Causes and Types of ED (Erectile Dysfunction) | Differences by Age | Doctor Supervised

The Japanese Society for Sexual Medicine’s “ED Clinical Guidelines (3rd Edition)” defines ED as “a persistent or recurrent condition in which sufficient erection cannot be achieved or maintained for satisfactory sexual intercourse.” Importantly, ED does not only refer to a complete inability to achieve erection. The following symptoms also medically qualify as ED.

The prevalence of ED in Japan is reported at approximately 20% in the 40s, 40% in the 50s, and over 60% in the 60s, increasing with age. However, in recent years, ED among younger men in their 20s and 30s has also been on the rise, making it a common condition that many men can experience regardless of age.

When you suspect you may have ED, the IIEF-5 (International Index of Erectile Function, abbreviated version) self-check allows for a simple self-assessment. This is a globally widely used evaluation tool that can quantify erectile function by answering just five questions.

The IIEF-5 is scored out of 25 points, and a score of 21 or below suggests the possibility of ED. Scores of 5–7 indicate severe ED, 8–11 moderate ED, 12–16 mild-to-moderate ED, and 17–21 mild ED. However, self-checks are only a guideline. For an accurate diagnosis, it is important to undergo a medical consultation and examination. If any of the above signs apply to you, we recommend consulting a specialist at an early stage.

Organic ED is a type of ED where erectile function declines due to physical problems involving blood vessels, nerves, and hormones. Organic causes are the most common cause of ED, particularly prevalent in men from their late 40s onward.

Since erection occurs through increased blood flow to the corpora cavernosa of the penis, vascular health is directly linked to ED development. As atherosclerosis progresses, blood supply to the penis becomes insufficient, making it difficult to achieve adequate erection. Since atherosclerosis is advanced by lifestyle diseases such as diabetes, hypertension, dyslipidemia, and obesity, individuals with these underlying conditions face an increased risk of ED.

Nerve damage is also a cause of organic ED. ED can develop from neurological conditions such as spinal cord injury, stroke, and Parkinson’s disease, as well as when nerves involved in erection are damaged during surgery for prostate cancer or rectal cancer. Additionally, age-related decline in testosterone (male hormone) is a contributing factor to organic ED. Testosterone is deeply involved in libido and erectile function, and its decrease directly leads to reduced erectile capacity.

A characteristic of organic ED is a decrease in the frequency of morning erections (nocturnal penile tumescence). Morning erections are a physiological phenomenon that occurs automatically during sleep, and a clear reduction in their frequency suggests an organic problem. Since morning erections are usually maintained in psychogenic ED, this serves as one indicator for distinguishing between the two.

Psychogenic ED is a type of ED where erection is hindered by mental and psychological factors despite no physical problems. It is commonly seen in relatively younger generations from teens to their 40s, but it can develop regardless of age.

The causes of psychogenic ED are broadly divided into “immediate psychological causes” and “deep psychological causes.” Immediate psychological causes refer to cases where stress and anxiety felt in daily life directly trigger ED. Common causes include work pressure, interpersonal relationship troubles, financial anxiety, changes in the relationship with a partner, and pressure from fertility treatments. In particular, cases where the experience of “failing during the last sexual encounter” becomes traumatic and creates anticipatory anxiety of “what if I fail again” that generates a vicious cycle are very frequently reported.

On the other hand, deep psychological causes refer to cases where past trauma or repressed emotions that the individual is not even aware of are the cause of ED. Childhood sexual trauma, guilt about sex, and unconscious fears may have an influence, and in such cases, specialized treatment such as psychological counseling or cognitive behavioral therapy may be necessary.

A major characteristic of psychogenic ED is that erection is possible during morning erections and masturbation. Symptoms often appear only in specific situations (such as during sexual intercourse with a partner), and there is no problem with physical function itself. Therefore, a treatment approach that supports erection temporarily with ED medication and breaks the negative psychological cycle by accumulating “successful” experiences is effective.

