Erectile Dysfunction Symptoms and Treatment: A Physician’s Perspective

Feb 5
6 min read

I talk to men every week who are quietly worried something isn’t right—but they’re not sure if it’s serious enough to bring up. Erectile dysfunction often starts subtly, and many men spend months, sometimes years, trying to ignore it.

It’s important to know that occasional erection trouble is common and not always a cause for concern. However, if erection trouble persists, it may indicate a more serious problem that should be evaluated by a healthcare professional.

This is understandable. Erectile issues are personal. They can bring up fear, embarrassment, or concern about what it might mean long-term. My goal in writing this is to help you understand what erectile dysfunction can look like early on, what it may be signaling, and how I approach treatment in a thoughtful, medical, and discreet way.

Erectile Dysfunction Doesn’t Always Start the Same Way

When most people think of erectile dysfunction, they imagine a complete inability to get an erection. In reality, that’s often not how it begins.

These are some of the symptoms men describe to me most often:

Erections that aren’t as firm as they used to be
Difficulty maintaining an erection through intercourse
Erections that vary from day to day
Less reliable morning erections
Needing more stimulation than before

Premature ejaculation is another common sexual health concern that may occur alongside or independently of erectile dysfunction.

Many men assume this is “just stress” or “just getting older,” and sometimes that’s partly true. But persistent changes are worth paying attention to.

Understanding What Erectile Dysfunction Is (Definition and Prevalence)

Erectile dysfunction (ED) is defined as the consistent difficulty in achieving or maintaining an erection firm enough for sexual intercourse. It’s one of the most common issues affecting men’s health, with more than 18 million American men experiencing some degree of ED. While it’s often thought of as a problem that only affects older men, ED can occur at any age and is influenced by a range of factors.

Healthy erections depend on proper blood flow, balanced blood pressure, and a healthy mental state.

When any of these are disrupted—whether by high blood pressure, mental health conditions like anxiety or depression, or other health conditions—erectile dysfunction can develop. Recognizing that ED is both common and treatable is the first step toward improving sexual health and overall wellbeing.

Why I Take Erectile Dysfunction Seriously

Erections rely on healthy blood flow, intact nerves, a properly functioning nervous system, balanced hormones, and mental focus. When something changes, it’s often because one—or more—of those systems isn’t functioning optimally.

When a patient comes to see me for erectile dysfunction, I’m not just thinking about sexual performance. I’m also thinking about:

Circulation and cardiovascular health
Hormone levels, including low testosterone, which is a common contributing factor
Blood sugar and metabolic health
Sleep, stress, and mental wellbeing
Medications that may be contributing

In many cases, erectile dysfunction is an early signal. It can appear before other health issues become obvious. That’s one of the reasons I encourage men not to ignore it.

What Causes Erectile Dysfunction?

Erectile dysfunction can result from a complex interplay of physical and mental health factors. Physical causes often involve issues with blood vessels, such as atherosclerosis or other cardiovascular diseases, which can restrict blood flow to the penis. Nerve damage, hormonal imbalances, and certain chronic health conditions can also play a significant role.

Mental health conditions—including stress, anxiety, and depression—are equally important contributors. These can interfere with sexual arousal and the body’s ability to respond. Additionally, certain medications, excessive alcohol consumption, and lifestyle choices like smoking can worsen ED symptoms. Identifying the underlying cause—whether it’s a physical issue, a mental health concern, or a combination—is essential for creating an effective treatment plan tailored to each individual.

When Erectile Dysfunction Becomes a Pattern

An occasional off night happens to everyone. That alone isn’t erectile dysfunction.

I become more concerned when symptoms are:

Happening regularly
Gradually worsening
Affecting confidence or intimacy
Leading to avoidance of sex

Ongoing erectile dysfunction can contribute to relationship problems, as these challenges may both result from and contribute to ED.

If you find yourself planning around the issue, feeling anxious before intimacy, or noticing that erections are becoming less predictable, those are signs it’s time to talk with a physician.

Recognizing the Risk Factors

Understanding what increases your risk for erectile dysfunction can help you take proactive steps to protect your sexual health. Some of the most significant risk factors include cardiovascular disease, high blood pressure, diabetes, and obesity. Smoking and excessive alcohol use can also damage blood vessels and reduce erectile function.

