ED Causes & Treatment Options
Understanding what causes erectile dysfunction is the first step to finding the right treatment. ED is very common, usually treatable, and can be a sign of other health issues worth addressing.
ED is Common and Treatable
Around 50% of men aged 40-70 experience some degree of ED. Most cases can be successfully treated with medication, lifestyle changes, or other therapies.
Physical Causes of ED
Physical causes account for the majority of ED cases, particularly in men over 40. Many are related to cardiovascular health.
- Atherosclerosis (narrowed arteries)
- High blood pressure
- Heart disease
- High cholesterol
ED can be an early warning sign of cardiovascular problems
- Type 2 diabetes
- Obesity
- Metabolic syndrome
Diabetes is one of the most common causes of ED
- Multiple sclerosis
- Parkinson's disease
- Spinal cord injury
- Stroke
Nerve damage can interfere with signals needed for erection
- Low testosterone
- Thyroid disorders
- Hyperprolactinemia
Hormonal imbalances are less common but treatable causes
ED as a Warning Sign
ED can appear 3-5 years before other symptoms of cardiovascular disease. If you develop ED, especially if sudden or without obvious cause, it's worth having a cardiovascular health check.
Psychological Causes of ED
Psychological factors can cause ED on their own or make physical ED worse. They're particularly common in younger men.
Common Psychological Causes
- • Performance anxiety
- • Stress (work, financial, life events)
- • Depression
- • Anxiety disorders
- • Relationship problems
- • Low self-esteem or body image issues
- • Previous negative sexual experiences
Signs ED May Be Psychological
- • ED came on suddenly rather than gradually
- • You can get erections during masturbation or morning erections
- • ED occurs with one partner but not another
- • ED is situational (e.g., only during intercourse)
- • You're under significant stress
- • You're younger with no obvious physical risk factors
Note: In practice, most ED has both physical and psychological components. Even when the initial cause is physical, anxiety about ED can make it worse. Treatment often addresses both.
Lifestyle Factors That Affect ED
These factors can cause or worsen ED - and importantly, addressing them can often improve erectile function significantly.
Impact: Damages blood vessels and restricts blood flow
Good news: Quitting can improve erectile function within weeks to months
Impact: Depresses nervous system and affects hormone levels
Good news: Reducing alcohol often leads to noticeable improvement
Impact: Associated with cardiovascular issues, diabetes, and low testosterone
Good news: Weight loss can significantly improve erectile function
Impact: Poor cardiovascular fitness affects blood flow
Good news: Regular exercise improves both ED and overall health
All Treatment Options
From first-line treatments to specialist options, here's everything available for treating ED in the UK.
How it works: Increase blood flow to the penis by blocking the PDE5 enzyme
Best for: Most men with ED, first-line treatment
Considerations: Not suitable for men taking nitrates; side effects possible
How it works: Address underlying risk factors and improve cardiovascular health
Best for: Men with lifestyle-related ED; complements other treatments
Considerations: Takes time to see results; requires commitment
How it works: Addresses performance anxiety, relationship issues, mental health
Best for: Men with anxiety-related ED; relationship difficulties
Considerations: May take multiple sessions; works best with trained therapist
How it works: Creates vacuum to draw blood into penis; ring maintains erection
Best for: Men who can't take medications; prefer non-drug approach
Considerations: Can feel unnatural; requires practice; erection may feel different
How it works: Medication injected directly into penis relaxes blood vessels
Best for: Men who don't respond to oral medications
Considerations: Requires self-injection; risk of priapism; can cause pain
How it works: Small pellet inserted into urethra releases medication
Best for: Men who can't take oral meds and don't want injections
Considerations: Less effective than injections; can cause burning sensation
How it works: Surgically implanted device provides mechanical erection
Best for: Men who haven't responded to other treatments
Considerations: Irreversible surgery; risk of complications; last resort
When to See a Doctor
While occasional erectile difficulties are normal, you should consider seeing a doctor if:
- ED is persistent (happening more than 50% of the time)
- ED came on suddenly without obvious cause
- You have risk factors for cardiovascular disease
- ED is causing relationship problems or distress
- You want to rule out underlying health conditions
Don't be embarrassed: Doctors deal with ED regularly. It's a medical issue like any other. Getting proper assessment ensures you get the right treatment and identifies any underlying health issues.
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Medical Disclaimer
This information is for educational purposes only and does not constitute medical advice. Erectile dysfunction can be a sign of underlying health conditions. Always consult a healthcare provider for proper diagnosis and treatment recommendations tailored to your individual circumstances.
Last updated: December 2025