Drug-induced ED is a type where ED symptoms appear as a side effect of currently prescribed medications. If ED develops after starting a medication belonging to certain drug categories, drug-induced ED is a possibility. Since it can occur at any age, caution is needed for anyone regularly taking medication.

If drug-induced ED is suspected, you must not stop taking your medication on your own judgment. This could worsen the underlying condition. Always consult with your prescribing physician to discuss options such as changing medications, reducing dosage, or adding ED medication. Cases have been reported where switching antihypertensives to ARBs (angiotensin II receptor blockers) or changing antidepressants to agents with less serotonergic effect has improved ED symptoms.

Mixed ED is a type of ED that develops from the complex interplay of organic and psychogenic factors. Many actual ED patients are said to fall into this mixed category, making it the most common type of ED. It is particularly prevalent among men in their 30s to 50s who are at the peak of their careers.

A typical example is the negative cycle where a slight decline in erectile function due to aging or lifestyle diseases (organic factor) leads to the experience of “not being able to get an erection like before,” generating stress and anxiety (psychogenic factor) that further worsens ED. Conversely, there are also cases where someone who originally had psychogenic ED develops atherosclerosis due to stress-induced lifestyle disruption (overeating, lack of exercise, smoking, drinking), adding organic factors.

In treating mixed ED, a comprehensive approach that supports erectile function with ED medication while also addressing the root causes is important. By restoring erectile function with ED medications such as Viagra (sildenafil) and Cialis (tadalafil), while simultaneously improving lifestyle habits, managing stress, and undergoing counseling as needed, effective improvement can be expected.

The causes of ED in teens are nearly 100% psychogenic. There are almost no physical problems, and the primary causes are extreme nervousness and pressure stemming from limited sexual experience. A typical case involves the trauma of “the first sexual experience not going well,” followed by continued anxiety about sexual activity.

Additionally, in recent years, excessive pornography consumption has been drawing attention as a cause of ED in teens. This is a phenomenon where becoming accustomed to explicit content makes it difficult to become sufficiently aroused during actual sexual activity with a partner. Furthermore, low self-esteem characteristic of puberty, body image complexes, and guilt about sex also contribute as psychological factors.

Since ED in teens has no physical cause, the majority of cases recover with psychological care and lifestyle rhythm improvement. Rather than struggling alone with serious concerns, consulting a physician early can help find a path to resolution. Men’s Care Clinic also handles ED consultations for teens, so please feel free to reach out without carrying the burden alone.

The causes of ED in the 20s are primarily psychogenic. Stress from professional life, work pressure, interpersonal relationship troubles, and financial anxiety accumulate, creating psychological blocks against sexual activity. The fact that over 1,300 people per month search for “ED causes in 20s” demonstrates that the number of people struggling with young-onset ED is increasing.

A particularly common cause pattern of ED in the 20s is trauma from failed sexual experiences. Nervousness during sexual activity with a first or new partner leads to failure, and that experience creates anticipatory anxiety of “what if I fail again,” resulting in a vicious cycle of inability to achieve erection on subsequent occasions.

Additionally, in recent years, the increasing incidence of metabolic syndrome at younger ages due to irregular eating habits, lack of exercise, and obesity has become a problem even among those in their 20s. Even without significant physical problems, these lifestyle disruptions can affect vascular function, and cases where organic elements are added are increasing. If you experience ED symptoms in your 20s, it is important not to dismiss it as “I’m young, so it’s fine” and to consult a specialist early.

While psychogenic causes remain common for ED in the 30s, it is an age when physical effects from lifestyle disruption begin to appear. Taking on positions of greater responsibility at work leads to longer working hours and increased mental pressure. Additionally, lifestyle changes associated with marriage and child-rearing also become sources of stress.

A psychogenic ED cause unique to the 30s is pressure from fertility treatments. The sense of obligation that “we must have sexual intercourse timed to ovulation” can paradoxically hinder erection. Changes in the relationship with a partner (routine and lifestyle disconnects) are also factors that reduce motivation for sexual activity.

