What Is Erectile Dysfunction (ED) and What Causes It?

Erectile dysfunction (ED) means having trouble getting or keeping an erection that is firm enough for satisfying sexual activity. ED is very common, especially as men get older, but it can affect men at any age. It can have a big impact on quality of life and relationships.[1][2][3][4]
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​What Causes ED?
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ED can be caused by a mix of physical and psychological factors. Some of the most common causes include:
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- Blood flow problems: Conditions that affect blood vessels, like high blood pressure, high cholesterol, and atherosclerosis (hardening of the arteries), can reduce blood flow to the penis.[5][1][2][3][4][6][7][8][9]
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- Nerve problems: Diabetes, multiple sclerosis, spinal cord injuries, and certain surgeries can damage the nerves needed for an erection.[1][2][3][8][9]
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- Hormone issues: Low testosterone or other hormone imbalances can play a role.[1][2][3][8][9]
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- Medications: Some medicines, such as those for depression, high blood pressure, or prostate problems, can cause or worsen ED.[2][3][4][8][9]
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- Psychological factors: Stress, anxiety, depression, and relationship problems can all contribute to ED.[1][2][3][4][6][7][9]
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- Lifestyle factors: Smoking, drinking too much alcohol, being overweight, and not getting enough exercise can increase the risk of ED.[5][1][2][3][4][6][7][8][10][9]
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​Who Is at Risk?
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Certain factors make ED more likely, including:
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- Age over 40
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- Diabetes or prediabetes
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- Heart disease or high blood pressure
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- High cholesterol
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- Obesity or being overweight
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- Smoking
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- Lack of physical activity
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- Depression or anxiety
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- Use of certain medications (like antidepressants or opioids)
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- Chronic kidney disease
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- History of pelvic surgery or radiation[1][2][3][4][8][9]
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ED can also be an early warning sign of other health problems, especially heart disease. That’s why it’s important to talk about ED with a healthcare provider.[5][2][3][8][9]
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​How Does Total Virility Approach ED?
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At Total Virility, the care team uses a comprehensive, evidence-based approach to help men with ED:
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- Thorough Evaluation: This includes a detailed medical and sexual history, physical exam, and lab tests (such as blood sugar, cholesterol, and testosterone levels) to find possible causes and related health issues.[5][1][2][3][7][8][9]
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- Lifestyle Support: Patients are encouraged to make healthy changes, such as quitting smoking, eating a balanced diet, exercising regularly, losing weight if needed, and limiting alcohol. These steps can improve both overall health and erectile function.[5][1][2][3][4][6][7][8][10][9]
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- Personalized Treatment: Depending on the cause, treatment may include:
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- Oral medications called phosphodiesterase type 5 inhibitors (PDE5 inhibitors), such as sildenafil (Viagra), tadalafil (Cialis), vardenafil, or avanafil. These are usually the first treatment tried and are effective for many men.[5][1][2][3][4][6][8][10][9]
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- Adjusting or changing medications that may be causing ED, if possible.[2][3][9]
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- Hormone therapy if low testosterone is found.[1][3][4][8][9]
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- Counseling or therapy for stress, anxiety, or relationship issues.[1][2][3][4][5][6][7][9]
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- Other options, such as vacuum devices, penile injections, or surgery, if first-line treatments are not effective.[1][2][3][10][9]
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The team at Total Virility works with each patient to find the best plan, focusing on restoring sexual health and improving quality of life. Partners are welcome to be involved in discussions and care decisions.[5][1][3][6][7][9]
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If you have questions or concerns about ED, please reach out to the care team. Early evaluation and treatment can make a big difference.
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