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Erectile dysfunction (impotence)

• is the inability to get and keep an erection firm enough for sex.

• The first thing you will do exame generale for diagonstic the cause 
• getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.
• Oral medications are a successful erectile dysfunction treatment for many men. They include:

1. Sildenafil (Viagra)
2. Tadalafil (Adcirca, Cialis)
3. Testosterone replacement. Some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone.
4. Alprostadil urethral suppository. 

• If you smoke, quit it .
• Lose excess pounds.
• physical activity in your daily routine. 
• Get treatment for alcohol or drug 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
• Psychological counseling If your erectile dysfunction is caused by stress, anxiety or depression

1. Heart disease
2. Clogged blood vessels (atherosclerosis)
3. High cholesterol
4. High blood pressure
5. Diabetes
6. Obesity
7. Certain prescription medications
8. Tobacco use
9. Peyronie's disease — development of scar tissue inside the penis
10. Alcoholism and other forms of substance abuse
11. Sleep disorders
12. Treatments for prostate cancer or enlarged prostate
13. Surgeries or injuries that affect the pelvic area or spinal cord
14. Psychological causes Depression, anxiety

• 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.