Understanding Erectile Dysfunction: Causes and treatment
Erectile dysfunction, often called ED, happens when you have trouble getting or keeping an erection that’s firm enough for sex. It’s much more common than many people realize. In the United States, up to 50 million men experience ED. It becomes more likely as you get older, affecting about 9% of men aged 40–44 and more than 56% of men over 65.
Even though ED can feel stressful or embarrassing, it’s important to know that it’s highly treatable. Most men are able to improve or fully restore sexual function with the right treatment plan.
100% online, 100% convenient
An Overview of Erectile Dysfunction
Erectile dysfunction (ED) can occur if blood flow into the penis is insufficient or if the penis is unable to retain the blood during an erection. It can also happen if nerve signals from the brain or spinal cord don’t reach the penis. The definition of ED can be somewhat subjective, as it largely depends on what is considered satisfying. If a person is unsatisfied with their ability to achieve or maintain an erection, they may be categorized as having ED.
Another way to view ED is as a combination of various conditions. This is because the process of achieving an erection involves multiple bodily systems working together. If any part of this complex process fails to function properly, it can prevent an erection from occurring.
How does Erectile Dysfunction happen?
You get an erection when your brain, nerves, hormones, and blood vessels all work together. ED can develop when something interrupts that process — for example:
- Not enough blood is reaching the penis
- Blood enters the penis, but does not stay there
- Nerve signals not reaching the penis
- Stress, anxiety, or emotional concerns affecting your arousal
Because an erection involves multiple systems in the body, ED is often the result of more than one cause happening at the same time.
How common is Erectile Dysfunction?
ED is one of the most common sexual health concerns for men, especially after age 40. You’re also more likely to experience ED if you have certain health conditions, including:
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- Heart disease
These conditions all affect blood flow, which is essential for healthy erections.
What causes Erectile Dysfunction?
Many of the factors that contribute to ED are also linked to atherosclerosis, a condition where arteries become narrow or blocked. This is the same process that increases your risk for heart attacks and strokes. That’s why ED can sometimes be an early warning sign of cardiovascular problems.
Common causes include:
- Aging
- High cholesterol
- High blood pressure
- Cardiovascular disease
- Diabetes
- Obesity
- Hormone imbalances
- Nerve damage
- Pelvic injuries
- Spinal cord or brain injuries
- Smoking
- Excessive drinking
- Certain medications
- Emotional factors like stress, anxiety, or depression
If you’re experiencing ED, it’s a good idea to talk to a healthcare provider about checking your cholesterol, blood sugar, and blood pressure.
100% online, 100% convenient
How are depression and erectile dysfunction connected?
Your mental health plays a big role in your sexual health. Research shows people with depression are about 40% more likely to experience ED. At the same time, men who already have ED are three times more likely to develop depression.
This creates a cycle:
- Depression lowers energy, focus, and libido.
- Sexual performance becomes harder.
- ED increases stress, guilt, or embarrassment.
- Depression worsens.
Treating both ED and mental health concerns at the same time often leads to the best results.
How is Erectile Dysfunction diagnosed?
When a man seeks medical help for erectile dysfunction, simply reporting the issue is often enough for a diagnosis, as it is a subjective and personal experience. However, a healthcare provider will still take additional steps to assess the condition and determine its underlying causes. The individual can expect a thorough review of their medical history, particularly focusing on vascular health, as well as any psychiatric history and substance use. The provider will also inquire about the occurrence of spontaneous erections, such as those in the morning, and ask what treatments the individual has already tried.
The provider will then perform a physical examination and may order lab tests to identify potential health issues. In some cases, more specialized tests, such as a penile Doppler to assess blood flow to and from the penis, may be conducted.
Premature Ejaculation
Premature ejaculation is another common sexual health concern that often occurs alongside erectile dysfunction, but it presents its own unique challenges. It is characterized by the inability to control ejaculation during sexual activity, resulting in an early release that can impact both confidence and sexual satisfaction for individuals and their partners. Recognizing premature ejaculation as part of the broader sexual health picture underscores the importance of addressing both conditions for a more comprehensive approach to care.
Treatment options for premature ejaculation—such as behavioral techniques, medications, and counseling—offer effective solutions and can significantly improve quality of life. Just like with erectile dysfunction, seeking professional help is crucial for those affected, as treatments aim to enhance sexual function, restore confidence, and improve relationship dynamics. These interconnected sexual health issues highlight the importance of a holistic approach, where addressing one concern can often help improve the overall sexual well-being of both partners.
