Erectile Dysfunction: Causes, Myths, and When to See a doctor

01/30/2026 Helal Medical

Erectile Dysfunction (ED) is a common condition that affects many men, especially after the age of 40. Despite this, it remains a sensitive topic that many men avoid discussing, even with their doctors. Some assume it is a normal part of aging.

As a doctor, I often encounter patients hesitant to discuss their poor performance in bed. They present, at the start, with a different complain, like being tired, headache, mood changes and alike. I recall one patient who suffered silently for years, embarrassed to seek help. After building trust, he opened up, revealing his anxieties. We discussed his options, from lifestyle changes to medical treatments, and together, we found a solution that restored his confidence and intimacy. This story is a reminder that open communication is key to addressing ED and improving men’s quality of life.

At Helal Medical Manila, we emphasize that impotence is often a medical symptom, not just a sexual problem. In many cases, it can be an early sign of underlying health conditions such as heart disease, diabetes, or hormonal imbalance.

In this article, I will explore ED, its causes, available options, from lifestyle changes to medical treatments, and when to visit a doctor.

What Is Erectile Dysfunction?

It is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is also referred to as impotence, though this term is used less often now. Occasional difficulty, not consistent, is normal and does not indicate ED. However, ongoing or worsening problems require medical evaluation. This issue can impact men’ and their partners, with negative emotional well-being.

Common Causes

ED can result from conditions affecting the circulatory, nervous, or endocrine systems. Psychological or emotional conditions and certain medications or substances can also cause it.

1. Vascular (Blood Flow) Problems

Adequate blood flow is essential for an erection. Conditions that damage blood vessels can lead to ED, including:

High blood pressure
Atherosclerosis (narrowed arteries)
Heart disease

ED may appear years before heart symptoms, making it an important early sign and marker.

2. Diabetes

It affects both circulatory and nervous systems reasons:

Blood vessels and nerves are involved in erection. Diseases affecting them can negatively affect erection.

Men with poorly controlled diabetes have a significantly higher risk of erectile dysfunction.

3. Hormonal Imbalance

Low testosterone levels may reduce sexual desire and contribute to ED. Hormonal causes should always be evaluated with proper blood tests before treatment.

4. Psychological Factors

Mental health plays a major role. Often, psychological and physical causes coexist. Common contributors include:

Stress
Anxiety
Depression
Relationship problems
Performance anxiety

5. Medications and Lifestyle Factors

Certain medications can affect erections, such as:

Some blood pressure drugs
Antidepressants
Sedatives

6. Lifestyle Factors

Obesity
Alcohol overuse
Lack of physical activity
Poor sleep
Smoking

Common Myths

Myth 1: ED Is Just a Normal Part of Aging

While ED becomes more common with age, it is not inevitable and should not be ignored.

Myth 2: ED Is Only a Psychological Problem

Many cases have a physical cause, especially in men over 40.

Myth 3: Supplements Are Safer Than Medical Treatment

Many over-the-counter “sexual enhancers” are unregulated and may contain harmful substances.

Why Impotence Should Not Be Ignored

It may indicate:

Early cardiovascular disease
Poor blood sugar control
Hormonal disorders
Chronic stress

Addressing ED early can help prevent serious health complications later.

In the middle of medical evaluation, doctors often discover that erectile issue is the first visible sign of systemic disease.

How It Is Diagnosed

A proper medical evaluation is required. Self-diagnosis should be avoided. A doctor can diagnose ED and determine its cause through a review of medical, sexual, and mental health history, a physical exam, and lab tests.

Detailed medical and sexual history
Blood pressure measurement
Blood tests (blood sugar, cholesterol, testosterone)
Cardiovascular risk assessment
Lifestyle review

Treatment Options

Treatment for ED involves identifying the underlying cause. Options include lifestyle change, talking to a sex therapist, oral medications, and other medical treatments.

Lifestyle Changes

Often the first and most effective step:

Regular exercise
Weight management
Smoking cessation
Reduced alcohol intake
Stress management

Medical Treatment

Depending on the cause, options may include:

Prescription oral medications
Hormonal therapy (when indicated)
Management of underlying conditions

When Should You See a Doctor?

Men should seek medical advice if:

ED persists for more than 3 months
Erections are consistently weak or absent
Libido has significantly decreased
ED is associated with fatigue or mood changes
There is a history of diabetes or heart disease

Medical consultations are confidential, respectful, and patient-focused.

Summary

Erectile dysfunction means difficulty getting or keeping an erection. It is common and often treatable. ED is not just about sex — it can be a sign of heart problems, diabetes, or hormone issues. Seeing a doctor early helps treat the problem and protect your overall health.

It is a medical condition that deserves attention, not embarrassment. With proper diagnosis and treatment, most men can regain sexual function and confidence.

Early medical consultation leads to safer, more effective outcomes and better long-term health.

🔗 Sources

Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction
Cleveland Clinic
https://my.clevelandclinic.org/health/diseases/15029-erectile-dysfunction
Harvard Health
https://www.health.harvard.edu/mens-health/erectile-dysfunction

Erectile Dysfunction: Causes, Myths, and When to See a doctor

What Is Erectile Dysfunction?