How common is erectile dysfunction? 

Erectile dysfunction (“ED”) is defined as the recurrent inability to generate or maintain an erection sufficiently rigid for sexual intercourse. Erectile dysfunction is very common. As men age, ED becomes more common; 8% of men between 20 and 30 years old report ED where 37% experience this issue after 75 years of age (1). If you are suffering from this issue, you are not alone. 

How do erections work? 

Having and maintaining an erection is a biologically complex process, requiring functional cardiovascular, neurological, endocrine (hormonal) and psychological parts of our bodies. First, the male brain is triggered to have an erection through either erotic stimuli & fantasy or through physical sensations, such as stroking and touching. The blood vessels going into the penis (arteries) pump blood into the tissue faster than the veins can remove the blood which compresses the veins further, preventing blood outflow. Testosterone increases desire, which makes it easier to form erections from erotic stimuli & fantasy. Furthermore, testosterone is an important part of the hormonal signaling that allows an erection to form. Finally, male sexual function is also dependent on a healthy psychological system and issues related to communication, intimacy and self-esteem can all impact erectile function. 

What causes erectile dysfunction?

There are many disease states that are associated with erectile dysfunction, in particular, cardiovascular disease, neurological issues such as multiple sclerosis, hypogonadism & low testosterone, diabetes and chronic kidney disease. There are also many other factors, such as medications and lifestyle stress, that play a contributing role in ED. While this may sound cliche, it really is imperative that you talk to your doctor to identify that cause of your erectile dysfunction. ED can be an early sign of much larger issues and treating those larger issues, earlier, often results in better outcomes. 


What are simple things I can do to decrease my risk for erectile dysfunction? 

  1. Move your body! Exercise has been shown to help decrease the risk of erectile dysfunction. Americans are recommended to get at least 150 minutes of moderate intensity exercise per week. 
  2. Kick those habits! Smoking and excessive alcohol use are both associated with an increased risk for erectile dysfunction. Excessive alcohol use is defined as more than 7 drinks per week for females and more than 14 drinks per week for males or more than three drinks in one sitting for females or more than four drinks in one sitting for males. 
  3. Turn off the TV! Higher levels of television watching is associated with more erectile dysfunction. 
  4. Have sex! Males that have sex less than once per week are 2x as likely to experience erectile dysfunction as males that have sex weekly. Don’t have a current sex partner? Masturbate! 
  5. Really though, talk to your doctor! If your chronic diseases are uncontrolled, there will likely be worse health problems on the horizon. While certain diagnoses can be overwhelming or scary sometimes, there is a lot that medicine can offer to help get these things controlled. 


Dr. Lauren Gresham at Nutima Integrative Medicine is a specialist in treating an array of sexual dysfunction issues. Please feel free to reach out and continue the discussion if you need any support in this area of your life. You deserve to be having all the wonderful sex you desire! Dr. Gresham can be reached at or by calling our office at 206.542.4325. 


1. UpToDate article titled, “Overview of Male Sexual Dysfunction”, December 2019.