When Should You Worry About Erectile Dysfunction?


For most men, an occasional bout with erectile dysfunction (ED) is normal. Stress, fatigue, or a case of bedroom nerves can all lead to a soft or flaccid penis. Alcohol and various medication side effects may also inhibit sexual function.
But in spite of the common idea that a soft penis is caused by a lack of attraction or performance anxiety, it’s estimated that ED is linked to a physical health problem. And if a man frequently has trouble getting an erection, that can be a sign of a more serious underlying condition.
Many people think impotence means the penis is not able to get hard at all. But for doctors, ED can also include cases where an erection doesn’t last long enough for satisfying sex. Either way, if you’ve been experiencing ED for longer than a couple of months, it’s a good idea to address it with your doctor.
Doctors can usually determine whether ED is physical or psychological by taking a complete history, conducting a physical exam, doing blood work, and monitoring whether erections occur during sleep. In a simple test, a piece of paper or tape is wrapped around the soft penis before bed. If in the morning the paper has broken, it means an erection occurred overnight and the plumbing is working just fine. If the paper remains in place, it might be a sign that impotence is caused by a physical problem.
In fact, ED is commonly associated with several life-threatening health conditions, including diabetes and heart disease. ED is even associated with a greater risk of death. That’s why you should always bring it up with your doctor. In many cases, ED is one of the first symptoms of a more serious problem. By addressing it early, you can start treating health problems early, when they’re easier to treat.
Health conditions that can cause erectile dysfunction include:
Heart Disease and Erectile Dysfunction
For an erection to happen, the blood vessels in the penis need to relax and become engorged with blood, which is why ED is closely tied to cardiovascular health. In fact, doctors have called ED a “canary in the coal mine” for heart disease, because it’s often one of the earliest symptoms of cardiovascular problems.
Arteries to the penis are smaller than the ones that lead to the heart, so any blockages or other problems that inhibit blood flow will show up in the penis first, sometimes years before symptoms are seen in other parts of the body. In fact, men who start experiencing ED in their 40’s have an 80% chance of developing heart problems within 10 years, even if they have no other symptoms of cardiovascular disease.
Diabetes and Erectile Dysfunction
According to one study, as many as half of men with type 2 diabetes will go on to develop ED. Diabetes can affect the penis in multiple ways. It can slowly damage the blood vessels that lead to the genitals, leading to reduced blood flow to the area.
As diabetes progresses it can also cause peripheral neuropathy, or nerve damage. While this most commonly leads to numbness and weakness in the extremities like hands and feet, it can also affect the penis. Diabetic neuropathy is more common in people who are older, overweight and have high blood pressure.
Low Testosterone and Erectile Dysfunction
Impotence can sometimes be a sign of low levels of testosterone, the sex hormone produced by the testes. Testosterone plays a role in libido and sexual desire, but it can also affect someone’s energy levels, muscle development, bone strength, and their overall mood. While testosterone can decrease as men age, low testosterone can also be caused by other medical conditions including problems with the thyroid, pituitary gland, and liver, and problems with the testicles. Symptoms of low testosterone can include:
- Fatigue
- Moodiness and irritability
- Reduced libido
- Weight gain
- Reduced muscle mass
- Hot flashes
If your doctor diagnoses you with ED due to low testosterone, testosterone replacement therapy may help.
Neurological Conditions and Erectile Dysfunction
Erections are triggered by the central nervous system, so it’s not surprising that disorders and injuries that damage the spinal cord and nerves can also cause ED. Loss of sexual function is a common symptom of multiple sclerosis and Parkinson’s disease, and can often be treated with medication.
Mental Health and Erectile Dysfunction
Even though the majority of cases of ED are caused by a physical problem, psychological issues like depression and anxiety can also play a role. But it’s a two-way street. Erectile dysfunction can be a symptom of depression, which also commonly causes fatigue, loss of interest in activities, trouble sleeping, and low self-esteem. But ED can trigger depression as it cause men to become frustrated, sad, and feel insecure.
Anxiety, PTSD, and other mental health issues are also associated with ED, and it’s important to remember that impotence can be a side effect of substance abuse, including chronic alcohol use, and some illegal drugs.
When ED is psychological, addressing the underlying mental or emotional cause can often help, either with medication or with talk therapy. Treatment can be complicated, however, by the fact that some medications that treat depression and other issues can actually make ED worse.
If you’re having trouble maintaining an erection long enough for satisfying sex, don’t suffer in silence. Impotence isn’t a personal failing, and may often be an early symptom of a more serious physical problem. The good news is that by talking with your doctor and addressing ED early, you can not only restore intimacy to your relationships and improve your quality of life, you can also help take care of your overall health.

Ilima Loomis
Ilima Loomis is a freelance writer and journalist who specializes in writing about health care, HR, science, travel, and Hawaii. You can find more of her work at ilimaloomis.com. Ilima is a regular contributor to the RxSaver blog.
The information on this site is generalized and is not medical advice. It is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. Always seek the advice of your healthcare professional with any questions you may have regarding a medical condition. Never disregard seeking advice or delay in seeking treatment because of something you have read on our site. RxSaver makes no warranty as to the accuracy, reliability or completeness of this information.
If you are in crisis or you think you may have a medical emergency, call your doctor or 911 immediately.
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