Inability to attain an erection of the penis; also called impotence or erectile dysfunction.

The primary cause is vascular. Other causes of the condition include: hormonal disorders, psychogenic factors, neurologic problems, drug use, and fibrotic cavernous sheath (see Analogous Code: 7599-7522 Peyronie's disease). The condition may also occur following prostate surgery.

The major manifestation is inability to attain or maintain an erection. The signs and symptoms of underlying diseases which affect erectile function can be found in related conditions involving peripheral vascular disease. (See Diagnostic Code: 7913 Diabetes mellitus and Analogous Code: 7599-7522 Peyronie's disease.)

In order to determine whether the cause is physical or psychological, a nocturnal penile tumescence test (NPT) is done. Laboratory assessment of glucose level, testosterone, thyroid function, and prolactin levels are needed. Examination should include a history of alcohol use, drug use, smoking, and a search for neurologic, vascular, and hormone disorders is essential.

Treatment of underlying physical disorders is indicated. The options available to bring about an erection are injection therapy, oral medication, and/or penile prostheses implanted surgically. Counseling and behavioral therapy are helpful.

Erectile dysfunction is not hopeless and can be corrected.

• If a prosthetic implant restores erectile and ejaculatory powers, terminate SMC under 38 CFR 3.105 [Revision of decisions] and 38 CFR 3.105(e) [Reduction in evaluation -compensation]. 

• The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date.  38 CFR 3.951(a)

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.

• For the purpose of VA disability evaluation, a disease or traumatic injury of the penis resulting in scarring or deformity shall be rated under diagnostic code 7522.