Most of the time, circulatory problems, especially those that affect blood flow, are the main cause of erectile dysfunction (ED). Atherosclerosis, a condition in which arteries get narrowed from plaque buildup, can make it hard for blood to get to the penis, making it hard to get or keep an erection. Heart problems like high blood pressure, high cholesterol, and diabetes can also make ED worse by hurting nerves and blood vessels.
ED can also be caused by problems with hormones like low testosterone, brain disorders, mental health issues like stress, anxiety, or sadness, and lifestyle choices like smoking, drinking too much alcohol, or being overweight. Finding and treating the root cause is important for treatment to work, so talking to a medical professional is necessary for correct evaluation and management.