Typical symptoms of ED include:

  • Erections too soft for penetration

  • Erections too brief for penetration

  • An inability to achieve erections

Erectile Dysfunction Defined

Erectile dysfunction (ED) affects millions of men in the United States. In the field of sexual health, ED is the most common challenge reported to doctors. Worldwide, one in ten men report problems with erectile dysfunction. However, the true number is thought to be much higher. Many men are not comfortable discussing sexual issues with their health practitioner, regardless of how common the problem may be.*

Simply put, ED is the inability to consistently produce and maintain an erection suitable for intercourse.

While it is normal to have occasional difficulty obtaining an erection, routine struggling or progressive worsening that interrupts overall sexual health can be classified as erectile dysfunction.

ED threatens a man’s capability to achieve a satisfying sex life. Symptoms include decreased sexual desire and difficulty obtaining and maintaining an erection. As time goes on, erectile dysfunction may lead to undue stress, low self-confidence, and relationship issues.

* According to the Male Massachusetts Aging Study, the prevalence of impotence (minor, moderate and complete) actually hovers above 50% for men aged 40-70.


What Causes Erectile Dysfunction?

The natural aging process is a predominant factor in ED, yet isn’t necessarily the root cause. Diabetes and cardiovascular disease, resulting in high blood sugar and high blood pressure, can diminish blood flow to the penile tissue. Nerve damage or small vessel disease can also result from diabetes, yielding erectile dysfunction.

In addition to vasculogenic issues, there are a number of other potential causes of ED. Parkinson’s disease, multiple sclerosis, Peyronie’s disease, atherosclerosis, obesity, and kidney disease are other physical causes of impotence. Certain pharmaceutical medications prescribed to treat medical conditions are also linked to ED, for example, antidepressants and high blood pressure medications. Certain cancer treatments, including surgery and radiation, can also contribute to erectile dysfunction.

Any disease, injury, or surgery near the lower abdomen or pelvic area can potentially damage nerves leading to the penis, resulting in erectile dysfunction. Hormones may also play a role in erectile dysfunction. Thyroid abnormalities, elevated prolactin, abuse of steroids, and hormone treatment of prostate cancer each might lead to impotence. While low testosterone may affect erectile dysfunction, it’s not often singularly responsible for inducing ED.

ED is also linked to emotional issues. Depression and anxiety are clearly associated with ED, as are the pharmaceuticals often prescribed to treat these emotional disorders. Relationship conflicts — including resentment and trust issues — can lead to ED, as can perpetual unease about sexual performance. Stress from work, home, social, religious, or cultural contexts can all contribute to ED.

Finally, lifestyle choices, such as smoking, drugs, excessive alcohol intake, and insufficient exercise may also increase the risk of erectile dysfunction.


By and large, erectile dysfunction results from nerve damage or limited blood flow to the penis. In fact, over 80% of erectile dysfunction issues are vasculogenic in nature. This decline in vascular function can be a result of:

  • Age

  • High blood pressure

  • Diabetes

  • Smoking


What Happens When Erectile Dysfunction is Left Untreated?

Erectile dysfunction, on its own, typically doesn’t lead to additional physical problems. ED might, however, be a strong indication of underlying conditions. Cardiovascular disease is of particular concern. The vascular system may be incurring blockages that — along with ED — can eventually cause stroke, heart attack, and circulatory difficulties in the lower limbs.

Erectile dysfunction can also lead to emotional challenges — such as low self-esteem, distress, anxiety, and depression. Relationship issues may also result. Difficulties with pregnancy — as well as a man and his partner’s unsatisfactory sex life — can produce relationship tension and strife.