What Are The Warning Signs Of Erectile Dysfunction?

Erectile dysfunction (ED) is a common condition for many men and is quite treatable. Here’s what to look out for, how to prevent erectile dysfunction, and how it can be treated. 

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What is erectile dysfunction?

ED is experienced by many men and can greatly impact both sexual relationships and daily life. It is estimated that over half of men¹ between 40 and 70 years of age will experience erectile dysfunction at some time in their lives. 

Erectile dysfunction² is the inability to achieve or maintain an erection required for satisfactory sexual intercourse. Many known causes of ED are often linked to age and physical health. 

To understand what causes ED, it is first important to understand how an erection works. Normally, when there is no sexual arousal, the blood vessels around the penis are contracted, letting in only small amounts of blood. 

However, when aroused, these blood vessels relax or vasodilate. They open up, allowing more blood to flow into areas of the penis called the corpora cavernosa. These areas fill with blood and cause the penis to become erect. 

ED can occur when this pathway doesn’t work as it should. This may be because the blood vessels responsible for filling the penis with blood become damaged, as may happen to smokers. 

Changes in the neurotransmitters or hormones which tell these blood vessels to expand can also result in ED. 

Warning signs of erectile dysfunction

Some common warning signs of ED can include difficulty getting an erection or maintaining an erection. Other symptoms also include a drop in sexual desire, also called libido. 

It can be useful to compare how erections or libido (sexual desire) have changed over time to identify any changes that may indicate the development of ED. 

Causes of erectile dysfunction

ED occurs when the blood vessels that supply the ‘erectile tissue’ in the penis fail to fill up with blood. This may be due to the vessels getting clogged up or, on the other hand, a breakdown in the chemical signals that tell these vessels to expand. 


Smoking is linked³ to erectile dysfunction. Smoking and other nicotine use can cause damage to the lining of blood vessels in the penis. This can reduce blood flow to the penis, making achieving or maintaining an erection more difficult. 

Another very common cause of erectile dysfunction in men of all ages is the excess consumption of alcohol. This phenomenon is more colloquially known as ‘whiskey dick’. Diet can also contribute to erectile dysfunction. 

Studies⁴ have found that obese men are much more likely to develop erectile dysfunction than men who maintain a healthy weight. 

Anxiety is another common cause of erectile dysfunction in men. Both stress and anxiety can lead to the development of ED. This may develop into performance anxiety and result in experiencing erectile dysfunction on subsequent occasions, creating a vicious cycle. 

Health conditions 

Diseases such as diabetes have also been known to cause ED. This is because diabetes is commonly associated with conditions like smoking, obesity, and hypertension — all risk factors for ED. Some diabetics experience a drop in nitric oxide. This may cause ED because nitric oxide is responsible for relaying the message to the blood vessels to expand, necessary for achieving an erection.

Cardiovascular diseases are also linked⁵ to erectile dysfunction. Cardiovascular diseases can be caused by many factors that cause erectile dysfunction. These include factors such as a breakdown in neurotransmitters and damage to blood vessels. Studies have found a strong correlation between men with cardiovascular disease and men who experience erectile dysfunction.

How to get help for erectile dysfunction

There are many medications on the market which treat ED. The most well-known, Viagra, is a prime example of one such medication. Viagra works by slowing down an enzyme called PDE5.⁶ 

This enzyme shuts off the relaxation of blood vessels in the penis during an erection. By decreasing its action, it allows for blood flow into the penis to continue, helping maintain an erection. Other medications that work in the same way include Cialis and Levitra. 

Several other medications that treat erectile dysfunction are available. Consult your doctor, who can help you choose the best option. 

Tips for preventing erectile dysfunction

1. Lifestyle changes 

Lifestyle factors play a major role in the development of ED in many men. This includes smoking, diet, and alcohol consumption. Moderating alcohol intake and smoking, along with eating a balanced diet, are all factors that can help prevent ED. 

2. Stress management 

Managing stress can be an important tool in preventing the development or recurrence of ED. This may involve the development of coping mechanisms to deal with lifestyle stresses, including exercise⁷ or seeking professional help from counselors or therapists. 

Open communication with sexual partners may also help to alleviate performance anxiety and prevent further erectile dysfunction. 

3. Early treatment of health conditions 

ED can also be caused by other diseases, including diabetes and cardiovascular diseases. Early identification and treatment of these conditions may help to prevent the development of ED. 

When to visit your doctor

If you are experiencing symptoms of ED, such as a drop in sex drive, or an inability to achieve or maintain an erection, it is important to talk to your doctor. 

There are many treatment options for ED, and a large body of research continues to grow, meaning there may well be further treatment options in the future.

Talk to your doctor if you are experiencing any other symptoms of conditions such as diabetes or heart disease. Early interventions may help to reduce your risk of developing ED. Your doctor will help you to manage these conditions and improve your sexual health. 

The lowdown

Erectile dysfunction is a common condition that many men experience at some point in their life. ED can be caused by many factors, including lifestyle and health conditions. The good news is that many ways to prevent and treat ED. These include changes in lifestyle and the early treatment of other health conditions.

Talk to your doctor about treatment options and modifications you can make to maintain or restore your sexual health.

  1. Erectile dysfunction (2016)

  2. Erectile dysfunction – an update of current practice and future strategies (2013)

  3. Effects of cigarette smoking on erectile dysfunction (2015)

  4. Obesity and erectile dysfunction: From bench to clinical implication (2019)

  5. Anatomy, pathophysiology, molecular mechanisms, and clinical management of erectile dysfunction in patients affected by coronary artery disease: A review (2021)

  6. PDE5 inhibitors | NIH: National Library of Medicine

  7. Physical activity to improve erectile function: A systematic review of intervention studies (2018)

Other Sources:

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