What Is Erectile Dysfunction? Causes, Symptoms, Diagnosis & Best Treatments

Updated on November 27, 2023

For many men, erectile dysfunction (ED) serves as a silent barrier, casting a shadow over their relationships and self-esteem. While it’s a common issue, understanding its root causes and implications remains challenging for many.

Is it a fleeting issue or a symptom of an underlying condition? And if faced with it, what are the most effective treatments?

This review aims to demystify this often misunderstood condition. We’ll explore its cause, symptoms, diagnosis, and some of the best treatments, like BlueChew.

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What Is Erectile Dysfunction?

First, what is erectile dysfunction (ED)? ED is a medical condition in which a person experiences consistent or recurring difficulties in achieving and sustaining the necessary physical response for satisfactory sexual activity.

The condition can result in personal distress or complications in intimate relationships, and you may experience it alone or as a symptom of other health problems [1].

What Are the Types of Erectile Dysfunction?

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Erectile dysfunction can be classified into different types based on its underlying causes and contributing factors. The main types of erectile dysfunction include:

  • Circulatory, where impaired blood flow leads to ED
  • Endocrine ED typically involves low testosterone
  • Psychogenic ED, where an overactive stress response dampens erections
  • Neurogenic ED, where spinal cord injury, multiple sclerosis, and other issues affect nerve function
  • Drug-induced ED from drugs including beta-blockers, psychotherapeutics, and anti-androgens

What Are the Symptoms of Erectile Dysfunction?

If you were wondering what is erectile dysfunction’s symptom? The answer is that it’s fairly simple. ED involves persistent trouble in gaining or maintaining an erection, which is severe enough to affect your sex life [2]. It does not necessarily affect arousal unless you have a testosterone deficiency.

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What Causes Erectile Dysfunction?

What is the main cause of erectile dysfunction? While they often overlap, the contributing factors to ED are mostly identifiable.

Physical Causes of Erectile Dysfunction

Conditions that affect circulatory health and testosterone production, such as diabetes, cardiovascular disease, kidney disease, and certain cancers, contribute to ED. Nerve injuries, including spinal cord injury and diabetic neuropathy, are other causes.

Psychological Causes of Erectile Dysfunction

Stress, anxiety, and depression can trigger psychogenic ED. Noradrenaline, part of the stress response, may also reduce the strength of erections.

Medical And Health Causes of Erectile Dysfunction

A range of medications can cause sexual dysfunction, such as antidepressants, anticholinergic drugs, cardiovascular drugs, and some antibiotics. Obesity, smoking, and excessive alcohol use are common lifestyle-related health problems linked to ED [2].

Risk Factors for Erectile Dysfunction

Perhaps the biggest risk factor for erectile dysfunction is the biological aging process. Cardiovascular and metabolic conditions, which increase with age, also contribute. Around 40% of men with ED have high blood pressure, and this same proportion also have high triglycerides and/or cholesterol. Plus, one in five have diabetes [2].

How Common Is Erectile Dysfunction?

What is erectile dysfunction’s prevalence? Up to 30 million men experience erectile dysfunction in the United States alone, a country of over 330 million people [2]. This is almost one-fifth of the male population. 

What Is the Common Age for Erectile Dysfunction?

Just over half of men aged 40-70 have erectile dysfunction. Among men over 70, this increases to around two-thirds [2]. However, men of all ages can develop ED.

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Diagnosis of Erectile Dysfunction

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Your physician can readily diagnose erectile dysfunction; there is no need to visit a specialist. If potential ED symptoms are bothering you, an in-person or telehealth visit can help.

How Is Erectile Dysfunction Diagnosed?

Erectile dysfunction is diagnosed by looking at your complete symptomatic picture, including severity, onset, and exacerbating factors. You do not need physical examination or imaging unless there may be a serious underlying issue.

It’s also essential to find out your blood pressure and weight because ED is linked to obesity and cardiovascular issues [2].

Management and Treatment of ED

What is erectile dysfunction treated with? Both pharmaceutical and natural interventions are available today.

Medications for Erectile Dysfunction

The medications specifically for erectile dysfunction are known as PDE-5 inhibitors. These widen your blood vessels, allowing more blood to enter the penis by improving circulation. BlueChew, Hims, and Roman all offer PDE-5 inhibitors such as sildenafil and tadalafil.

Perhaps you’re asking, what is the best injection for erectile dysfunction? Or what is the best cream for erectile dysfunction? Alprostadil, which also dilates the blood vessels, is an effective injection, and it can be taken in cream form, too [3].

Vacuum Erection Devices (VEDs)

VEDs are clear plastic devices tightened over the lower abdomen to create a vacuum. Once enough blood flows into the penis, you can take it off, leaving on the constriction band [3]. If you’re wondering what is the best vacuum device for erectile dysfunction? The answer depends on your size and preference. 

Penile Implants for ED

Penile implants are usually reserved for men who don’t respond to other treatments. Today, the most common type is inflatable implants that you can use to start an erection as needed [3]. 

Lifestyle Changes and ED Treatment

Diet, exercise, stress management, reducing alcohol, and quitting smoking can all work together to improve your circulation, restore testosterone production, and calm an overactive stress response [4]. 

Alternative Treatments for ED

Supplements and new, holistic approaches may complement or work well instead of typical ED treatments. For example, supplements containing the amino acid L-arginine can restore erectile function [5]. More high-tech treatments, like The Phoenix, use shockwave therapy to improve tissue repair and address ED at its underlying cause [6]. 

What Is the Best Way to Fix Erectile Dysfunction?

The best way to fix erectile dysfunction is with a holistic treatment plan that includes medication and interventions to address underlying causes. You may benefit from Viagra, but exercise, a heart-healthy diet, stress management, and even testosterone-boosting supplements can optimize your results.

