Medical disclaimer: This article is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read here.
Medically reviewed by Jack Bruder, MD, board-certified urologist, Luzato Medical Group. Reviewed September 2026.
Erectile dysfunction (ED) is trouble getting or keeping an erection firm enough for satisfying sex. It is extremely common, it is not an inevitable part of aging, and it is treatable. Because erections depend on healthy blood flow and nerves, ongoing ED can also be an early sign of a treatable health condition, so it is worth discussing with a doctor.
If you have been putting off that conversation, you are far from alone. The good news is that a clear, medical explanation usually replaces worry, and most men have effective options once the cause is understood. Here is what the leading medical authorities say about ED and when to seek help.
How common is erectile dysfunction?
More common than most men realize. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that between 30 million and 50 million men in the United States have ED, with prevalence rising with age from roughly 40% at age 40 to about 70% by age 70.
Importantly, NIDDK stresses that ED is not a routine part of aging. Occasional difficulty is normal, but a persistent pattern deserves evaluation rather than resignation. Our team explains our full approach on the erectile dysfunction page.
What are the symptoms of ED?
ED is defined by a pattern, not a single episode. Mayo Clinic notes that erectile dysfunction symptoms are ongoing and often get worse over time, and may include trouble getting an erection, trouble keeping an erection, and reduced interest in sex.
An isolated night of difficulty after stress, alcohol, or poor sleep is not ED. A recurring problem over weeks or months, on the other hand, is the pattern worth bringing to a urologist.
What causes erectile dysfunction?
ED usually has a physical cause, an emotional cause, or a combination of both. According to Mayo Clinic, an erection involves the brain, hormones, emotions, nerves, muscles and blood vessels, and common physical contributors include heart disease, clogged blood vessels, high blood pressure, and diabetes.
Psychological and lifestyle factors, including stress, anxiety, depression, smoking, and heavy alcohol use, can also play a role. Because so many systems are involved, an accurate diagnosis matters, and it is one reason ED is best evaluated by a specialist rather than self-managed.
Can ED be a warning sign of a bigger health problem?
Yes. This is one of the most important reasons not to ignore it. Johns Hopkins Medicine reports that erectile dysfunction is often a hint of underlying heart disease, explaining that the blood-vessel changes behind heart disease often affect the blood vessels of the penis first.
That is why a good ED evaluation looks beyond the symptom. As Johns Hopkins advises, men with ED should talk to their doctor about being screened for risk factors such as high blood pressure, diabetes and heart disease. At Luzato Medical Group, our urologists coordinate with our cardiology and internal medicine colleagues when appropriate through our full range of men’s health services.
When should you see an ED doctor in NYC?
See a doctor when the problem is persistent, worsening, or affecting your relationship or confidence, and sooner if you have diabetes, heart disease, or another chronic condition. Mayo Clinic advises talking with a provider if you worry about your erections or you have other sexual problems, or if you have a health condition that might be linked to ED.
If you are looking for a confidential, experienced evaluation, our board-certified urologists in Manhattan see patients across the city.
What does treatment involve?
Treatment starts with identifying the cause, then matching it to safe, evidence-based options, which range from lifestyle changes to managing an underlying condition and other medical therapies your provider may discuss. Some men also have concerns that overlap with ED, such as premature ejaculation, which is a separate but likewise treatable condition. Your urologist will personalize any plan to your health, and this article does not recommend specific medications or doses.
Frequently Asked Questions
Is erectile dysfunction a normal part of getting older?
No. ED becomes more common with age, but NIDDK is clear that it is not a routine part of aging. Persistent ED at any age is worth evaluating.
Can lifestyle changes really improve ED?
For many men, addressing factors such as smoking, excess alcohol, inactivity, and unmanaged conditions like high blood pressure or diabetes can help. Your provider can advise what is appropriate for you.
Does ED mean I have heart disease?
Not necessarily, but ED can be an early warning sign, which is why Johns Hopkins recommends men with ED be screened for cardiovascular risk factors. An evaluation helps clarify your individual risk.
Is ED always physical?
No. It can be physical, psychological, or a mix of both. That is why an accurate diagnosis is important before starting any treatment.
Are ED evaluations confidential?
Yes. Your visit and personal health information are private, and our team discusses these concerns respectfully and without judgment.
How soon should I make an appointment?
If difficulty has been ongoing for several weeks or is getting worse, or if you have a chronic health condition, it is reasonable to schedule an evaluation rather than wait.
Sources
Mayo Clinic, “Erectile dysfunction: Symptoms & causes”; NIDDK (NIH), “Definition & Facts for Erectile Dysfunction”; Johns Hopkins Medicine, “Erectile Dysfunction and Your Health.”
Medical disclaimer: This article is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read here.
In a medical emergency, call 911 or go to the nearest emergency room.