Physically, the effects of unhealthy habits continuing from the 20s (smoking, excessive drinking, lack of exercise, unbalanced diet) begin to accumulate. More people are flagged for hypertension and dyslipidemia at health checkups, and the characteristic of the 30s is that these precursors of lifestyle diseases begin to contribute as organic factors of ED. It can be said that this is an age group prone to transitioning into “mixed ED” where psychogenic and organic causes overlap.

The 40s are the age group where mixed ED is most common. The incidence of lifestyle diseases such as metabolic syndrome, hypertension, diabetes, and dyslipidemia rises, and the vascular dysfunction caused by these conditions becomes the organic cause of ED. At the same time, stress from work and family life remains significant, and psychogenic factors cannot be ignored.

A noteworthy aspect of ED in the 40s is that ED can be a sign of atherosclerosis. Since the penile arteries are thinner than the coronary arteries of the heart, they are believed to be affected by atherosclerosis earlier. Cases have been reported where angina pectoris or myocardial infarction develops several years after ED symptoms appear, giving ED significant importance as an “alarm signaling vascular health status.”

Additionally, the 40s are also a period when testosterone levels begin to gradually decline. Decreased testosterone leads to reduced libido and increased fatigue, indirectly worsening ED symptoms. If you experience ED symptoms, we recommend not just getting an ED medication prescription, but also undergoing blood tests and screening for underlying conditions. ED in the 40s can be an opportunity to reassess overall health.

The causes of ED in the 50s become primarily organic. This is a period when age-related vascular aging (progression of atherosclerosis), decline in nerve function, and long-term effects of lifestyle diseases combine to cause an overall decline in erectile function. The ED prevalence rate among men in their 50s is estimated at approximately 40%, making it an age group where nearly one in two men experience ED symptoms.

A particularly noteworthy cause of ED in the 50s is LOH syndrome (Late-Onset Hypogonadism). Commonly referred to as “male menopause,” this condition presents with various symptoms including ED, decreased libido, fatigue, mood depression, and reduced concentration due to declining testosterone levels. LOH syndrome is diagnosed by measuring testosterone levels through blood tests, and hormone replacement therapy is considered as needed.

Since ED in the 50s is primarily caused by organic factors, there are cases where ED medication alone does not provide sufficient improvement. In addition to a comprehensive lifestyle review (dietary therapy, establishing exercise habits, smoking cessation, moderation of alcohol), a multifaceted approach combining treatment of underlying conditions and hormone replacement therapy is necessary. At Men’s Care Clinic, in addition to prescribing ED medication, we propose comprehensive treatment plans tailored to each patient’s health condition.

ED in the 60s and beyond is primarily caused by age-related decline in vascular function and changes in hormonal balance. The ED prevalence rate among men in their 60s is estimated at over 60%, and aging is the greatest risk factor for ED. However, there is no need to give up thinking “it’s just because of my age.”

Specific causes of ED in the 60s and beyond include further progression of atherosclerosis, sustained decline in testosterone levels, long-term effects of underlying conditions such as diabetes and hypertension, and the effects of treatment for benign prostatic hyperplasia and prostate cancer. ED after prostate cancer surgery (radical prostatectomy) has a particularly high incidence rate, and whether nerves could be preserved during surgery significantly affects the development of post-operative ED.

ED medication remains effective even in the 60s and beyond. However, some medications cannot be used depending on the status of underlying conditions (such as heart disease), so please ensure you receive a prescription only after a physician’s examination. For those currently using nitrates (such as nitroglycerin), concomitant use with ED medication is contraindicated. At Men’s Care Clinic, we prioritize safety above all and propose the optimal treatment after confirming each patient’s medical history and current medications.

Smoking is one of the greatest risk factors for ED. Nicotine in cigarettes constricts blood vessels, and carbon monoxide damages the vascular endothelium. This accelerates atherosclerosis, and ED develops due to chronic insufficient blood flow to the penis. Research indicates that the risk of developing ED in smokers is approximately 1.5 to 2 times that of non-smokers, with the risk increasing as the number of cigarettes smoked and the duration of smoking increase.

