Erectile Dysfunction – What You Need to Know

If you’ve ever struggled to get or keep an erection, you’re not alone. About one in ten men under 40 and almost half of men over 70 experience erectile dysfunction (ED) at some point. It’s a physical issue that can feel embarrassing, but it’s also a signal that something in your body might need attention.

ED isn’t just about sex; it can affect confidence, mood, and relationships. The good news is that most cases have a clear cause and can be treated without a lot of hassle. Below we’ll break down why it happens and what you can do today to start feeling better.

Why It Happens

There are three big buckets of reasons for ED: physical, psychological, and medication‑related. Physically, anything that limits blood flow to the penis can cause trouble. Diabetes, high blood pressure, high cholesterol, and heart disease are all common culprits because they damage blood vessels and nerves.

Stress, anxiety, and depression fall into the psychological side. Worrying about performance can create a feedback loop that makes it harder to get aroused. In many cases, both physical and mental factors mix together, so treating one side can improve the other.

Medications are a hidden cause that many people overlook. Drugs that affect blood pressure, antidepressants, antipsychotics, and even some over‑the‑counter supplements can lower libido or interfere with the nerve signals needed for an erection. If you’re on a medication that carries a bleeding risk, such as certain anticoagulants, the CRUSADE Bleeding Score can help your doctor weigh the safety of adding an ED treatment. Always ask your prescriber if a drug might be affecting your sexual performance.

How to Manage It Safely

The first step is to talk openly with your doctor. A quick check of blood pressure, blood sugar, and cholesterol can reveal hidden health issues that need treatment. Your doctor may also review every prescription and supplement you take, looking for anything that could be contributing to ED.

Lifestyle changes are surprisingly powerful. Losing a few pounds, exercising regularly, quitting smoking, and limiting alcohol can improve blood flow and boost confidence. Simple habits like getting enough sleep and reducing stress through meditation or hobby time also make a difference.

If lifestyle tweaks aren’t enough, your doctor might suggest a medication. The most common first‑line drugs are PDE‑5 inhibitors like sildenafil (Viagra) or tadalafil (Cialis). They work by widening blood vessels in the penis, but they’re not safe for everyone—especially if you’re on nitrates for heart disease or certain blood thinners. That’s where a bleeding‑risk assessment, such as the CRUSADE Bleeding Score, comes into play. It helps clinicians decide if the benefits of an ED drug outweigh any added bleeding risk.

Other options include vacuum erection devices, penile injections, or hormone therapy if low testosterone is part of the problem. These approaches bypass oral meds and can be useful when pills aren’t suitable.

Remember, ED is treatable, and most men find a solution that works for them. The trick is to stay informed, keep an open line with your healthcare team, and make small, steady changes that improve overall health. By tackling the root causes—whether they’re blood‑flow issues, medication side effects, or stress—you’ll give yourself the best chance at a healthy sex life and better overall well‑being.