What Is Erectile Dysfunction

Erectile dysfunction (‘ED‘), also known as impotence, is a medical term that describes the inability to achieve and maintain a penis adequately erect for penetrative sexual intercourse.

Most men have at some point experienced problems obtaining or maintaining an erection. This could be due to fatigue, lack of sleep, an increase in stress, illness, etc.

This is normal and is not referred to as the condition called erectile dysfunction.

Erectile dysfunction describes a condition where satisfactory sexual intercourse has been impossible during a period of time consisting of several weeks or months.

Let’s take a look at how common erectile dysfunction is world-wide.

World Map Erectile Dysfunction

How Common Is Erectile Dysfunction World-Wide?

Because very few people talk about erectile dysfunction, you may think that it’s not very common at all.

Men normally don’t talk to their friends or colleagues about their erectile dysfunction, and many men don’t even talk to doctors about it. Therefore, erectile dysfunction often doesn’t get a lot of attention, but rather goes ‘under the radar’.

But it turns out that erectile dysfunction is in fact very common.

In order to get an understanding of how common erectile dysfunction is around the world, the best place to look are the various surveys and studies that already investigate the prevalence of ED on a per country basis.

Unhappy Couple In Bed Erectile Dysfunction

When looking at these studies as a whole, we find a few interesting observations.

Firstly, a lot of young men (men in their 20’s and 30’s) suffer from erectile dysfunction.

A second observation is that ED is more and more common as men get older.

And a third observation is that ED is common all over the world. Erectile dysfunction is a condition that affects men not just in certain countries, but it affects men world-wide.

Looking at these reports and surveys, we can draw the following preliminary conclusions regarding the prevalence of erectile dysfunction world-wide:

  • Age group 20-29: 5-10%
  • Age group 30-39: 10-30%
  • Age group 40-49: 15-40%
  • Age group 50-59: 25-50%
  • Age group 60-69: 35-70%
  • Age group +70: 50-75%
What Percentage Erectile Dysfunction

As we see from the numbers above it seems like the average number is somewhere around 20%, or perhaps even above 20%.

And any condition that affects approximately 20% of all men world-wide would be considered very common.

But it should also be said however, that a considerable amount of this information comes from self-reported surveys. Meaning, it is filled out by the men who take the surveys.

What does this mean?

It means that the answers would probably sometimes not be totally honest. It is possible, that some men with erectile dysfunction would state in the survey that they don’t have erectile dysfunction, because they don’t want anyone to know or are embarrassed about it.

Doctor patient erectile dysfunction

In other words, the actual number might be even higher than the approximate 20% figure.

But let’s go with the 20% figure.

20% of all men on planet earth. Do you know how many men that is?

There are approximately 8 billion people on planet earth, and about 4 billion men.

20% of 4 billion men is 800 million men.

In other words, there could be about 800 million men worldwide suffering from erectile dysfunction.

It has also been predicted that the prevalence of erectile dysfunction is likely to increase because our lifestyles continue to get less and less healthy.

As we live less healthy, we get more health issues, and one of them is erectile dysfunction.

Doctor Patient ED

Now that we know approximately how many men world-wide have erectile dysfunction, let’s try to understand the most common factors that cause this condition.

What Are The Causes Of Erectile Dysfunction?

Erectile dysfunction can have many causes. The body is a complex system and the process of getting an erection is a sophisticated procedure that involves a number of steps.

However, although erectile dysfunction can have a number of causes, I would dare to say that the majority of the reasons why erectile dysfunction happen, is a result of our modern lifestyles.

This is because our modern lifestyles are often not supportive of functioning well sexually. In other words, the way we live our modern lives often makes it more difficult to get erections and have a normal sexlife.

Couple In Bed Erectile Dysfunction

For instance, many of us don’t do much exercise and are not very active. Our diets also often contain large amounts of processed foods and few useful nutrients.

We tend to stress a lot, we sleep less than we did in the past, we often don’t get a lot of sunshine, etc.

And because our lifestyles are generally not particularly healthy, a number of dysfunctions tend to show up in our bodies over time.

These dysfunctions then often translate into impaired bloodflow. And this is typically the underlying problem that causes men to experience erectile dysfunction.

Let me repeat that: the underlying problem that causes men to experience erectile dysfunction is typically always impaired bloodflow.

