Erectile Dysfunction: 4 Main Causes & How to Treat Them

最終更新日： 2026年5月18日

No doubt that nowadays the so-called ED or Erectile Dysfunction is a major concern for men. It’s surprisingly common even in younger men – I often take care of patients as young as 20 years old. Erectile dysfunction is defined as a “persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance.”

勃起不全は一般的な問題です

ED is more significant than many realize – it can be an early indicator of future cardiovascular events and has a significant impact on relationship quality. More than 50% of U.S. men aged 40 and above are affected, and recent literature shows that 25% of new-onset ED cases are in men under 40 years old.

4 main causes of Erectile Dysfunction.

Hormonal issue – Testosterone is the essential sexual hormone. Levels peak at age 20 and gradually decline with aging. Low testosterone presents as depressed mood, fatigue, and reduced energy. Early morning blood testosterone testing is recommended when suspected. Testosterone replacement therapy benefits elderly men with confirmed deficiency, but requires careful consideration in younger men.
Neurogenic issue – Erection is controlled by the brain and nervous system. Brain lesions from stroke or Parkinson’s disease, or spinal cord injuries from trauma, can significantly impair erectile function and are among the more difficult forms of ED to treat.
Vasculogenic issue – Poor vascular quality accounts for 75% of ED cases. Smoking damages blood vessel quality throughout the body – especially the small penile vessels. Obesity, hypertension, diabetes mellitus, and hypercholesterolemia must be well-monitored and well-controlled to protect erectile function.
Mental (psychological) issue – Stress from work, family responsibilities, and daily life directly impacts sexual performance. Conversely, good sleep, regular exercise, and recreational activities can significantly improve psychological ED.

タバコはEDの主要な原因の1つです

自分を健康に保つことは、EDに適しています

If you’d like to discuss this topic further, please give me a text or PM 私!

If you are experiencing erectile dysfunction or suspect low testosterone and would like a confidential specialist evaluation, Dr. Soarawee Weerasopone offers consultations at Bangkok Hospital Headquarters. 診療をご予約.

Frequently Asked Questions about Erectile Dysfunction

What is erectile dysfunction (ED)?

Erectile dysfunction is defined as the persistent inability to attain and maintain an erection sufficient for satisfactory sexual performance. It affects more than 50% of men aged 40 and above in the US, and 25% of new ED cases now occur in men under the age of 40. Beyond sexual health, ED is recognized as an important early marker of cardiovascular disease risk.

Can low testosterone cause erectile dysfunction?

Yes. Testosterone is essential for sexual drive and erectile function. Levels peak around age 20 and decline gradually with aging. Symptoms of low testosterone include low libido, fatigue, depressed mood, and reduced morning erections. A blood testosterone level measured in the early morning is the standard diagnostic test. Testosterone replacement therapy is effective in men with confirmed deficiency, particularly in older patients.

Does smoking cause erectile dysfunction?

Yes. Smoking is a major modifiable cause of ED. Nicotine and other cigarette toxins damage the small blood vessels inside the penis, impairing the blood flow necessary for erection. Vasculogenic (blood vessel-related) causes account for 75% of all ED cases. Quitting smoking, combined with managing obesity, hypertension, diabetes, and high cholesterol, significantly improves erectile function.

Can stress and anxiety cause erectile dysfunction?

Yes. Psychological factors including work stress, relationship anxiety, performance pressure, and depression are significant causes of ED, particularly in younger men. The brain controls the erection reflex, so mental state directly affects sexual function. Regular exercise, adequate sleep, stress management, and sometimes psychological counseling can substantially improve psychogenic ED.

Is erectile dysfunction treatable?

Yes. ED is highly treatable in most cases. First-line treatment includes oral PDE5 inhibitors (such as sildenafil or tadalafil), lifestyle modifications, and addressing underlying causes. Second-line options include penile injections and vacuum erection devices. For refractory cases, penile prosthesis implantation offers a permanent solution. The most appropriate treatment depends on the underlying cause and should be determined in consultation with a urologist.

**免責事項:** このコンテンツは、バンコク病院本部の認定泌尿器科医であるSoarawee Weerasopone博士によって作成およびレビューされました。教育目的のみのものであり、医学的アドバイスを構成するものではありません。いかなる医療処置を開始する前にも、必ず資格のある医療専門家にご相談ください。.

医学的に記述・監修： ソアラウィー・ウィーラソポーン医師（ポム医師） — バンコク病院本社泌尿器科専門医。国際フェロー：ベイラー医科大学（米国）、順天堂大学（日本）、長庚紀念医院（台湾）。.

ソアラウィー・ウィーラソポーネ博士

ソアラウィー・ウィーラソポーン医師（ポム医師）は、バンコク病院本院の泌尿器科専門医で、男性医学、ロボット手術（ダヴィンチシステム）、腎結石治療を専門としています。ベイラー医科大学（米国）、順天堂大学医学部附属順天堂医院（日本）、長庚記念医院（台湾）での国際フェローシップを修了しています。このサイトのすべての医療コンテンツは、ソアラウィー医師の臨床経験と国際的なトレーニングに基づいて、同医師によって作成・監修されています。.

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