An erection involves the brain, nerves, hormones, muscles, and circulatory system. These systems work together to fill the erectile tissue in the penis with blood.

A man with erectile dysfunction (ED) has trouble getting or maintaining an erection for sexual intercourse. Some men with ED are completely unable to get an erection. Others have trouble maintaining an erection for more than a short time.

ED is more prevalent among older men, but it also affects younger men in large numbers.

There are many possible causes of ED, and many of them are treatable. Read on to learn more about ED’s causes and how it’s treated.

The University of Wisconsin reports an approximate correlation between the percentage of men affected by mild and moderate ED and their decade in life. In other words, approximately 50 percent of men in their 50s and 60 percent of men in their 60s have mild ED.

A 2013 study published in the Journal of Sexual Medicine suggests that ED is more common among younger men than previously thought.

Researchers found that ED affected 26 percent of adult men under 40. Almost half of these young men had severe ED, while only 40 percent of older men with ED had severe ED.

Researchers also noted that younger men with ED were more likely than older men with ED to smoke or use illicit drugs.

You may feel uncomfortable discussing ED with your doctor. However, having an honest conversation is worth it, as facing the problem head-on can lead to proper diagnosis and treatment.

Your doctor will request your complete medical and psychological history. They’ll also perform a physical exam and select lab tests, including a testosterone level test.

ED has several potential physical and psychological causes. In some cases, ED can be an early sign of a serious health condition.

Heart problems

Getting and keeping an erection requires healthy circulation. Clogged arteries — a condition known as atherosclerosis — is one possible cause of ED.

High blood pressure can also lead to ED.

Diabetes

ED can be a sign of diabetes. This is because high levels of blood glucose can damage blood vessels, including those responsible for supplying blood to the penis during an erection.

Obesity

Obesity is a risk factor for diabetes and hypertension. Overweight young men should take steps to lose excess weight.

Hormonal disorders

Hormonal disorders, such as low testosterone, may contribute to ED. Another possible hormonal cause of ED is increased production of prolactin, a hormone the pituitary gland produces.

Additionally, an abnormally high or low thyroid hormone level can result in ED. Young men who use steroids to help build muscle mass are also at a higher risk for ED.

The feelings of sexual excitement that lead to an erection start in the brain. Conditions such as depression and anxiety can interfere with that process. One major sign of depression is withdrawal from things that once brought pleasure, including sexual intercourse.

Stress related to jobs, money, and other life events can contribute to ED too. Relationship problems and poor communication with a partner can also cause sexual dysfunction in both men and women.

Alcohol addiction and drug abuse are other common causes of ED among young men.

Treating the cause of ED may help resolve the problem. Lifestyle changes and natural remedies make a positive difference for some men. Others benefit from medications, counseling, or other treatments.

According to recent guidelines from the American Urological Association (AUA), certain groups of men may need specialized testing and evaluation to help shape their treatment plans. These groups include young men and men with a strong family history of heart disease.

Ignoring ED isn’t advised, particularly because it can be a sign of other health problems.

Healthy lifestyle changes

Healthier eating, getting more exercise, and losing weight may help minimize the problems caused by ED. Quitting smoking and reducing alcohol use is not only wise in general, but it may also help with ED.

If you’re interested in natural remedies such as herbs, let your doctor know before trying them.

Communication with your partner is also essential. Performance anxiety can compound other causes of ED.

A therapist or other mental health professional may be able to help you. Treating depression, for example, may help resolve ED and bring about additional benefits as well.

Oral medications

Oral phosphodiesterase type 5 (PDE5) inhibitors are prescription drugs that can help treat ED. These medications are recommended before more invasive treatments are considered.

PDE5 is an enzyme that can interfere with the action of nitric oxide (NO). NO helps open the blood vessels in the penis to increase blood flow and produce an erection.

There are four PDE5 inhibitors currently on the market:

Side effects may include headache, flushing, vision changes, and upset stomach.

Intracavernosal injections

Alprostadil (Caverject, Edex) is a solution that’s injected into the base of the penis 5 to 20 minutes before sex. It can be used up to three times each week. However, you should wait at least 24 hours between injections.

Side effects may include pain and burning in the genital area.

Intraurethral suppositories

Alprostadil is also available as a suppository for erectile dysfunction. It is sold as MUSE (Medicated Urethral System for Erections). It should be used 5 to 10 minutes before sexual activity. Avoid using it more than two times in a 24-hour period.

Side effects may include pain and burning in the genital area.

Testosterone

Men whose ED is the result of low testosterone may undergo testosterone therapy. Testosterone

is available in a variety of forms, including gels, patches, oral tablets, and injectable solutions.

Side effects may include moodiness, acne, and prostate growth.

Vacuum constriction devices

Other treatment options may be considered if medications aren’t entirely successful. Vacuum constriction devices are generally safe and effective.

The treatment involves placing a cylinder over the penis. A vacuum is created inside the cylinder. This leads to an erection. A band is placed around the base of the penis to preserve the erection, and the cylinder is removed. The band must be taken off after about 30 minutes.

Find one on Amazon.

Surgery

A last resort for men with ED is the implantation of a penile prosthesis.

Simple models allow the penis to bend downward for urination and upward for intercourse. More advanced implants allow fluid to fill the implant and form an erection.

There are risks associated with this operation, as there are with any surgery. It should only be considered after other strategies have failed.

Vascular surgery, which aims to improve blood flow in the penis, is another surgical option.

ED can be an uncomfortable topic to discuss, especially for younger men. Remember that millions of other men are dealing with the same issue and that it’s treatable.

It’s important to seek treatment for ED because it may be a sign of other health problems. Addressing the condition directly with your doctor will lead to faster and more satisfactory results.