effects: temporary numbness, mild pain, bruising, or a painful ejaculation. It has no absolute contraindications, so it can be a good choice if pills aren’t right for you.

3) Intraurethral alprostadil (MUSE®)

A tiny pellet is placed into the urethra (the urine channel). Some men prefer this because it does not involve a needle, but it may cause urethral discomfort.

4) Injection therapy (ICI)

You (or your partner) inject a small dose of medicine into the side of the penis before sex. It can be very effective when taught properly—many men get an erection firm enough for intercourse. We teach the technique, choose a safe starting dose, and may do an in‑office teaching session. Possible side effects include pain, bruising, scarring/curve, and priapism (a prolonged erection). If an erection will not go down, follow the plan we give you and seek emergency care if it stays firm.

5) Penile implant (prosthesis) surgery

If other options don’t meet your goals, a penile implant can restore reliable rigidity. There are two types: malleable (bendable) and inflatable (a hidden pump). Satisfaction rates are high, but all surgery has risks (infection, device problems over time). Some men notice the penis looks or feels shorter, and the penis head may stay softer. We will discuss benefits, risks, and what to expect after surgery.

Safety reminders

• Never mix ED pills with nitroglycerin or other nitrates for chest pain. Tell paramedics or ER staff if you have taken an ED pill.

• Priapism (erection >4 hours) is an emergency—go to the ER.

Getting ready for your visit

• Bring a list of your medications.

• Think about your goals (firmness, timing, frequency).

• Consider coming with your partner.

• Be ready to discuss lifestyle and mental well‑being—these matter. We will decide together on the best plan for you (shared decision‑making).

This page offers general information and does not replace medical advice. Please speak with your clinician for guidance that fits your health and needs.