Mental health conditions such as depression and anxiety are closely linked to ED, as are certain medications and chronic health conditions like digestive and kidney diseases. Hormonal imbalances can further impact your ability to achieve and maintain an erection. By being aware of these risk factors, you can work with your healthcare provider to address them early and reduce your chances of developing ED.

How I Diagnose Erectile Dysfunction

Diagnosing erectile dysfunction is a thoughtful process that goes beyond just discussing symptoms. I start with a detailed medical history to understand any existing health conditions, medications, or lifestyle factors that could be affecting erectile function. A physical exam helps identify any underlying physical causes, such as issues with blood flow or nerve function.

We’ll also talk about your sexual history and any changes you’ve noticed in your erections or sexual desire. This conversation is important for pinpointing the underlying cause of ED and developing a treatment plan that addresses your unique needs. My goal is always to create a supportive environment where you feel comfortable sharing your concerns, so we can work together toward the best possible outcome.

How I Approach Erectile Dysfunction Treatment and Blood Flow

There isn’t a single “best” treatment for erectile dysfunction. Treatment works best when it’s individualized.

My approach always starts with listening. I want to understand:

When the changes started
How often they’re happening
What else is going on with your health and life

From there, we look at possible contributing factors. In some men, circulation plays the biggest role. In others, hormones are a factor. Stress, sleep quality, medications, and overall health often overlap. Low testosterone and nervous system disorders, such as multiple sclerosis, can also be underlying health conditions that contribute to ED.

Treatment may involve:

Addressing underlying health conditions, such as heart disease, high cholesterol, multiple sclerosis, and prostate cancer
Lifestyle changes that support blood flow and hormone balance
Medication when appropriate; prescription drugs and over the counter drugs may be considered, and these medications work by increasing blood flow to the penis, often in response to sexual stimulation
Ongoing follow-up to adjust the plan

The goal is to fix erectile dysfunction by addressing underlying health conditions and improving sexual activity.

In some cases, surgical treatment such as penile implants may be recommended when other options have not been successful. These procedures work by supporting the erectile tissue to allow for sexual activity.

I’m careful not to jump straight to a one-size-fits-all solution. Treating the symptom without understanding the cause often leads to frustration.

Lifestyle Changes That Can Make a Difference

Simple lifestyle changes can have a powerful impact on erectile dysfunction and overall sexual health. Quitting smoking and reducing alcohol consumption are two of the most effective ways to improve blood flow and support healthy erectile function. Regular physical activity not only benefits your heart and blood vessels but also helps manage stress and mental health conditions that can contribute to ED.

Maintaining a healthy weight, eating a balanced diet, and prioritizing good sleep are all important for reducing ED symptoms. Managing stress through relaxation techniques or professional support can also make a significant difference. By making these healthy lifestyle choices, you can lower your risk of developing ED, improve your sexual health, and enhance your overall quality of life.

A Note on Privacy and Discretion

One of the most common things men tell me is how relieved they feel once they finally talk about this out loud.

Erectile dysfunction is common. It’s medical. And it’s something I discuss every day in a professional, respectful setting. My clinic is designed to be private, calm, and discreet. There is no judgment here—only problem-solving.

When I Recommend Getting Checked to Diagnose Erectile Dysfunction

I encourage men to schedule an evaluation if:

Erectile issues are persistent
Symptoms are getting worse
You’re also noticing fatigue, low libido, or changes in mood—mental health issues can also be a reason to seek evaluation
The issue is affecting your relationship or confidence

Early evaluation often leads to better outcomes, not just for sexual health, but for men's health and overall wellbeing.

Final Thoughts

Erectile dysfunction doesn’t define you, and it’s not something you need to handle on your own.

In many cases, it’s your body asking for attention. Addressing it thoughtfully can improve far more than erections alone. My goal is always to help patients understand what’s happening and guide them toward a solution that makes sense for their health and their life.

Ready to Talk?

If you’re noticing symptoms of erectile dysfunction and want a clear, medical conversation about what’s going on, I’m here to help.

Morgan Men’s Health Center

2018 Garden AveEugene, OR 97403

To schedule a confidential consultation, call 458-247-9188.We’ll take the time to talk through your concerns and decide on next steps together.

458-247-9188