What Is Erectile Dysfunction?
Having trouble getting it up from time to time is normal and can happen to any man. This can happen if you are tired, drink too much alcohol, or just aren't very aroused, but if it happens often, it could be a sign of an underlying medical condition. The good news is that it can be treated.
What Causes Erectile Dysfunction?
Erectile dysfunction mainly happens because of insufficient blood flow to your penis to achieve or maintain a full erection, but when it comes to the potential causes, it gets a bit tricky. This is because there are a few types of erectile dysfunction which affect the penis—and the ability to get erections—in different ways.
Here's a quick overview of each type:
Vascular erectile dysfunction
This is the most common type and there are many things that can impact your blood vessels' ability to send blood to your penis for a healthy erection. It can happen when your arteries stop enough blood from getting to your penis or when blood leaves your penis too quickly, which is medically known as venous leak syndrome. High cholesterol, high blood pressure, and obesity can all lead to vascular erectile dysfunction.
Hormonal erectile dysfunction
Problems with certain hormones can affect your ability to get an erection. This can include having low testosterone, too much or too little thyroid hormone, or too much prolactin, which is produced by the pituitary gland in your brain.
Low testosterone can contribute to ED several ways, such as reducing your sex drive, negatively affecting your mood, and causing fatigue – all of which can make it difficult to get sufficiently aroused for an erection. Low testosterone is also linked to weight gain, diabetes, and heart disease, which are also risk factors for ED.
Thyroid hormones can also cause ED, though researchers are still trying to understand why. Experts believe that when the thyroid makes too few thyroid hormones (hypothyroidism), it increases levels of the hormone prolactin, which can cause low libido and sexual dysfunction. When the thyroid makes too much (hyperthyroidism), it increases sex binding globulin (SHBG), which lowers free testosterone.
Psychogenic erectile dysfunction
Your thoughts, feelings, and behaviors play a big part in arousal, so if you're struggling with a psychological condition, it could impact your erections. Depression, anxiety, and stress, as well as relationship issues are just some examples.
Neurogenic erectile dysfunction
Problems with nerves can stop signals from your brain from reaching your penis which can affect your ability to get an erection. This can happen because of conditions like multiple sclerosis (MS) and Parkinson's, problems in your spine, or a stroke. It can also happen if nerves are damaged from an injury, surgery, or medical treatment, like pelvic surgery or radiation for cancer.
Other causes
Erectile dysfunction can also be caused by certain medications, like those used to treat depression, anxiety, cancer, and blood pressure, as well as by addictive substances, like nicotine, alcohol, marijuana, and illicit drugs.
This is not an exhaustive list of all the things that can cause erectile dysfunction. While it may seem daunting, the good news is that many of these can be improved with medication or other treatments.
Who Is at Risk?
Males of any age can experience erectile dysfunction, but it's most common in men aged 40 and over with the risk increasing with age (Leslie & Sooriyamoorthy, 2024).
You may also be at higher risk if you:
Have diabetes
Are overweight or have obesity
Are a smoker
Don't get much exercise
Struggle with depression
If you have any of these risk factors, know that there are plenty of things that can be done to help you lower your risk.
What Are the Symptoms?
Erectile dysfunction doesn't necessarily mean never being able to get an erection. It can also mean:
Being able to get an erection sometimes but not every time before sex.
Being able to get an erection but not staying hard long enough during sex.
Needing a lot of stimulation to maintain an erection.
Not being able to get an erection at all.
Depending on what’s causing it, you may notice other symptoms with erectile dysfunction. For instance, if you’re carrying extra weight, you may also feel sluggish or tire easily. If low testosterone is the culprit, you may notice a drop in your sex drive, trouble concentrating, or mood changes.
How Is Erectile Dysfunction Diagnosed?
If you’re dealing with erectile dysfunction, whether it’s occasional or frequent, it’s a good idea to see a doctor and find out what’s going on.
There are several things a healthcare provider can do to diagnose erectile dysfunction, including:
Review your medical history
You may feel awkward talking about erectile dysfunction, but it’s an important part of getting the right diagnosis and treatment. Your doctor will ask about your health, medications, and mental well-being. They will also ask about your relationships, sex life, and erections. This information helps them determine if any of these might be affecting your ability to get or keep an erection and get you closer to finding the right solution.
