There are many potential causes of erectile dysfunction – from underlying medical conditions to unhealthy lifestyle habits, from psychological causes to hormonal changes. Alcohol abuse and smoking affect your erections, too. Erections are the result of complex internal processes – and your sensitive parts are not immune to any wider health problems that you may have.

The most common causes of ED are in your vascular system. When blood can’t flow easily around the body – due to high cholesterol, high blood pressure, cardiovascular disease, or heart disease – enough of it won’t get to where it’s needed. As a result, you won’t be able to achieve a fully firm erection.

However, other causes originate elsewhere. Diabetes, for example, can cause ED, with rates among diabetics potentially as high as 75%. It is thought to be caused by nerve and blood vessel damage, the result of chronic issues with high blood sugar levels.

Meanwhile, men who watch a lot of porn are at risk, too. It’s known as porn-induced erectile dysfunction. It’s thought that pornography can give men unrealistic expectations of what sex is – influencing their ideas of intimacy, sexual performance, and their partners’ bodies. As a result, those who habitually satisfy themselves through porn can struggle to get aroused in real sexual encounters.

ED can also be caused by low testosterone, prostate cancer, kidney disease, Parkinson’s disease, and Peyronie’s disease. Meanwhile, relationship problems, abuse of recreational drugs, and mental health problems including low self esteem can also contribute.

There’s no reason to believe that your erectile dysfunction will become permanent – unless a serious health problem is the cause. In the majority of cases, ED can be stopped using a combination of immediate fixes (e.g. Viagra or Cialis), and long-term psychological and/or physical health improvements.

Studies have shown that if you stop smoking and reduce alcohol intake, the symptoms of ED can improve. If you’re overweight – a risk factor for ED – losing it can help you to regain erectile function. In the meantime, ED medications will usually help.

ED can be treated in the short-term effectively, safely, and easily – in most cases, just by popping a pill. Treatments like Sildenafil and Tadalafil – the active ingredients in Viagra and Cialis respectively – have been shown to be effective in over 80% of cases, and side effects of these drugs are very uncommon.

Both drugs are PDE5 inhibitors. They target the enzyme, phosphodiesterase 5, which is responsible for smooth muscle contraction in the blood vessels supplying your penis. By inhibiting this enzyme, blood flow is improved – increasing the chances of achieving and maintaining a full erection.

Improving your lifestyle – through exercise, a healthy diet, and a reduction in your intake of alcohol and cigarettes – can be a longer-term cure for ED too. Psychological causes can be treated through counselling (CBT), self-talking therapies, and psychosexual counselling. It might also help to engage in mindfulness and relaxation therapies.

Sildenafil and Tadalafil – known by their common brand names, Viagra and Cialis – are the most effective erectile dysfunction drugs on the market. They work in over 80% of men, and studies have shown that they are less likely than Vardenafil and other PDE5 inhibitors to cause side effects.

So, both are effective. However, which is best for your specific needs is a different question. Whilst Sildenafil can take up to 30 minutes to an hour to take effect and lasts for 4-5 hours, Tadalafil can be effective within 30 minutes – and can last up to 36 hours.

Erectile dysfunction is not something just for older men. Men as young as twenty can experience it, too.

That is in part because they are more likely to smoke, more likely to binge drink, and are less likely to be able to manage stress. That’s a cocktail of psychological and physical causes present in your early adulthood that can potentially cause ED – and that’s before we mention things like performance anxiety.

Studies show that over a third of men under 30 have experienced some degree of ED in their lives. That said, ED in your 20s or 30s shouldn’t be seen as “normal”. It may be a warning sign for an unhealthy lifestyle, and this should be addressed as soon as possible. There’s no shame in using Viagra or Cialis, though, if you need help to achieve and maintain an erection.

ED is not thought to be a natural part of ageing – even though it is a condition usually associated with older men. Rather, it is more likely to be the sign of an underlying health condition that would benefit from your attention. This includes general health and fitness, as well as diet.

About 50% of men in their 50s experience erectile dysfunction. As you age, it is more likely that ED is the result of atherosclerosis, or the narrowing of your arteries. It’s usually the sign of poor cardiovascular health, but could also indicate something more serious. In these instances, we recommend you see your GP for a health check to exclude underlying causes.