Bloodflow Erectile Dysfunction

There needs to be enough blood flowing to the penis to fill it and build pressure inside it. If there is inadequate bloodflow, the penis will not become engorged. No blood flow or not enough blood flow = no erection.

Another problem that will normally cause erectile dysfunction is when the penis is unable to retain the blood that has already entered it.

In other words, if blood flows to the penis, but it is not contained or trapped in the penis, and therefore flows right back out, the erection will fade. This is called venous leak.

Let’s look at the most common factors that can directly or indirectly weaken bloodflow, and therefore can cause erectile dysfunction.

Low Testosterone

Low testosterone will almost always ruin a man’s ability to function sexually.

Testosterone ED

That is because testosterone, the primary male sex hormone, is simply necessary in order to function sexually, get erections and have a sex drive.

Testosterone supports and controls sexual functions, and it governs the environment in which sex can take place. Testosterone enables sex to happen. Without adequate testosterone, getting erections would be practically impossible.

So if you have low testosterone levels, you will in all likelihood have difficulties getting erections, and if so, you will be dealing with erectile dysfunction.

Low testosterone levels can be caused by several factors, such as old age, lack of exercise, a poor diet, stress, lack of sunshine, pollution, smoking, etc.

To learn more about how to increase testosterone levels naturally on Truelibido, please go here.

Testosterone Strength


As we age, our cells become older, are less able to divide, and cells in certain parts of our body stop being replaced by newer cells.

Our bones tend to become less dense, muscle tissue starts to decrease in size, blood vessels tend to become stiffer and often clogged with plaque, and our DNA structure becomes shorter.

In short, the body experiences an overall level of decay.

Testosterone levels also normally fall as we age, and you can expect a drop of about 1% every year after turning 30.

This decay brought about by age also impacts the sexual organs and sexual functions.

Old Man Erectile Dysfunction

In particular, the number of cells in the testes normally decrease with age.

Aging may also have a gradual negative effect on the compliance of the tissues in the corpora cavernosa and overall penile health.

Therefore, as we age, we normally find that our sexual functions start working less well, and ED becomes more common.

Lack Of Exercise

Exercise is one of the best actions you can take to combat erectile dysfunction. It is beneficial for sexual functions in so many ways.

But the opposite, not exercising enough or simply being out of shape will also often cause erectile dysfunction in several ways.

Erectile Dysfunction Bad Diet

For instance, if you eat more calories than you burn, or if you are overweight, you will typically have more ‘bad stuff’ floating around in your blood.

And ‘bad stuff’ refers predominantly to glucose, triglycerides and bad cholesterol. These substances make your blood thicker, which in turn makes it flow more slowly around your body. This will reduce your bloodflow.

In addition, thicker blood can increase your blood pressure, which in turn can have several damaging effects, including erectile dysfunction.

In addition, as you have higher levels of these substances in your blood, they will over time get attached to the inner walls of your blood vessels. This will cause plaque build-up which can lead to the condition called atherosclerosis.

This will make your blood vessels narrower, stiffer, and more prone to ruptures. All of this will normally have a negative effect on bloodflow.

Big Bellly Erectile Dysfunction

But there is more:

If you weigh more than you should, and particularly if you have a large belly, your body will likely start converting your male sex hormone testosterone into the female sex hormone estrogen.

This will not only reduce your overall testosterone levels, but also shift your testosterone / estrogen balance so that testosterone is even less effective than before.

This can be damaging:

Because as you have less testosterone and the ratio is out of balance, you will normally be less able to maintain your muscle mass.

As your muscle mass declines, you will be less able to burn the calories you put into your body.

And if you keep eating as you did before, these extra calories will be stored as fat.

Fat Erectile Dysfunction

And more fat means even less testosterone. And the vicious circle has started.

Increased amounts of body fat also normally lead to an increase in cortisol levels.

Excess amounts of cortisol will normally reduce testosterone levels, and hence by being overweight, testosterone gets attacked by yet another front.

And one more thing:

As you are not exercising enough or being out of shape, your body will also normally produce less nitric oxide.

With less nitric oxide it will be more difficult for you to get erections because nitric oxide is necessary in order for blood to flow into your penis.

Pizza Erectile Dysfunction

To learn more about my experiences with exercise on Truelibido, plese go here.

A Poor Diet

If you don’t eat well, you are also significantly more likely to suffer from erectile dysfunction.

Every second of every day, your body needs the appropriate amount of vitamins, minerals, fatty acids and other essential nutrients in order to function optimally.