Living With ED 

What is erectile dysfunction’s effect on your daily life? For many men, it can be psychologically debilitating, so your mental well-being is an essential aspect of treatment. Here are some factors to consider:

Communication With Your Partner

Do not hesitate to communicate with your partner about intimacy and any aspect of your health that may be bothering you. They may be your most vital source of support and understanding. The topic can be sensitive for many, but silence often breeds misunderstanding and unnecessary tension.

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Seeking Couples Therapy

A professional can provide a safe environment for discussing sensitive topics and offer strategies to cope with ED’s emotional and relational challenges. Sometimes, partners might misinterpret ED as a lack of attraction or desire. Therapy can help clarify such misunderstandings.

Intimacy and Emotional Connection

The emotional side of intimacy is critical for a healthy relationship. Non-sexual affection and simply spending time together, whether you choose an activity or simply talk, give you something to focus on besides sex and are fantastic for bonding and stress relief. 

When Should I See a Healthcare Provider?

See a healthcare provider when you feel ready to seek treatment. Online telehealth services, like BlueChew, remove much of the awkwardness of a doctor’s appointment, but you may need an in-person appointment if you have underlying health issues.

Lifestyle Changes to Improve Erectile Dysfunction

For countless men, the answer to what is the main cause of erectile dysfunction? is their lifestyle.

Diet and Nutrition Changes

A Mediterranean-style diet with regular fruit intake has been shown to improve erectile function scores. This is thanks to its protective antioxidants and nitric acid content in some foods, which may widen your blood vessels.

Exercise and Physical Activity

Exercise may work by increasing nitric oxide, too, alongside reducing inflammation. If your sport or workout routine leaves your heart pumping and face flushed, we especially recommend it for circulatory health. 

Smoking Cessation and ED

If you smoke, we advise you to quit as soon as possible. Cigarette smoke may damage the blood vessels, causing them to stiffen and reduce nitric oxide. 

Reducing Alcohol Consumption

Excessive alcohol consumption and the sugar inside many alcoholic drinks may also lead to tissue damage in the blood vessels. 

Stress Management Techniques

As stress hormones interfere with erections, learning to manage stress can go a long way in improving sexual health. Whether outdoor sports, meditation, yoga, or another activity for decompression works, ensure you practice it regularly. 

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What is erectile dysfunction, and what are the main causes? Here’s what you need to know. 

How Can You Tell if a Man Has Erectile Dysfunction?

A man might have erectile dysfunction if he consistently finds it difficult to get or keep an erection firm enough for sexual intercourse. It’s a common issue; a healthcare provider can provide a definitive diagnosis.

How Do You Fix an Erectile Dysfunction?

Treatment for erectile dysfunction varies depending on the cause. It may include lifestyle changes (like exercising and quitting smoking), medication, therapy for anxiety or depression, hormone therapy, or even surgical interventions like penile implants.

At What Age Do Guys Have Trouble Getting Hard?

While the risk of erectile dysfunction increases with age, it can occur at any age. It’s more common in men over 40, and its prevalence increases significantly with each decade of life. However, younger men can also experience ED, especially if they have underlying health conditions or psychological stressors.

Can I Combine Treatment Options?

You can combine treatments such as the best ED pills with testosterone-boosting supplements or shockwave therapy. However, do not use two meds with the same target pathway at once. 

What Is Erectile Dysfunction? Final Verdict

Erectile dysfunction, though common, can be a deeply personal and challenging topic to navigate. Recognizing the causes and symptoms is the first step, and seeking the right diagnosis and treatment follows. 

With platforms like BlueChew, personalized and effective solutions are within reach. Remember, ED doesn’t define you; it’s just one facet of your health. You can rediscover intimacy and confidence in your relationships and yourself with the right guidance and support.


  1. Yafi, Faysal A et al. “Erectile dysfunction.” Nature reviews. Disease primers vol. 2 16003. 4 Feb. 2016, doi:10.1038/nrdp.2016.3
  2. Irwin, Gretchen M. “Erectile Dysfunction.” Primary care vol. 46,2 (2019): 249-255. doi:10.1016/j.pop.2019.02.006
  3. Mobley, David F et al. “Recent advances in the treatment of erectile dysfunction.” Postgraduate medical journal vol. 93,1105 (2017): 679-685. doi:10.1136/postgradmedj-2016-134073
  4. Ostfeld, Robert J et al. “Vasculogenic Erectile Dysfunction: The Impact of Diet and Lifestyle.” The American journal of medicine vol. 134,3 (2021): 310-316. doi:10.1016/j.amjmed.2020.09.033
  5. Chen, J et al. “Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study.” BJU international vol. 83,3 (1999): 269-73. doi:10.1046/j.1464-410x.1999.00906.x
  6. Porst, Hartmut. “Review of the Current Status of Low Intensity Extracorporeal Shockwave Therapy (Li-ESWT) in Erectile Dysfunction (ED), Peyronie’s Disease (PD), and Sexual Rehabilitation After Radical Prostatectomy With Special Focus on Technical Aspects of the Different Marketed ESWT Devices Including Personal Experiences in 350 Patients.” Sexual medicine reviews vol. 9,1 (2021): 93-122. doi:10.1016/j.sxmr.2020.01.006

Fact Checker: Daniel Boyer M.D. ([email protected])
Daniel Boyer is a practicing Doctor of medicine with a passion for medical research. He specializes in molecular biology, histology, and pharmacology.

Kire Stojkovski M.D
Kire Stojkovski M.D

Kire Stojkovski is a practicing medical doctor whose work has been published in some of the most respected medical journals.