On the other hand, the relationship between alcohol and ED is somewhat complex. Small amounts of alcohol can have a relaxing effect and may help alleviate psychogenic ED. However, excessive drinking suppresses the central nervous system, impedes the transmission of sexual arousal, and decreases testosterone production. Chronic heavy drinking causes liver dysfunction, negatively affects hormone metabolism, and worsens ED. It is important to maintain moderate alcohol consumption (up to approximately one medium bottle of beer per day).

Improvement in vascular function from smoking cessation appears relatively quickly, with blood flow beginning to improve within a few weeks after quitting. When smoking is the cause of ED, quitting is the most effective lifestyle improvement measure for enhancing the effectiveness of ED medication.

Obesity is an independent risk factor for ED. Multiple large-scale studies have shown that higher BMI (Body Mass Index) correlates with increased ED incidence. The mechanisms by which obesity causes ED are diverse. First, increased visceral fat causes chronic inflammation and reduces vascular endothelial function. Additionally, since adipose tissue contains the enzyme aromatase, which converts testosterone to estrogen, obesity leads to decreased testosterone levels.

Lack of exercise similarly increases the risk of ED. Regular aerobic exercise improves vascular endothelial function and promotes the production of nitric oxide (NO). NO is an essential substance for erection, playing the role of relaxing the smooth muscles of the corpora cavernosa and increasing blood flow. Physical inactivity reduces this NO production, adversely affecting erectile function.

Research reports that at least 150 minutes of moderate aerobic exercise per week (walking, jogging, swimming, etc.) significantly reduces the risk of ED. Additionally, reports indicate that approximately one-third of obese ED patients who successfully lose weight see improvement in their ED symptoms, making weight management a fundamental ED countermeasure.

Diet is closely related to ED. High-fat, high-salt, and high-sugar diets promote atherosclerosis and cause a decline in vascular function. A diet skewed toward fast food and instant meals, with insufficient intake of vegetables and fish, constitutes eating habits that increase ED risk.

On the other hand, research results suggest that the Mediterranean diet (a dietary approach rich in olive oil, fish, vegetables, fruits, and nuts) is effective for ED prevention. The Mediterranean diet is said to contribute to improving vascular endothelial function, anti-inflammatory effects, and maintaining testosterone levels. Additionally, zinc (found in oysters, beef, liver, etc.) is a mineral necessary for testosterone production, and its deficiency increases the risk of ED.

When diet is the cause of ED, conscious intake of the following nutrients is recommended. L-arginine (soybeans, nuts) is converted to NO (nitric oxide) in the body and promotes vasodilation. Vitamin D (fish, mushrooms) is involved in maintaining testosterone. Polyphenols (berries, green tea, dark chocolate) protect blood vessels through their antioxidant effects.

Sleep deprivation directly leads to decreased testosterone levels. Since testosterone is primarily secreted during sleep, chronic sleep deprivation disrupts hormonal balance and triggers decreased libido and ED symptoms. One study reported that restricting sleep to 5 hours per night for one week resulted in a 10–15% decrease in testosterone levels.

Chronic stress is similarly a major cause of ED. When under stress, the body secretes cortisol (the stress hormone). Chronic elevation of cortisol suppresses testosterone production and activates the sympathetic nervous system, causing blood vessel constriction. Since erection requires a parasympathetic-dominant state (a relaxed state), being constantly exposed to tension and stress is a direct cause of ED.

For the prevention and improvement of ED, it is important to ensure 7 to 8 hours of quality sleep and to have your own stress relief methods. Creating an environment where you can relax on a daily basis — such as avoiding smartphone and computer use before bed, warming the body through bathing, and making moderate exercise a habit — leads to eliminating the causes of ED.

Diabetes is one of the greatest risk factors for ED, and the incidence of ED in diabetic patients is reported to be 2 to 3 times that of healthy individuals. When hyperglycemic conditions persist over a long period, vascular endothelial function is impaired (diabetic vasculopathy), and peripheral nerve damage (diabetic neuropathy) progresses further. This causes both blood supply to the penis and neural signal transmission involved in erection to decline, leading to the development of ED.