If you don’t give your body these nutrients, your body has no chance of functioning optimally.

Because if your body don’t have the right nutrients, it cannot carry out its normal tasks the right way.

Hamburger Erectile Dysfunction

For instance, if your body is instructed to synthesize a certain hormone that needs vitamin B6, but your body doesn’t have enough vitamin B6, the hormone your body produces will be faulty.

As a result, the functions in your body that rely on this hormone, will now work slower or perhaps even stop working completely.

For many men, me included, when I don’t provide my body with the right nutrients, one of the first function to stop working is my ability to get erections.

And if your body doesn’t get the right nutrients over a long period of time, and hence keeps maintaining and building your body with improper building materials, you can cause your body semi-permanent damage.

This can then make it very difficult to function well sexually.

Unhealthy Food Erectile Dysfunction

Also, as mentioned above regarding lack of exercise, if you eat more calories than you burn, your blood will likely contain more glucose, triglycerides and bad cholesterol than it should.

This will thicken your blood, reduce bloodflow and cause similar effects as described above in the exercise section.

A note on sugar and salt:

Consuming too much sugar is also likely to contribute to erectile dysfunction.

Excess sugar can increase your levels of the free radical superoxide, which in turn decreases antixodants. Antixodants protect nitric oxide, therefore excess sugar can reduce your nitric oxide levels.

Excess sugar (or glucose) in your blood can also be converted to triglycerides, can cause blood pressure to increase, and can cause an increase in bad cholesterol.

Sugar Erectile Dysfunction

Lastly, a high salt intake will normally increase your blood pressure and decrease your nitric oxide production, both of which can lead to erectile dysfunction.

To learn about my experiences with different diets, please go here.

High Blood Pressure, Diabetes, And Cardiovascular Diseases

High blood pressure, diabetes, and cardiovascular diseases are all conditions that have to do with with your heart or bloodflow.

As a result, all of them are likely to reduce the free flowing of blood through your body and to your penis.

Although, these illnesses can to some extent be genetically determined, they are also very often associated with the modern lifestyle. Or in other words, a poor diet, lack of exercise, etc.

Blood Pressure Test

These conditions can cause damages to the blood vessels and build-up of plaque inside the arteries, called atherosclerosis.

This build-up will sometimes in turn cause big pieces of plaque to be broken off, causing raptures to blood vessels, which can cause them to leak.

Drifting pieces of plaque may also block smaller blood vessels elsewhere in the body.

When atherosclerosis becomes advanced, it often makes your blood vessels narrower and stiffer, and your blood will then have a tougher time to flow through your vessles.

This process often clogs up the smaller arteries first, such as those in the penis, and will often lead to erectile dysfunction.

When arteries become harder and stiffer, they also break and leak more easily.

Diabetes Erectile Dysfunction

High blood pressure, diabetes, and cardiovascular diseases can also cause thickening of the blood, slower bloodflow, reduced nitric oxide production, and lower testosterone production.

All of the above are likely to have a negative effect your ability to get erections.

A note on diabetes:

Erectile dysfunction tends to develop 10-15 years earlier in diabetic men than in non-diabetic men.

Many men with diabetes also develop a muscle disease called myopathy.

This may cause ED because the muscles in the corpora cavernosa may experience a decreased overall compliance. This may cause an inability to obtain and maintain an erection.

Atherosclerosis Erectile Dysfunction


The modern human being stresses a lot more than he should. And stress can be your worst enemy to having a normal sex-life.

A little bit of stress won’t hurt you. However, it’s the long-lasting, every-day and constant stress that can wreck havoc with your ability to get erections.

But let’s start from the beginning:

Because stress is actually good. It has a very useful purpose.

It is a mechanism for dealing with a situation that is perceived as potentially dangerous, or requiring special attention.

Let’s say you’re walking down a dark alley at night and you are being followed by someone you think have bad intentions.

Dark Ally Stress

In this situation, your brain will normally give you a burst of energy, which will make you more alertsee clearer, hear better, and mobilize extra energy in your muscles in case you need to run or fight.

These effects happen because your body produces cortisol, adrenaline, norepinephrine, dopamine, and other chemicals, and release them into your bloodstream.

This stress is extremely useful, as it may save your life or help you avoid harm.

What just happened is that your body channeled attention to those parts of your body that were critical for the dangerous situation, such as hearing, vision, the heart, muscles needed for a quick escape, etc.