Order blood tests
Your doctor may order blood tests to get a better picture of your overall health and to look for signs of conditions that can cause erectile dysfunction. For instance, tests to check your testosterone levels, lipids, kidney and liver function, or your blood glucose to check for diabetes.
Refer you for other medical tests
Your doctor may recommend other types of tests to look at how blood flows to your penis and to measure how the nerves in your penis respond to stimulation. Other imaging tests to check your veins and arteries may also be used.
How Is Erectile Dysfunction Treated with Regenerative Therapies?
Regenerative therapies for erectile dysfunction include treatments like:
Low-intensity shockwave therapy (LISWT), which uses sound waves to encourage your body to create new blood vessels and improve blood flow.
Platelet-rich plasma (PRP), which involves injecting your own concentrated blood platelets into your penis so that the growth factors can stimulate tissue regeneration and increase blood flow.
Stem cell therapy (SCT), which is a treatment that takes stem cells from your body (usually from fat or bone marrow) and injects them into your penis to help repair tissue and boost blood flow.
While these may be relatively new approaches for treating erectile dysfunction, they have the potential to offer patients longer-lasting results than conventional treatments, such as medications, which only work for a few hours.
Traditional erectile dysfunction treatments, including PDE5 inhibitors, which include medications like sildenafil (Viagra) and tadalafil (Cialis), or vacuum devices (also called "penis pumps"), are used as-needed to manage symptoms. Regenerative therapy, on the other hand, aims to heal or restore damaged tissue by encouraging your body's natural repair processes.
Regenerative therapies for erectile dysfunction are considered experimental in the United States but are being used by doctors worldwide--including in the U.S.--with promising results (Al Hashimi, et al., 2025).
While results can vary, some people are seeing results for several months after treatment. For instance, in 2021, a study involving 425 men with vascular erectile dysfunction who were treated with LISWT showed that nearly 40 percent of them were treated successfully for 30 months (Adeldaeim, et al., 2021).
There's also evidence that combining regenerative therapies with conventional treatment can be especially beneficial for people with erectile dysfunction caused by vascular problems and diabetes who have a limited response to PDE5 inhibitors (Quistini, et al., 2025).
Your doctor can walk you through the different regenerative therapies available for erectile dysfunction and guide you on which treatment or combination of treatments may be best based on your situation.
What Are Possible Complications?
Living with erectile dysfunction can have a negative impact on life in and out of the bedroom for you and your partner.
A 2021 review of 20 studies published over 20 years showed that erectile dysfunction significantly affects quality of life and relationship satisfaction in men and their partners (Elterman, et al., 2021). It also found the condition negatively impacted men's work attendance and productivity.
Other possible complications of erectile dysfunction include:
Low self-esteem and confidence
Stress, depression, or anxiety
Relationship issues
Not being able to get your partner pregnant
Complications from underlying conditions causing your erectile dysfunction, like diabetes or heart disease
Whether you're worried about complications from your erectile dysfunction or are already experiencing them, remember that you have options that can help you manage these conditions and regain your confidence.
Can Erectile Dysfunction Be Prevented?
You may not be able to prevent erectile dysfunction, but you can lower your risk by adopting a healthy lifestyle which can help prevent many of the conditions associated with it.
Here are some things that may help you lower your risk:
Eat a heart healthy diet that's rich in fruits, vegetables, and healthy fats.
Engage in regular exercise, including cardio, like walking, running, or cycling.
Maintain a healthy weight.
Avoid smoking.
Reduce your alcohol consumption or avoid it all together.
Get enough good quality sleep, aiming for at least 7 to 9 hours a day.
Take care of your mental health, including getting professional help if needed.
Try to minimize your stress.
It may take some time, but making healthy changes can make all the difference! And if you're already experiencing erectile dysfunction, these changes can help.
Takeaway
It's understandable that talking to a doctor about erectile dysfunction may feel a little uncomfortable, but it's important that you do it. Not only can trouble getting or keeping an erection put a damper on your sex life--it can also be a sign of an underlying medical condition that needs treatment.
