Erectile dysfunction or ED, is the most common sex problem that men report to their doctor. It affects as many as 30 million men.

ED is defined as trouble getting or keeping an erection that’s firm enough for sex.

Though it’s not rare for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated.

ED can happen:

• Most often when blood flow in the penis is limited or nerves are harmed 
• With stress or emotional reasons
• As an early warning of a more serious illness, like: atherosclerosis (hardening or blocked arteries), heart disease, high blood pressure or high blood sugar from Diabetes 

Finding the cause(s) of your ED will help treat the problem and help with your overall well-being. As a rule, what’s good for your heart health is good for your sex health.

Erectile Dysfunction Causes

ED can result from health problems, emotional issues, or from both. Some known risk factors are:

• Being over age 50 but this can happen to younger men as well
• Having high blood sugar (Diabetes)
• Having high blood pressure 
• Having cardiovascular disease
• Having high cholesterol
• Smoking
• Using drugs or drinking too much alcohol
• Being obese
• Lacking exercise

Even though ED becomes more common as men age, growing old is not always going to cause ED. Some men stay sexually functional into their 80s. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.

Physical Causes of Erectile Dysfunction

ED happens when:

• There is not enough blood flows into the penis
  Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (Diabetes) and smoking.
• The penis cannot trap blood during an erection
  If blood does not stay in the penis, a man cannot keep an erection. This issue can happen at any age.
• Nerve signals from the brain or spinal cord do not reach the penis
  Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis.
• Diabetes can cause small vessel disease or nerve damage to the penis
• Cancer treatments near the pelvis can affect the penis’ functionality
  Surgery and or radiation for cancers in the lower abdomen or pelvis can cause ED. Treating prostate, colon-rectal or bladder cancer often leaves men with ED. Cancer survivors should see a Urologist for sexual health concerns.
• Drugs used to treat other health problems can negatively impact erections
  Patients should talk about drug side effects with their primary care doctors.

Emotional Causes of Erectile Dysfunction

Normal sex needs the mind and body working together. Emotional or relationship problems can cause or worsen ED.

Some emotional issues that can cause ED are:

• Depression
• Anxiety
• Relationship conflicts
• Stress at home or work
• Stress from social, cultural or religious conflicts
• Worry about sex performance 

Erectile Dysfunction Treatment

Non-invasive treatments are often tried first. Most of the best-known treatments for ED work well and are safe. Still, it helps to ask your health care provider about side effects that could result from each option:

• Oral drugs or pills known as phosphodiesterase type-5 inhibitors are most often prescribed for ED (Viagra, Cialis)
• Testosterone Therapy (when low testosterone is detected in blood testing)
• Penile Injections
• Intraurethral medication
• Vacuum Erection Devices also known as penis pumps
• Penile Implants
• Penis rings
• Surgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma. Penile vascular surgery is not recommended for older men with hardened arteries.