How an erection actually works
An erection is a chain of four events. When any link is weak, erections get softer, shorter or less reliable. Finding the weak link is the whole point of the assessment.
1. Arousal
Your brain sends a signal from touch, sight or thought.
Weakened by stress, anxiety, low desire
2. Nerves
Nerves carry the signal down the spine to the penis.
Weakened by diabetes, some surgeries
3. Nitric oxide
Blood vessels release nitric oxide and relax open.
Weakened by smoking, poor diet, age
4. Blood flow
Blood rushes in and is trapped, making it firm.
Weakened by high BP, cholesterol, inactivity
What causes erectile dysfunction
In most men it is not one thing. Doctors usually find two or three causes stacking up. These are the most common, with how often doctors see them as a factor.
Blood vessel health
High blood pressure, high cholesterol, smoking and inactivity narrow the arteries. This is the leading cause in men over 40.
Stress and performance anxiety
Worry releases adrenaline, which works directly against an erection. This is the leading cause in men under 40.
Sleep, alcohol and weight
Short sleep lowers testosterone. Heavy drinking dulls nerve signals. Belly fat is linked to both.
Side effects
Some antidepressants, blood pressure pills and hair-loss drugs affect erections. Never stop a medicine without asking your doctor.
ED can be an early warning sign. The arteries in the penis are smaller than those around the heart, so circulation problems often show up there 3 to 5 years earlier. If this is new for you, a check-up is worth it whatever plan you choose.