An important point regarding the relationship between diabetes and ED is that ED can be a trigger for early detection of diabetes. It is not uncommon for diabetes to be discovered for the first time during examinations of patients who visit for ED. Especially if ED symptoms suddenly appear after age 40, we recommend having your blood glucose and HbA1c levels tested.

In treating ED caused by diabetes, optimizing blood glucose control is the basic foundation. The goal is to maintain HbA1c below 7.0%. ED medications (Viagra [sildenafil], Cialis [tadalafil], Levitra [vardenafil]) are also effective for diabetic ED, but their effectiveness may be limited when vascular and nerve damage has advanced significantly. It is important to pursue diabetes treatment and ED treatment in parallel from an early stage.

Hypertension is a condition strongly associated with ED. When hypertension persists for a long time, sustained pressure is placed on the vessel walls, damaging the vascular endothelium and promoting atherosclerosis. When blood vessels narrow and harden due to atherosclerosis, blood supply to the corpora cavernosa becomes insufficient and ED develops.

It should be noted that antihypertensive medications themselves can sometimes cause ED. Beta-blockers and certain diuretics are known to increase the risk of ED development. However, since leaving hypertension untreated will allow atherosclerosis to progress and ED to worsen further, you must not stop taking antihypertensive medications on your own judgment. If you are concerned about ED as a side effect, consult your physician about switching to antihypertensives with lower ED risk, such as ARBs (angiotensin II receptor blockers) or ACE inhibitors.

Atherosclerosis is a condition that occurs in blood vessels throughout the body, but since the penile arteries are thinner than the coronary arteries (heart arteries), the effects of atherosclerosis may manifest as ED first. Reports indicate that the risk of cardiovascular events (myocardial infarction or stroke) increases an average of 2 to 3 years after ED onset, and ED is attracting attention as an early warning sign of cardiovascular disease.

Radical surgery for prostate cancer (radical prostatectomy) is a representative surgical cause of ED. Since the prostate is located in close proximity to the cavernous nerves involved in erection, damage to these nerves during surgery leads to post-operative ED. Even when nerve-sparing surgery is performed, temporary ED often occurs and it can take approximately 6 months to 2 years for erectile function to recover.

ED has also been reported in some patients after surgery for benign prostatic hyperplasia (transurethral resection of the prostate: TURP), although the incidence rate is considered lower compared to radical surgery. Additionally, radiation therapy for prostate cancer may also cause ED within months to years after treatment.

For ED after prostate surgery, early rehabilitation (regular administration of ED medication as “penile rehabilitation”) is said to promote recovery of erectile function. If you are struggling with post-surgical ED, we recommend consulting your urologist or ED specialist early.

When ED medication stops working, the first thing to check is problems with how it is taken. Viagra (sildenafil) has significantly reduced absorption and effectiveness when taken after a fatty meal. There may be cases where proper timing is not being observed, such as “taking it right after eating” or “having sexual activity without waiting long enough.”

ED medications are called PDE5 inhibitors and work by dilating blood vessels to promote erection. Pharmacologically, “tolerance” (the phenomenon of medication becoming ineffective) has not been reported. In other words, it is highly likely that rather than “the body becoming accustomed to the medication and it becoming ineffective,” some other cause is diminishing its effectiveness.

If ED medication stops working, first review how it is being taken, and if there is still no improvement, switching to a different type of medication can be effective. While Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are all PDE5 inhibitors, each has different pharmacological characteristics, so there are cases where switching from one that is insufficient to another produces improvement.

For example, those who find Viagra is easily affected by food may benefit from switching to Cialis, which is largely unaffected by meals. Additionally, for those who feel Cialis takes too long to take effect, the fast-acting Levitra may be more suitable. It is important to understand the characteristics of each ED medication and choose the one that best fits your lifestyle.

