Erectile Dysfunction Risk Factors, Symptoms & Diagnosis

Risk Factors of Erectile Dysfunction

- Injury to the pelvic area
- Medical conditions such as heart disease, diabetes, peripheral artery diseases, hypertension 
- Prostate, colon, rectum, or bladder surgery 
- Alcohol, nicotine, and recreational drug use
- Certain medications 
- Mental health conditions such as anxiety (including OCD) and depression

Symptoms of Erectile Dysfunction

- Difficulty in getting an erection
- Difficulty in maintaining an erection 
- Getting a partial erection, not firm/hard enough for vaginal penetration 
- Reduced libido or sexual desire
- Increased anxiety and stress associated with sexual intercourse

The severity of ED is determined by how hard the penis is when aroused. Based on this, there are ways to describe the hardness of the penis.
Severe ED: Penis is not hard.
Moderate ED: Penis is hard, but not hard enough for penetrative sex.
Mild ED: Penis is hard enough for penetrative sex, but not rigid.
No ED: Penis is hard and rigid enough for penetrative sex.

Low Sexual Desire

Low sexual desire or libido is a common symptom of erectile dysfunction. Is also often associated with interpersonal concerns within relationships, increased stress, or sexual dysfunction.

However, everyone's sexual desire levels can vary because of the many dependent factors. There is no ballpark level for sexual desire. Professionals approach the symptom of low sexual desire by determining the cause behind it and prescribing appropriate therapy which can include medications and/or therapy depending on if the cause is physical or psychological.

Causes of Low Sexual Desire

- Loss or lack of sexual attraction  
- Conflict and interpersonal issues with partner
- Lack of communication and trust 
- Physical problems such as medical conditions or medication-related side effects
- Psychological problems such as depression or anxiety

Diagnosing Erectile Dysfunction

Diagnosing ED may require a physical and/or a psychological examination along with medical history taking.

Not all cases require a physical examination. The process of undergoing diagnostic tests and imaging helps a professional determine the cause behind the patient’s ED along with ruling out any underlying medical conditions.

Here’s what the diagnostic process for ED may entail (not every patient with ED needs all the following tests; it is decided on a case by case basis):

- Physical examination of external penis anatomy
- Blood tests/hormone levels check: to rule out medical conditions such as diabetes, heart disease along with checking testosterone levels.
- Urinalysis: can detect certain underlying medical conditions
- Psychological examination: to rule out or treat mental health conditions such as depression, and/or anxiety
- Ultrasound of the penis and testicles to check for blood flow issues or any other problems 

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Erectile Dysfunction
Erectile Dysfunction

Erectile Dysfunction is defined as the inability to sustain an erection sufficient for sexual intercourse. The condition can affect anyone at any age.


Remember - the blood flow (BF), the nerve supply, and the balance of sex hormones - a concern in any of these can lead to Erectile Dysfunction. Erectile Dysfunction can be caused by a physical (a ‘hardware’ problem) or psychological (mental health effects) - mental health can play a huge part.

Fact Check

Did you know that Erectile Dysfunction can be an indication of cardiovascular concerns? Chronic health conditions affecting blood flow can lead to Erectile Dysfunction.

Premature Ejaculation
Premature Ejaculation

If a man lasts less than 2 minutes after penetration (all or most of the time), and/or if it leads to frequent dissatisfaction for him or his partner, he may have Premature Ejaculation.


The causes of Premature Ejaculation include:
(1) Physical Factors: Medical conditions, chronic health conditions, or sexual disorders are some physical causes of Premature Ejaculation.
(2) Psychological Factors: Depression, Anxiety 

Fact Check

Did you know that Erectile Dysfunction can be a cause of Premature Ejaculation?

Premature Ejaculation can lead to other sexual dysfunctions, but that is not a wide-known fact.


Vaginismus is a condition in which the muscles in the vagina tighten up during penetration.


Vaginismus is commonly caused by psychological factors. Women don't have control over the tightening, and it can be uncomfortable. Due to the physical discomfort, the anxiety or fear response gets worse, and this can lead to a cycle of avoidance.

Fact Check

Did you know that there are four types of Vaginismus?

(1) Primary Vaginismus

(2) Secondary Vaginismus

(3) Situational Vaginismus

(4) Global Vaginismus

Low Sexual Desire
Low Sexual Desire

Low sexual desire, commonly referred to as low libido, is a decrease in sex drive.


Individuals that experience low sexual desire due to various causes are impacted physically, mentally, and emotionally by the symptoms the condition can cause.

Fact Check

Like other most common sexual disorders, low sexual desire can be influenced by many aspects, such as hormonal imbalance, increased age, side effects of medications, chronic illnesses, and addictive or compulsive behavior.

Couple Sex Problems
Couple Sex Problems

This would include concerns with infertility and/or conception. Sexual disorders such as Erectile Dysfunction, Premature Ejaculation, and Vaginismus can lead to challenges with pregnancy attempts.


There could be various causes of infertility, such as sexual dysfunctions, chronic illnesses, and mental health conditions leading to low sexual desire and a low sperm count. A sexual health professional should evaluate the causes of failed pregnancy attempts because there can be a variety of causes.

Fact Check
Porn Addiction
Porn Addiction

Porn addiction refers to a person becoming excessively dependent on pornography leading to a disruption in their everyday life. This could include their job, relationships and at times, their day-to-day lifestyle.


The causes behind porn addiction could be:

(1) Negative sexual experiences

(2) Incorrect understanding of porn and its uses

(3) Initially trying to learn about sexual experiences, resulted in dependency

(4) Experiencing mental health disorders such as OCD (an anxiety disorder) or depression

Fact Check

Watching porn isn’t a bad thing, nor should it be associated with any shame. However, compulsive porn watching can have negative effects on your sexual, physical and mental health.

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