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Symptoms, causes, and risk factors of ED

Along with death, taxes, and your footy team’s chance of winning the grand final, erectile dysfunction (ED), or impotence, is a common topic of worry amongst men. Defined as an inability to develop or maintain an erection firm enough for penetrative sex, erectile dysfunction is a condition that affects an estimated 150 million men worldwide. And this figure is likely to double by the year 2025.

So, if a floppy penis is interfering with your sex life or poking fun at your masculinity, consider this our public service announcement that erectile dysfunction is treatable. The first step is learning how to know if you have erectile dysfunction in the first place.

What are the symptoms of erectile dysfunction?

Obvious symptoms of erectile dysfunction point to an inability or difficulty to develop and sustain an erection that enables sex. Decreased sexual desire or diminished libido also count as signs of erectile dysfunction in men.

If you fall into any of these categories, there’s a chance you may have erectile dysfunction. The next step is to determine the cause of your ED, so a treatment plan can be put in place.

What are the causes of erectile dysfunction?

Doctors once considered psychological problems, like anxiety and depression, to be the main cause of erectile dysfunction. However, new research indicates physical illness as the primary cause of erectile dysfunction in men.

Erectile dysfunction can also be worsened by a combination of physical and psychological factors. For instance, a minor blood vessel problem may cause performance anxiety that weakens one’s inability to develop and maintain an erection.

Physical causes of erectile dysfunction

Physical causes of erectile dysfunction are related to conditions that affect the heart, blood vessels, hormones, nerves, cholesterol, and bodyweight.

Blood vessel and heart conditions

The penis needs a healthy supply of blood to get up, so any condition that affects that blood flow can result in erectile dysfunction. In fact, blood vessel and heart conditions are one of the leading causes of ED and are often linked to high blood pressure, high cholesterol, diabetes, smoking, obesity, and atherosclerosis or vascular disease (a health condition that causes blood vessels to clog).

Hormonal problems

Common hormonal issues that can alter your libido include decreased testosterone production, increased prolactin production, steroid use, too much or too little thyroid hormone, and too much cortisone.

Nerve damage

When you’re aroused, your brain communicates to specific penile nerves to release chemicals that cause the blood vessel walls to relax, enabling blood to flow into the penis to form an erection. Conditions associated with nerve damage, like multiple sclerosis (MS) and Parkinson’s disease, interrupt communication between the brain and penis, ultimately affecting one’s ability to form an erection.


Despite not having a direct evidence-based link to erectile dysfunction, obesity is an ED risk factor by its association to heart disease, diabetes, high cholesterol and atherosclerosis.

Psychological causes of erectile dysfunction

Psychological causes of erectile dysfunction are related to your emotions and mental health. Conditions like stress, anxiety, and depression impact how the brain triggers the body’s physical responses. Case in point: how effectively your brain communicates the request of extra blood flow to the penis when aroused.

Stress and anxiety

Stress and anxiety are common mental health conditions caused by the pressures of work, money, relationships, and general life. Due to the stress hormones, cortisol and adrenaline, suppressing the sex hormones, stress and anxiety can manifest in an inability to develop or sustain an erection.

Depression and low self-esteem

Men who live with depression are more likely to experience feelings of anger, sadness, and frustration – emotions that can contribute towards a lowered onset of self-esteem.

This systematic review and meta-analysis determined a link between depression and sexual dysfunction for men. Not only did this include erectile dysfunction, but also sexual desire, sexual aversion, lack of sexual enjoyment, failure of genital response, and more.

Performance anxiety

There are many factors that can contribute to performance anxiety in the bedroom. Whether there are problems in your relationship, feelings of inadequacy, or concerns of premature ejaculation, it can be difficult to get out of your own head and be present during sex. And, when you’re mentally living out a moment in your mind, it can be difficult to get and sustain an erection in the physical world.

Based on the causes of erectile dysfunction, you may be able to close in on any suspicions you may have regarding your personal situation. If you aren’t currently diagnosed with any of these conditions yet believe you’re showing signs, speak with your doctor to determine a professional diagnosis.

What are the risk factors of erectile dysfunction?

The risk of erectile dysfunction increases considerably with age. Other potential risk factors for ED include smoking, low physical activity, high body mass index, certain medical treatments, injuries, medications, drug and alcohol use.

So, you think you have erectile dysfunction? Now what?

Found yourself nodding in agreement throughout this article? Congrats! You’ve landed on the first step towards finding out if you have erectile dysfunction. Before any worry of a doomed sex life sets in, let us remind you that ED is a treatable condition, not a life sentence. In most cases, ED is reversible.

These days there are many treatment options available to help restore normal sexual function. These include:

  • Oral medications
  • Penile implant
  • Penile injections
  • Hormone therapy
  • Vascular surgery
  • Counselling
  • Behavioural techniques

To find out the best treatment for you, consult with your trusted doctor or health professional. They’ll assess your medical history, underlying health conditions and conduct a physical examination

And the best part? We’re right here by your side to create a personalised treatment plan that seamlessly slots into your lifestyle. Start the conversation with one of Aussie doctors today.