What is causing ED and which lifestyle changes can help?

Written By

Our editorial team

Medically reviewed by

Dr. Mahesh Chhaya


Last review

11 November 2020

5 min read

Erectile dysfunction can be embarrassing, but is much more common than you might believe. In fact, approximately 50% of men are affected by the condition at some point in their life.

However, it is important to note ED may be an indicator of a more serious underlying illness which needs further examination by a doctor.

The research of erectile dysfunction and its treatments may lead many men to investigate their health and encourage them to see a doctor. In this way, something outwardly frustrating can contribute to a healthier life.

The mechanics

To understand erectile dysfunction, we first need to understand the mechanics of an erection. An erection is a reaction to aerosol, which sends signals to the muscles around the penis to relax. In turn, this allows more blood to flow into the veins and enlarge the penis. At this point, blood flow can be eight times stronger than usual.

Erectile dysfunction, or impotence, is the term used when a man can’t achieve or maintain an erection long enough for satisfactory intercourse. It is due to a lack of blood flowing to the penis, which can be caused by both psychological and physical issues.

“seeing a therapist or experimenting with ED treatments can be effective”


Psychological issues can include depression, stress, and relationship problems. These are usually short-term and more common in younger men. This kind of erectile dysfunction doesn’t necessarily require medication, but seeing a therapist or experimenting with ED treatments can be effective.


Physiological issues can include heart disease, diabetes, high blood pressure and obesity. These physical causes are more common in older men, and some may not be aware of these issues before experiencing the initial symptom of erectile dysfunction. Treating these conditions may resolve your ED. For example, managing blood pressure and blood sugar levels and losing weight. Using ED medicines such as Viagra, Cialis or Sildenafil can also be an efficient way to treat this type of erectile dysfunction.

Your lifestyle also has an impact on your ability to achieve and maintain an erection. Contributing factors can include over-the-counter and prescription medicines, smoking, excessive drinking and a lack of exercise. These factors, amongst others, can have a direct impact on your sex life, which is why you should always consider these first determining the cause of your impotence.

“pornography can increase the stress associated with sex”

Erectile dysfunction has increasingly become more common amongst younger men, and many believe that the over-consumption of porn causes this. Recent studies indicate that pornography can increase the stress associated with sex, making younger men feel nervous about their bedroom performance. If you suspect this is the cause of your ED, the best solution is often to discuss the issue openly with someone you trust.

How do you know?

So how do you know if your impotence is physical or psychological? The best method is to check if you still have an erection when you wake up in the morning, or if you can get an erection while masturbating. If this is the case, your problem is more likely psychological than physical.

The most effective means to treat erectile dysfunction is with medication.

Treatments became available in April 1998 when Viagra, created by Pfizer, was launched as the first erectile dysfunction medication. The little blue pill was prescribed 40,000 times within its first two weeks on the market. It is estimated that Pfizer earns £1 billion annually from Viagra alone.

History of Viagra

The history of Viagra is interesting, as the active ingredient, Sildenafil, was developed to treat high blood pressure. When the volunteers who had been testing the drug reported back, most of them said that they got an erection several times during their testing period. This encouraged Pfizer to spend more money on this research and did further tests on men in the United Kingdom, France, Sweden and Norway. With this further research they could conclude that Sildenafil does wonders for men with erectile dysfunction. In fact, it worked so well that Pfizer struggled to get their pills back after the trial.

Today there are many treatments available to help with erectile dysfunction, both branded options, such as Cialis and Levitra, and generic options like Sildenafil and Tadalafil.

The variety of ED treatments means that there is something for everyone, whatever your lifestyle.

The myths

There are also a lot of myths surrounding Erectile Dysfunction and its treatments, and we are here to debunk some of them!

  1. Erectile dysfunction only affects older men. This is not true, like we mentioned earlier, more and more younger men suffer from this condition. The good news is that it will most definitely go away with time.
  2. ED treatments, such as Viagra, Sildenafil, Cialis, and Levitra make you horny or give you an erection. This is not correct. These treatments are simply medicines that help the mechanics work properly. They will not work unless you are feeling arousal. The treatments can not make you horny either. However, you might feel excited about having the pills at home, which can be mistaken for arousal.
  3. ED treatments give you long and painful erections. Nope. The erection lasts until you ejeculate or don’t feel arousal anymore. If the erection is painful or lasts for a long time you should contact your doctor immediately.
  4. You can take as many pills as you want. No, this is not true, and can be dangerous. You should only take as many pills as stated on the patient leaflet or suggested by your doctor, which is usually only one pill a day.
  5. You can buy ED treatments without prescription. ED treatments are regulated medications and can only be used when prescribed by a doctor. This is partly because of the potential side effects, but also because it can affect you poorly if used in the wrong way. However, Pfizer has recently launched Viagra Connect which is a ED pill you can buy over the counter in the pharmacy. You still have to answer a lot of questions before buying it, and it is only being sold in 50mg, in packs of 4 or 8.

You can buy ED treatments online if you use a registered and safe online pharmacy, such as 121doc where our doctors make sure you get the treatment that suits you and your lifestyle best.