It’s a topic not many men want to discuss: Erectile dysfunction (ED). We hear you. But it’s actually more common than you think – and therefore worthy of a bigger discussion. Even better: It’s treatable when you look at the bigger picture of what’s going on down there.

To help you understand – and hopefully begin to reduce some of the stigma behind – erectile dysfunction, we’ve broken down the most common questions, including what is ED? What causes it? And what ED treatments are available to me?

What is erectile dysfunction, or ED?

Erectile dysfunction is the term used to describe when a man consistently (think: three or more months) has trouble getting an erection or keeping it long enough for sex. It’s usually the result of not enough blood flowing to the penis, which can happen for an array of reasons both physiological and psychological.

ED is also referred to as impotency, or being impotent.

What is the usual age for erectile dysfunction?

It’s not exactly good news, but if you’re struggling with exual dysfunction, perhaps you’ll find solace in this stat: ED is the most commonly reported sex-related condition, affecting approximately 30 million men in the United States.

It affects men of all ages but older men experience a hard time getting… harder, mostly due to chronic diseases and health problems which can cause ED such as heart disease, diabetes, and obesity.

What lifestyle factors contribute to erectile dysfunction?

For men in their 20s and 30s, the leading factors for ED are due to lifestyle – with the exception of performance anxiety or mental health issues (more on those below). Let’s discuss the top lifestyle factors.

If you’re a frequent smoker

If you ever needed a reason to quit smoking, knowing this may be your hail mary: Smoking cigarettes or tobacco is shown to lead to erectile dysfunction. Smoking is also linked to heart and blood vessel disease which can lead to ED.

If you’re a heavy drinker

Research indicates that high consumption of alcohol is more likely to affect erectile dysfunction.

The erection is very much linked to the mind-body connection, and alcohol disrupts the spinal cord-brain-body messaging system; thus, those neverending happy hours can have a direct impact on your ability to get and stay aroused.

If you partake in recreational drugs

In one study of more than 700 men who frequently partook in illicit drug use, ED was most commonly seen in heroin users, followed by amphetamine users, trailed behind by MDMA mono-users.

If you avoid the gym

You know it, we know it, everyone knows it: Exercise has a multitude of health benefits on the mind, body, and spirit – and also, the bedroom.

According to one Harvard study, just 30 minutes of walking a day was linked with a 41% drop in risk for ED. Besides physical activity, a strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein (time for Kegels!).

If you love junk food

Unfortunately, one simple trick to cure ED does not exist. However, eating a diet filled with fruit, vegetables, whole grains, and fish — with less red and processed meat and refined grains — does decrease your chances of ED. A healthy diet is never a bad idea!

What medical conditions contribute to erectile dysfunction?

Erections are quite complex – and require a strong, healthy body-brain connection in order to function. Some of the top erectile dysfunction causes stem from medical conditions. Let’s take a look.

Your mental health

Depression, anxiety, and stress are the catch-22s of ED. These psychological issues can be the primary cause of ED, or they can be a response to ED. That is, you can have anxiety over getting erections or you can have erection problems that cause you anxiety. Sigh.

Bedroom woes

Along the same lines, relationship problems, low self-esteem, or any sort of bedroom-related anxiety can impact your ability to get aroused. Because getting and staying hard can be seen as a “sign of masculinity,” social pressure can impact one’s ability to perform; this is often called “performance anxiety.”

Cardiovascular disease

Previously, it was believed that ED often preceded cardiovascular disease due to plaque buildup in the arteries, leading to reduced blood flow to the penis. However, it’s now understood to be a dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle.

Regardless, ED is a marker of a significantly increased risk of cardiovascular disease.

Endocrinologic conditions (e.g., diabetes)

Diabetes can cause small vessel disease or nerve damage to the penis. This means men with diabetes are three times more likely to have ED than men without diabetes.

Other endocrinologic conditions, often comorbid with diabetes, that can cause erectile dysfunction include: - Low levels of testosterone - Hypogonadism (gonads produce little or no hormones) - Obesity

Neurological disease

In addition to arousal and blood flow, the nervous system plays an important role in maintaining an erection. Neurological erectile dysfunction is any form of ED that’s caused by impairment to your nervous system. This may be caused by injuries that affect your nervous system, such as: - Surgery to the prostate or bladder - Multiple sclerosis - Epilepsy - Parkinson’s disease - Diabetic neuropathy

Medications that can have ED side effects

If you’ve started a new medication, and impotence quickly comes knocking on the bedroom door, it may be the side effects of your new prescription. Some medications can contribute to ED, these include:

  • Antidepressants
  • Anti-seizure medications
  • Antipsychotic medications
  • Certain blood pressure medications
  • Any medications that impact hormones
  • Finasteride* (see details here)

What are my options for safe treatment for erectile dysfunction?

The best course of action is to find out what’s going on with your emotional and physical health. Some STD clinics offer free or low-cost ED tests to determine the underlying cause.

Oral medications can help things return to normal during sex. They include: - Sildenafil citrate† (generic Viagra®) - Tadalafil†† (generic Cialis®)

The usage of each drug may vary. For example, some are taken before activity and some are taken daily. Overall, the road to effective ED treatment is to take your medication as prescribed. Studies of men who report non-response indicate that incorrect use (e.g., lack of sexual stimulation, medication taken with a large meal) accounts for the majority of treatment failures.

There’s hope ahead

Sexual dysfunction doesn’t have to be something you live with. If you’re experiencing ED symptoms, the first step is to speak with your primary care provider to discuss your symptoms and medical history.

If you’re looking for erectile dysfunction products, you can get discreet help delivered to your door through Keeps. Treatment is available, leading to not only improved intimacy for you and your partner but overall physical and emotional health for you.

Complete a consultation to connect with a Keeps medical provider to find the personalized ED treatment plan that’s right for you.


The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Finasteride (1mg), Rx only, treats male pattern hair loss (androgenetic alopecia). Finasteride may cause side effects, including decreased libido, erectile dysfunction, and ejaculation disorder. If you would like to learn more about finasteride, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH /default.htm or call 1-800-FDA-1088.

†Sildenafil citrate (generic Viagra®) (25mg, 50mg, & 100mg), Rx only, treats erectile dysfunction. Sildenafil citrate may cause side effects, including headache, flushing, and indigestion. If you would like to learn more about sildenafil citrate, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH /default.htm or call 1-800-FDA-1088.

††Tadalafil (generic Cialis®) (2.5mg, 5mg, 10mg, & 20mg), Rx only, treats erectile dysfunction. Tadalafil may cause side effects, including headache, indigestion, back pain, and muscle pain. If you would like to learn more about tadalafil, please see the full prescription information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: HTTPS://WWW.FDA.GOV/SAFETY/MEDWATCH /default.htm or call 1-800-FDA-1088.

**Consultation required. Medication prescribed if appropriate.

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