最后更新： 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.”
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.
If you’d like to discuss this topic further, please give me a text or PM 我!
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. 预约咨询.
Frequently Asked Questions about Erectile Dysfunction
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.
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.
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.
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.
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.
**免责声明：** 本内容由曼谷医院总院的认证泌尿科医生 Soarawee Weerasopone 医生撰写和审阅。本内容仅用于教育目的，不构成医疗建议。在开始任何医疗治疗前，请务必咨询合格的医疗专业人士。.
医学撰写与审阅： 素瓦瑞·维拉宋蓬医生（Pom医生）— 曼谷医院总部认证泌尿科医生。 国际学者：贝勒医学院（美国）· 顺天堂大学（日本）· 长庚纪念医院（台湾）。.
素瓦拉维·维拉索蓬医生（Pom 医生）是曼谷医院总部的注册泌尿科医生，专长于男性健康、机器人手术（达芬奇手术系统）和肾结石治疗。他曾在贝勒医学院（美国）、顺天堂大学医院（日本）和长庚纪念医院（台湾）完成国际深造。本网站所有医疗内容均由素瓦拉维医生根据其临床经验和国际培训撰写和审阅。.
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