Erectile Dysfunction: Causes, Symptoms, and Treatment Options

Erectile dysfunction is an increasingly common men’s health concern, especially among those in middle age.

After the age of 40, many men begin to experience challenges with maintaining an erection — a condition that can significantly impact their emotional well-being and intimate relationships.

Understanding erectile dysfunction and available treatment options is a crucial step toward maintaining both physical health and a fulfilling personal life.

What Is Erectile Dysfunction?

Erectile dysfunction (ED) is a sexual health condition in men where the penis is unable to achieve or maintain an erection firm enough for sexual intercourse. While it can occur at any age, ED is more commonly seen in middle-aged and older men.

What Causes Erectile Dysfunction? Who’s at Higher Risk?

Erectile dysfunction (ED) can be triggered by a wide range of factors, including:

• Psychological factors: Stress, anxiety, depression, and other mental health issues can significantly affect a man’s ability to maintain an erection. 
• Medical conditions: Chronic illnesses such as diabetes, high blood pressure, high cholesterol, and hormonal disorders are all common contributors to ED. 
• Lifestyle choices: Smoking, excessive alcohol consumption, drug use, and a sedentary lifestyle can all negatively impact sexual function. 
• Medications: Certain drugs, including antidepressants, sedatives, and medications for high blood pressure, may have side effects that include ED. 
• Injuries: Trauma to the pelvic area or spinal cord can interfere with the body’s ability to achieve an erection.
  

Erectile function is also influenced by testosterone levels. While the relationship is complex and not fully understood, low testosterone is associated with several chronic conditions such as type 2 diabetes, obesity, and heart disease — all of which may contribute to erectile dysfunction.

Who Is at Higher Risk of Erectile Dysfunction?

• Men over the age of 40 
• Individuals with diabetes 
• Those with a body mass index (BMI) over 25 
• Men experiencing depression 
• People with low levels of physical activity 
• Smokers

Signs and Symptoms of Erectile Dysfunction

Erectile dysfunction (ED) can present itself in a variety of ways, including:

• Inconsistent erections — you may be able to get an erection sometimes, but not every time you want to have sex. 
• Difficulty maintaining an erection — you can achieve an erection, but lose it during intercourse. 
• Complete inability to get an erection. 
• Requiring more stimulation than usual to become or stay erect.
  

These signs can vary in frequency and severity, and often increase with age or underlying health conditions.

Treatment Options for Erectile Dysfunction

Before determining the right treatment, it’s important to identify the root cause of ED. For many men, lifestyle changes can make a significant difference in restoring healthy sexual function and reducing the risk of cardiovascular disease.

Recommended lifestyle adjustments include:

• Engaging in regular physical activity 
• Adopting a healthier diet (consulting a nutritionist is ideal) 
• Quitting smoking, limiting alcohol, and avoiding recreational drugs 
• Managing chronic conditions like diabetes and high cholesterol 
• Reviewing current medications with a doctor to rule out side effects affecting sexual performance
  

Depending on the severity and underlying cause, medical professionals may also recommend the following therapies:

• Oral medications (e.g., PDE5 inhibitors) to increase blood flow to the penis
  
• Low-intensity shockwave therapy to improve vascular function in the penis
  
• Penile injections to induce an erection when oral medications are not effective
  
• Testosterone replacement therapy (TRT) available in gels, patches, injections, or pills if low hormone levels are contributing to ED
  

The Bottom Line

Erectile dysfunction is treatable, especially when the cause is clearly identified. Early consultation with a healthcare provider is key to developing an effective treatment plan. Combining medical care with a healthy lifestyle can greatly enhance outcomes and overall quality of life.