Additionally, if the effectiveness of ED medication is insufficient, dosage adjustment may be considered. Viagra comes in two doses of 25mg and 50mg, and Cialis in two doses of 10mg and 20mg, and increasing the dose may lead to improvement when the current dose is insufficient. However, dosage changes must always be made under a physician’s judgment. At Men’s Care Clinic, we propose the optimal medication and dosage tailored to each patient’s symptoms and constitution.

The first-line treatment for ED is ED medications called PDE5 inhibitors. The main ED medications approved in Japan are three types: Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil). All promote erection by dilating blood vessels to increase blood flow to the penis, but each has different characteristics.

All ED medications only take effect in the presence of sexual stimulation — they do not automatically produce an erection simply by being taken. Additionally, for those currently taking nitrates (such as nitroglycerin), concomitant use is contraindicated due to the risk of a dangerous drop in blood pressure. To use them safely, you must receive a prescription only after a physician’s examination. Men’s Care Clinic carries all three types of ED medications and proposes the optimal medication tailored to each patient’s symptoms and lifestyle. Please also refer to our detailed comparison of ED medications.

ED medication is symptomatic therapy and does not resolve the root cause. Lifestyle improvement is both a fundamental treatment for ED and an adjunctive therapy that maximizes the effectiveness of ED medication. As mentioned earlier, smoking, excessive drinking, lack of exercise, obesity, sleep deprivation, and stress are all risk factors for ED.

Since lifestyle improvement is unlikely to produce results in a short period, a realistic approach is to control symptoms with ED medication while pursuing improvements in parallel. Continued effort over several months to half a year can be expected to improve vascular function and hormonal balance.

When psychological factors play a significant role in psychogenic ED or mixed ED, psychological counseling is an effective treatment method. Specialized approaches such as cognitive behavioral therapy (CBT) and sex therapy address the root causes of anxiety and fear about sexual activity.

Particularly effective is the combination of ED medication and counseling. By accumulating successful experiences of “being able to achieve erection” with ED medication, confidence in sexual activity is restored, with the ultimate goal of being able to achieve erection without medication. Improving communication with your partner is also important, and in some cases, couple therapy where the partner participates in counseling sessions can be effective.

“Experiencing ED only with my wife/partner” — ED directed at a specific partner — is also a type of psychogenic ED and can be expected to improve with psychological counseling. Please also refer to our related article on the relationship between partner dynamics and ED. Rather than struggling alone, it is important to first consult a physician.

A. The causes of ED (erectile dysfunction) are broadly classified into four categories: “psychogenic” caused by stress and anxiety, “organic” caused by abnormalities in blood vessels, nerves, and hormones, “mixed” where both coexist, and “drug-induced” caused by medication side effects. In many cases, multiple factors intertwine to cause onset. The first step toward improvement is identifying the cause through a physician’s examination.

A. ED in the 20s is primarily psychogenic. The main causes include anxiety and pressure about sexual activity, trauma from past failures, and stress from work and interpersonal relationships. Even without significant physical problems, ED symptoms can occur from psychological factors alone. In recent years, the number of young people also developing organic factors due to lack of exercise and obesity has been increasing.

A. Factors that make someone more prone to ED include lifestyle diseases such as obesity, smoking, excessive drinking, lack of exercise, hypertension, and diabetes. Psychologically, severe stress, anxiety, and depressive symptoms are also risk factors. While these factors have an impact individually, the risk of ED rises significantly when multiple factors overlap. Lifestyle improvement directly leads to prevention.

A. The main causes for ED medication becoming less effective include worsening vascular function due to progression of diabetes or atherosclerosis, incorrect usage (such as taking it right after meals), and worsening psychogenic factors. Testosterone decline may also be progressing. If you feel the effectiveness has diminished, do not self-diagnose; consult a physician to consider changing the type or dosage of medication.

A. ED in the 50s is primarily organic, with the main causes being age-related aging of blood vessels and nerves, atherosclerosis, and progression of lifestyle diseases. “LOH syndrome (Late-Onset Hypogonadism)” where testosterone levels decline is also commonly seen. Many cases require a comprehensive approach including ED medication, hormone replacement therapy, and lifestyle review.

