Erectile Dysfunction: Causes, Fixes, and Modern Treatments for Men

Erectile dysfunction (ED) is far more common than most men realise—and far more treatable than many expect.

If you’re a man in your 30s, 40s, or 50s noticing changes in erection quality, consistency, or confidence, this isn’t a personal failure or “just getting older.” It’s a health signal—and often an early one.

Let’s break down why ED happens, what you can do right now, and the full spectrum of modern treatments—from lifestyle fixes to medical therapies.

What Is Erectile Dysfunction (Really)?

ED is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. That might look like:

• Difficulty getting an erection

• Losing it midway

• Softer erections than before

• Needing more stimulation than you used to

Importantly, ED isn’t just about sex—it’s closely linked to cardiovascular health, hormones, metabolic health, sleep, stress, and mental wellbeing.

The Real Causes of ED (It’s Usually Multifactorial)

1.

Vascular Health (The #1 Cause)

An erection is fundamentally a blood flow event. Anything that impairs circulation will affect performance.

Common contributors:

• High blood pressure

• High cholesterol

• Insulin resistance / diabetes

• Smoking or vaping

• Low cardiovascular fitness

ED is often an early warning sign of future heart disease—sometimes appearing 5–10 years earlier.

2.

Low Testosterone & Hormonal Imbalance

Testosterone plays a role in:

• Libido (desire)

• Erectile quality

• Energy and motivation

• Muscle mass and body fat distribution

Low testosterone doesn’t always cause ED directly, but it often lowers desire and reduces responsiveness to other treatments.

Other hormonal factors include:

• Elevated prolactin

• Thyroid dysfunction

• High oestrogen relative to testosterone

3.

Psychological Factors (More Common Than You Think)

Stress, anxiety, performance pressure, relationship tension, and low mood can all interfere with erections—especially in younger men.

This doesn’t mean “it’s all in your head.”

It means the brain–body connection matters.

4.

Lifestyle & Recovery Debt

Modern life is hostile to erections:

• Poor sleep

• Excess alcohol

• Chronic stress

• Sedentary work

• Low sunlight exposure

• Overtraining or under-recovery

Many men are unknowingly running a recovery deficit.

5.

Medications & Substances

Some common culprits include:

• Antidepressants (SSRIs)

• Blood pressure medications

• Finasteride

• Excessive alcohol

• Recreational drugs

Step One: Fix the Foundations

Before pills or injections, these changes alone can dramatically improve ED:

✅ Improve Cardiovascular Fitness

• Regular resistance training

• Zone 2 cardio

• Walking daily

✅ Optimise Sleep

• Aim for 7–9 hours

• Address sleep apnoea if snoring or unrefreshed

✅ Nutrition for Blood Flow & Hormones

• Adequate protein

• Healthy fats (olive oil, eggs, fish)

• Reduce ultra-processed foods

• Manage abdominal fat

✅ Stress & Nervous System Regulation

• Breathwork

• Time off devices

• Sunlight

• Real recovery days

These aren’t “soft” interventions—they’re foundational medicine.

Medical Treatments for ED (What Actually Works)

1.

Oral Medications (PDE5 Inhibitors)

Common options include:

• Sildenafil

• Tadalafil

They work by improving blood flow—but they don’t create desire and don’t fix the root cause.

Best results occur when:

• Cardiovascular health is addressed

• Testosterone is adequate

• Anxiety is managed

2.

Testosterone Optimisation (When Appropriate)

If blood tests confirm deficiency and symptoms align, testosterone optimisation can:

• Improve libido

• Enhance erectile quality

• Improve response to ED medications

• Increase confidence and wellbeing

This must be properly assessed and monitored—it’s not about chasing numbers.

3.

Psychosexual Support

For men with anxiety-driven or situational ED:

• Targeted counselling

• Mindset and confidence work

• Relationship communication strategies

Often combined with short-term medical support.

4.

Advanced Therapies (For Selected Cases)

• Vacuum erection devices

• Injection therapies

• Emerging regenerative approaches (case-dependent)

A Smarter Way to Approach ED

The biggest mistake men make is treating ED in isolation.

The smarter approach:

1. Identify root causes

2. Optimise lifestyle and health markers

3. Use medications strategically—not as a crutch

4. Rebuild confidence and performance together

ED is rarely “just bad luck.”

It’s your body asking for attention.

When Should You See a Doctor?

If ED is:

• Persistent (not just occasional)

• Getting worse

• Associated with fatigue, low libido, or mood changes

• Occurring alongside weight gain or poor fitness

…it’s time for a proper men’s health assessment, not just a script.

Final Thought

Strong erections are not a luxury—they’re a marker of health, vitality, and longevity.

Addressing ED properly doesn’t just improve sex.

It improves energy, confidence, performance, and long-term health.