Treatment Options for Erectile Dysfunction
There isn’t one single solution for ED. The best treatment depends on the cause, your health, and your personal preferences. Most providers start with lifestyle changes that support better erections and overall health:
- Regular physical activity
- Healthy eating
- Limiting alcohol
- Quitting smoking
- Managing blood sugar or cholesterol
- Reducing stress
Here are some common treatment options that may be considered:
- Injection Therapy: This involves self-administering papaverine, an alpha-blocker, and a vasodilator, each time an erection is desired. While there may be some drawbacks, such as discomfort and bruising, injections are highly effective and provide rapid results.
- Medications: Erectile Dysfunction medications work by dilating the arteries, allowing more blood flow to the penis, making it easier to achieve and maintain an erection. According to the National Library of Medicine, these drugs have an overall success rate of about 76%.
- External vacuum device: A non-surgical treatment for erectile dysfunction (ED) is the external vacuum device. This device is placed over the penis and manually pumped to create a vacuum, drawing blood into the area and causing an erection. Once achieved, a small rubber band is placed around the base of the penis to help maintain the blood flow and keep the erection. While effective, this method may cause discomfort, bruising, or even bleeding. Additionally, the erection may feel less secure compared to a natural one, as the penis is not as firmly supported.
- Surgical implants: Penile implants are considered the gold standard surgical treatment for erectile dysfunction, typically recommended when other options have been ineffective or are not suitable. The most commonly used type is the inflatable prosthesis, which includes a small pump placed in the scrotum. By squeezing the pump, the individual can inflate the device, causing the penis to become erect. While the inflatable prosthesis is more widely used and easier to operate, there is also the option of a malleable prosthesis. This version involves two bendable rods implanted into the penis, allowing the person to manually adjust the position of their erection by bending the rods up or down.
100% online, 100% convenient
When should you seek help for erectile dysfunction?
If you’re living with erectile dysfunction (ED), it’s important to seek help as soon as possible. The earlier you talk to a doctor, the better your chances of finding an effective treatment and improving your overall well-being. Many people feel nervous or embarrassed about discussing ED, but it’s a common issue, and healthcare professionals are trained to handle these conversations with care and confidentiality. Don’t let fear hold you back—getting the right treatment can make a significant difference in your quality of life.
Take some time to research trusted healthcare professionals in your area who specialize in ED. Look for someone you feel comfortable with and who can guide you through the options that are best for you. Remember, you’re not alone, and there’s no reason to delay seeking the help you deserve.
Final thoughts
Erectile dysfunction can feel overwhelming, but you’re not alone — and you don’t have to navigate it by yourself. ED is highly treatable, and most men improve significantly with the right support and treatment plan.
Taking the first step by talking to a provider can lead to better sexual health, improved confidence, and a stronger sense of well-being.
Frequently Asked Questions
What is TopEDTreatments, and do you sell medication?
TopEDTreatments is an independent review and comparison site that evaluates telehealth ED providers, products, pricing, and services — we do not sell prescription medication. Our goal is to help you compare options and find reputable providers that fit your needs.
How do these telehealth ED services work?
Most providers use a short online medical questionnaire reviewed by a U.S.-licensed clinician. If approved, a prescription is issued and filled by a partner pharmacy — delivered to your door or available for local pickup, depending on the service.
Do I need a prescription to get ED medication online?
Yes. Legitimate telehealth providers require a medical review before prescribing PDE-5 inhibitors (sildenafil, tadalafil, etc.). Any site offering prescription meds without a clinician review should be avoided.
Will my insurance cover telehealth ED prescriptions?
Generally, most telehealth ED subscription plans and direct-to-consumer meds are paid out-of-pocket and do not bill insurance at checkout. Check your insurer if you plan to seek reimbursement; policies vary.
Are online ED services safe?
When you use reputable telehealth providers that employ licensed clinicians and regulated pharmacies, online ED treatment can be safe. Always disclose medical history and medications (especially nitrates or heart drugs) during the consult and follow the clinician’s guidance.
Can I cancel or get a refund?
Refund and return policies differ by provider; because prescriptions are dispensed by pharmacies, returns are often restricted. Check the provider’s refund policy before purchasing and contact customer support promptly if you need to cancel before shipment.
How do I choose the right ED provider?
Decide what matters most: price, delivery speed, format (tablet vs chewable vs troche), clinician oversight, lab testing, or specialty care (hormone management). Use our comparison charts and in-depth reviews to match features to your priorities.
Is my information private?
Trusted providers follow industry privacy practices and use secure, encrypted platforms for medical intake and prescription handling. Always read a provider’s privacy policy and terms if you have specific confidentiality concerns.