What is erectile dysfunction?
ED is a common condition in men over the age of 40, becoming more prevalent with age as as other health conditions develop, however it can also affect younger men. Some of the health conditions which can cause ED are outlined in Causes of ED below.
Causes of ED
There are multiple possible causes of ED and often there is more than one contributing factor.[2-3]
Most older men who experience ED have an underlying condition which is causing the ED. In younger men, under the age of 40, ED is often caused by a psychological issue such as anxiety, depression or stress.
Causes may be:[1,2,4]
Men over the age of 40 are much more likely to experience erectile dysfunction. As men age, they are much more likely to also have health issues such as cardiovascular disease or high blood pressure which contribute to ED
ED may result from low self-esteem or mood and mental health issues such as anxiety, stress and depression. It may also be caused by performance anxiety or from relationship issues
Use of drugs including opioids, corticosteroids, antidepressants and antacids have been shown to contribute to ED
Injuries including testicular torsion may result in ED and as may other injuries such as spinal cord injuries or pelvic breaks
ED is also linked to smoking, alcoholism, diabetes and hyperlipidemia.
An underlying condition which affects blood flow
Low testosterone levels or thyroid issues
Such as conditions like multiple sclerosis
Determining the underlying cause of the ED is important as it allows your healthcare team to select the most appropriate treatment for you. It also allows them to check if you have any other health conditions which may also need to be managed.
As an initial recommendation and first-line form of treatment, your doctors may make some recommendations on how you can improve your overall health which will in turn improve your ED and also reduce your cardiovascular risk.
These recommendations can include increasing exercise, changing your diet and reviewing your nutrition, stopping smoking and stopping drug and alcohol use and gaining control of other issues such as diabetes and high cholesterol levels.
If your doctor expects your ED to be caused by a medication you are on, they may change or alter the dose of the medicine. If they expect your ED may be caused by psychological issues / mental heath issues, they may refer you for counselling.
There are medications available which can improve your ED such as PDE5 inhibitors which are taken orally or creams which you can apply to induce an erection. Speak with your healthcare professional to learn more about these options.
1. Sooriyamoorthy & Leslie. Erectile dysfunction. StatPearls. Accessed: May 2022.
2. Hatzimouratidis K, Eardley I, Giuliano F, et al. EAU Guidelines on Male Sexual Dysfunction — Update March 2015. EAU, Arnhem, the Netherlands.
3. Carson C, McMahon CG. Fast Facts: Erectile Dysfunction,
4th edition. 2008. Health Press Ltd, Oxford, UK.
4. Razdan S, et al. Postgrad Med J 2018 Mar;94(1109):171-178.