Erectile Dysfunction: Causes, Myths, and When to See a doctor
Last Updated on 02/16/2026 by 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.
What Are the 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. Diabetes disease affects them and can negatively affect erectile function. Men with poorly controlled diabetes are at a significantly higher risk.
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 (ED) Myths:
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.
2: ED Is Only a Psychological Problem
Many cases have a physical cause, especially in men over 40.
3: Supplements Are Safer Than Medical Treatment
Many over-the-counter “sexual enhancers” are unregulated and may contain harmful substances.
Why Should Impotence Not Be Ignored?
Impotence is not only about erection, but it can also indicate a serious underlying illness. S, it must 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 Is It 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
What are the 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.
Coping with Impotence
Impotence can be a difficult and embarrassing problem to cope with. Men may feel ashamed, guilty or like a failure because of it. It is important to understand that impotence is a common condition that can be treated. Here are some tips to help men cope with impotence:
- Communicate openly with your partner and loved ones.
- Seek professional help, such as counseling or therapy, to work through any emotional and psychological issues.
- Practice self-care and prioritize your physical and mental health.
- Join a support group, where you can connect with other men who are dealing with impotence.
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
Read More from Helal Medical
- Hypogonadism: Symptoms, Causes, and Treatment Options
- Causes of low sex drive (libido) in men
- Men’s Health: Interesting Facts & Health & Comprehensive Overview
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