A. ED in teens is almost entirely psychogenic. Causes include anxiety and pressure from limited sexual experience, habituation to stimulation from excessive pornography viewing, and low self-esteem characteristic of puberty. Since there are almost no physical problems, the majority of cases recover with psychological care and lifestyle rhythm improvement. We recommend consulting a physician before the concern becomes serious.

A. The 40s are the age group where “mixed ED,” combining psychogenic and organic factors, is most common. In addition to stress from work and family, it is also a period when the risk of lifestyle diseases such as metabolic syndrome, hypertension, and diabetes increases. The key to improvement is addressing both psychological and physical factors.

A. While ED in the 30s is often psychogenic, it is also an age when physical effects from irregular lifestyle and excessive stress begin to appear. The main psychological factors include work pressure, changes in the relationship with a partner, and pressure from fertility treatments. Cases where lifestyle disruptions such as smoking, drinking, and lack of exercise add organic factors are also increasing.

A. Stress is one of the major causes of ED. Excessive stress activates the sympathetic nervous system and suppresses the parasympathetic nervous system needed for erection. Not only chronic stress from work, relationships, and financial anxiety, but also acute stress from fear of failure during sexual activity can trigger ED. However, since other causes may be hidden, it is important to undergo a physician’s examination.

A. Experiencing ED only with a specific partner is a type of psychogenic ED. Causes include relationship routine, relationship stress, pressure from fertility treatments, and guilt toward the partner. In most cases there are no issues with other partners or masturbation, and the essential cause is a psychological block. Improvement can be expected through counseling and combined use of ED medication.

A. Diabetes is a major risk factor for ED. When hyperglycemia persists, blood vessels and nerves are damaged, blood flow to the penis becomes insufficient, and erectile function declines. The incidence of ED in diabetic patients is reported to be 2 to 3 times that of healthy individuals. Improvement can be expected through better blood glucose control along with ED medication prescriptions, so we recommend visiting a clinic early.

A. Even when the cause of ED cannot be identified, symptoms can often be improved first by taking ED medication (Viagra [sildenafil], Levitra [vardenafil], Cialis [tadalafil]). Restoring erectile function with medication can also help break the vicious cycle of psychological anxiety. An effective approach is to narrow down the cause through physician consultation and blood tests while simultaneously pursuing lifestyle improvements.

ED tends to be left untreated out of embarrassment or attributed to “just aging,” but it is a condition that can improve for many people with appropriate treatment. ED medications in particular have been confirmed to have high efficacy and can be expected to be effective for psychogenic, organic, and mixed types alike. What matters is accurately understanding the cause and choosing the right treatment to match it.

Men’s Care Clinic provides ED treatment with full respect for patient privacy across three clinics — Shimbashi, Akihabara, and Omotesando — as well as online consultations. We carry all three types of ED medication: Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil), and propose optimal treatment plans tailored to each patient’s symptoms and lifestyle. If you have even the slightest concern, such as “erections have been weaker recently” or “hardness isn’t what it used to be,” please feel free to consult with us.

For more detailed information about ED, please also refer to Men’s Care Clinic’s ED treatment page. Related medical columns include ED basics, young-onset ED, the ED treatment process, ED treatment costs, side effects of ED medications, online ED treatment, and ED and lifestyle habits.

※1) 日本新薬株式会社「EDの原因とタイプ」
※2) 日本大学医学部泌尿器科「ED」
※3) Biomedicine & Pharmacotherapy Volume 112, April 2019
※4) Translational Andrology and Urology 2017 Feb
※5) 日本性機能学会「ED診療ガイドライン［第3版］」
※6) EDネットクリニック.com（バイエル製薬）「データで読む日本人のED」
※7) 日本泌尿器科学会／日本Men’s Health医学会「加齢男性性腺機能低下症候群（LOH症候群）診療の手引き」