The problem caused by erectile dysfunction can be twofold: sending out the right signals from the brain or maintaining an erection that is firm enough for sex and remains in that state, allowing sexual intercourse.

Physical Causes of ED

If erectile dysfunction occurs more than half the time, it might be a sign of the following physical conditions, particularly if the man is older than 50: diabetes, high blood pressure, high cholesterol and cardiovascular disease. Lifestyle habits also play a role. If the patient is a smoker, drug or alcohol abuser, is obese and doesn’t exercise, then he may be a prime candidate for erectile dysfunction.

Most doctors will conduct a physical and an extensive interview to determine the root causes of erectile dysfunction. Particularly important is the timing of the onset and whether any work issues or other outside influences may contribute to the problem. The emotional roots of the issue are harder to pin down and may center on the relationship with a partner, satisfaction with sex life, and any history of mental illness or depression. The doctor also will ask about nocturnal penile tumescence or automatic erections during sleep, both signs that the physical tools are working properly.

It’s important for the doctor to understand whether medication may cause the issue and if there is any prior history of surgery or injury in the pelvic area, or if there are urinary problems. A blood test or urine sample may be necessary.

It is possible that an imaging test may be required. This will check inside the body for blood flow, leaks in the veins, scars in the erectile tissue areas and potentially clogged arteries. Sometimes, the imaging test is accompanied by an injection into the penis that will cause an erection. That way, the imaging will monitor the blood flow and other issues in the erect penis for comparison when it is flaccid.