Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 1/9/2021
Erectile dysfunction, or ED, is a common medical condition that affects approximately 30 million men in the United States.
ED can develop for a variety of reasons. Sometimes, it’s caused by a psychological factor or a lifestyle issue. In other cases, it’s caused by a physical health issue or an injury that may affect your ability to get and maintain an erection.
Some of the factors that cause ED are reversible, often by making changes to your habits and lifestyle. Others aren’t reversible, but can often be treated through a combination of changes to your lifestyle and the use of certain medications.
Below, we’ve gone into more detail about how ED occurs and how several common causes of ED can be treated or reversed. We’ve also talked about treatment options for ED that can help you to maintain an erection and improve your sexual performance.
Healthy erections are all about blood flow. When you’re aroused, your nervous system causes the soft tissue of your penis to relax, allowing blood to flow in. As blood flows in, the tissue of your penis traps the blood in place, keeping your penis hard as you have sex.
As a man, it’s common and perfectly normal to occasionally have difficulty getting or keeping an erection. However, when difficulty getting or maintaining an erection starts to interfere with your sex life, it’s generally viewed as erectile dysfunction.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, you may be affected by erectile dysfunction if you:
Can sometimes get an erection, but not every time you want to have sex
Can get an erection, but find it difficult to maintain it for fulfilling or satisfactory sex
Can’t get an erection at any time
Although ED is more common in older men, it’s far from uncommon to develop ED in your 20s or thirties. The good news is that regardless of how old you are or how severe your ED is, options are almost always available to treat it.
Numerous factors can contribute to ED. Since erections are all about strong blood flow, sexual desire and arousal, the most common causes of erectile dysfunction usually involve your vascular system, your endocrine system and/or your nervous system.
Diseases and health conditions that may cause ED include:
Atherosclerosis (clogged arteries)
High blood pressure
Chronic kidney disease
Type 2 diabetes
ED can also develop as the result of an injury. Some men develop ED following surgical injuries during treatment for prostate cancer or bladder cancer. Others may develop ED after injuries to the pelvis, spinal cord, penis, prostate or bladder.
As well as physical health issues, some psychological or emotional issues can cause or worsen erectile dysfunction. These include:
Sexual performance anxiety
Feelings of guilt regarding sex
Sometimes, ED can develop as a result of a medication you may use. Medications linked to ED include:
Blood pressure medications
Finally, ED can potentially develop as a result of your habits, lifestyle and behavior, especially if one or several of these factors begins to affect your physical or mental health. Lifestyle causes of ED may include:
Being overweight or obese
Living a sedentary lifestyle
Illicit drug use
Excessive alcohol use
Smoking or nicotine use
Because erectile dysfunction has several potential causes, there’s no one-size-fits-all process that can reverse ED in everyone.
However, depending on the cause of your ED, taking certain steps may help to get rid of some of your symptoms and improve your sexual performance without any need for ED medications like sildenafil (the active ingredient in Viagra®, or generic Viagra), tadalafil (Cialis®) or others.
Research shows that ED is often treatable without medication.
For example, a study from the University of Adelaide found that a large proportion of men with ED were able to overcome it naturally by focusing on specific lifestyle factors.
If your ED is caused by a lifestyle factor, such as obesity or smoking, taking action to treat the underlying cause may help to reduce the severity of your ED and let you get erections without the use of medication.
Other lifestyle changes, such as talking with your partner or cutting back on your porn usage, may also help to reverse ED and improve your sexual performance.
If your ED is caused by a medication, switching medications or adjusting your dosage may be all it takes to relieve your symptoms. Don’t do this on your own — instead, let your healthcare provider know about your issues and talk to them about your best options.
If your ED is caused by a psychological factor, such as depression or anxiety, it might improve and reverse as you treat the underlying psychological or emotional issue.
Several different methods are used to treat psychological issues that can cause ED, including counseling and cognitive behavioral therapy (CBT). We’ve talked about these in more detail in our guide to the psychological causes of erectile dysfunction.
If your ED is related to a physical health issue, such as atherosclerosis, diabetes or high blood pressure, treating this may help to reduce the severity of your ED.
Many of the physical health issues that cause or worsen erectile dysfunction can vary hugely in severity. Sometimes, making changes to your lifestyle may be enough to improve your physical health and reverse ED. In other cases, you may need medication or surgery.
If you’re affected by one of the physical health issues listed above, it’s important to talk to your healthcare provider to learn more about the most effective treatment options for you.
Many cases of ED can be reversed by making changes to your lifestyle, switching medications or simply treating underlying health conditions.
However, ED can be a persistent beast. Sometimes, even with major changes to your lifestyle and improvements to your overall health, you’ll still find it difficult to get or maintain an erection during foreplay and sex.
If you have persistent ED, or if the options listed above aren’t totally effective, you may want to consider using medication to treat your erectile dysfunction.
Currently, several FDA-approved medications are available to treat erectile dysfunction. These include:
Sildenafil. The active ingredient in Viagra, sildenafil works quickly and usually lasts for three to five hours.
Tadalafil. The active ingredient in Cialis, tadalafil is a longer-lasting ED medication that can provide relief for up to 36 hours at a time.
Vardenafil. The active ingredient in Levitra®, vardenafil treats ED for slightly longer per dose than Viagra.
Avanafil. The active ingredient in Stendra®, avanafil works very quickly, has a lower risk of causing side effects and treats ED for up to six hours at a time.
We’ve talked more about how these medications work, their effectiveness and more in our guide to the most common ED treatments.
Erectile dysfunction has many different causes, from physical diseases and medical conditions to psychological disorders, medications and more.
If your ED is caused by a psychological issue, lifestyle factor or medication, it may be possible to reverse it by addressing the underlying issue. Similarly, treating the physical issues that can cause ED may improve your symptoms and help you get an erection more easily.
Finally, ED medications like sildenafil, tadalafil and several others can provide relief from erectile dysfunction, improved sexual performance which may increase your self-confidence in bed.
Erectile dysfunction is a common issue that affects men of all ages and backgrounds. Our full guide to erectile dysfunction goes into more detail on why it happens, how it’s diagnosed and the treatments that are currently available.