About 40% of men report some erectile trouble by age 40. That sounds scary, but most causes are treatable. ED means you can’t get or keep an erection firm enough for sex. It can be one-time stress or a sign of a health issue. Here’s a clear, practical guide to help you figure out next steps.
Think of an erection as a plumbing and wiring problem at once. Poor blood flow (heart disease, high blood pressure, diabetes, smoking) and nerve damage (diabetes, surgery, injury) are the top culprits. Hormone issues like low testosterone matter less often but still show up. Many medications — especially some antidepressants and blood pressure drugs — can lower drive or performance. Don’t ignore anxiety and relationship stress; mental health plays a big role.
If you’re tracking causes, check three things: your general health (blood sugar, blood pressure, cholesterol), medicines you take, and recent life stress. Jot down when problems started and whether erections happen during sleep. That helps your doctor pinpoint physical versus psychological causes fast.
Small changes move the needle. Lose a bit of weight, move more (30 minutes of brisk walking most days), quit smoking, and cut back on heavy drinking. Sleep better and manage stress — both boost sexual performance. If a medication might be the issue, don’t stop it on your own. Talk to your prescriber about alternatives.
When it comes to meds that work, PDE-5 inhibitors are the go-to: sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil. They improve blood flow and work well for many men. Differences: onset and how long they last. Take sildenafil 30–60 minutes before sex and avoid a heavy fatty meal that slows it down. Important safety note: never mix PDE-5 drugs with nitrates (often in chest pain meds) — that combo can dangerously lower blood pressure.
Other options if pills don’t help: vacuum erection devices, penile injections, urethral suppositories, and implants. Counseling or sex therapy helps when anxiety or relationship issues are part of the picture. Newer treatments and next-gen PDE-5 drugs are in development — we cover alternatives and emerging options on the site if you want deeper reading.
Also, be careful buying meds online. Use pharmacies that require a prescription and have clear contact info. A safe pharmacy and a short chat with your doctor keep things effective and reduce risk.
When to see a doctor? If ED is sudden, severe, or comes with chest pain, fainting, or shortness of breath, get urgent care. If problems persist for weeks and affect your confidence or relationship, book a medical visit. A basic workup (blood tests, blood pressure check) plus an open talk usually points to the right solution quickly.
ED is common and treatable. Start with health checks and lifestyle tweaks, learn medication options and safety rules, and get professional help when needed. You don’t have to guess alone.
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