At the same time, those parts of the body that were not critical for the dangerous situation, such as the reproductive system, were basically shut down.

Stress Work Erectile Dysfunction

In other words, in this stressful situation, it would be very difficult for you to get an erection (because your body gives little attention to your reproductive organs). And the same goes for when you experience persistent and elevated levels of stress over a long period of time.

Therefore, if you experience this constant and elevated level of stress, you are significantly more likely to suffer from erectile dysfunction.

Two more items:

Excess levels of cortisol will also normally reduce testosterone levels, because cortisol and testosterone compete for the same space, meaning more of one normally means less of the other.

Also, elevated levels of stress over a long period of time put additional strain on your heart and may eventually lead to cardiovascular disease, which in turn may lead to decreased flow of blood in the body and the penis.

To learn about my experiences with stress on Truelibido, please go here.

Smoking Erectile Dysfunction

Cigarette Smoking

Cigarette smoking can also be a fierce enemy to your erections.

Cigarette smoke contains more than 40,000 chemicals, and many of these, such as acetone, ammonia, nicotine, arsenic, lead and tar, can cause great harm to your body.

I mentioned already that the body is a very fine-tuned system that can easily be kicked out of balance if we don’t live well.

Introducing 40,000 chemicals into your body that are not supposed to be there (at least not in great quantities) can certainly kick this delicate system out of balance.

This can cause several dysfunctions in the body, including erectile dysfunction.

Cigarette Erectile Dysfunction

So what kind of damage can cigarette smoke cause, that can in turn cause erectile dysfunction?

First of all, it can reduce nitric oxide levels. With low levels of nitric oxide, it becomes very difficult to get and maintain erections.

Smoking will normally also increase insulin resistance which will make it more difficult for your cells to absorb glucose.

With excess glucose in your blood, your blood gets thicker (moves slower through your body), which can cause atherosclerosis. This can reduce bloodflow, and can also further reduce nitric oxide production.

When you smoke, your body will also often blast out stored fat reserves into your blood that can cause a temporary overload of fat in your blood. This can have have a similar effect to those described above regarding excess glucose.

Cigarettes ED

Cigarette smoking can also increase blood pressure, increase bad cholesterol and reduce good cholesterol. All of these can be damaging for good bloodflow.

Another potential problem caused by cigarette smoke is that veins can form inside your existing veins. This is turn can cause impairments in bloodflow.

And let’s not forget:

In all likelihood, many of the more than 40,000 chemicals could potentially cause damages we are not even aware of. It could cause disruptions to hormones, the nervous system, brain function, etc.

Several research studies have shown that smokers are about 30% more likely to suffer from erectile dysfunction than non-smokers.

And a few words on drugs and substance abuse:

Drugs Erectile Dysfunction

Many recreational drugs and other forms of substance abuse can have similar and often even worse effects on your body, than those from smoking.

This can cause hormonal imabalances, disruption to bloodflow, brain damage, damage to the nervous system, and more.

And a consequence of any one of these can be erectile dysfunction.


Most people consume alcohol. And many people think alcohol is not harmful to the body, or even healthy in moderation.

But alcohol is a toxin. It is a toxin that is not supposed to be in your body in large quantities.

And when it is present in your body in large quantities, it can cause several kinds of damage.

Beer Erectile Dysfunction

For instance, research studies have shown that long-term excessive alcohol consumption is likely to cause coronary heart disease, atherosclerosis, hardening of the arteries and damage to the inner lining of the blood vessels, called the endothelium.

In addition, significant alcohol consumption can also cause a drop in testosterone levels and an increase in cortisol.

All of these effects are likely to contribute to or cause erectile dysfunction.

Pornography And Masturbation

Watching Pornography and masturbating can completely ruin a man’s ability to function sexually.

The term is called porn-induced erectile dysfunction.

Porn Masturbation Erectile Dysfunction

A key problem with pornography is that it is so incredibly easy to access. You can watch porn anywhere, anytime. All you need is a smartphone or computer, and you can have virtual sex where and when you want.

Another key problem is that advances in technology has made the quality of the porn amazingly real. With every passing day, pornography becomes closer and closer to real life.

Now there is even virtual pornography with smart goggles and sensors, which blurs the lines between reality and imagination. At one point the distinction between real sex and fantasy will probably disappear.

Yet another problem with porn is that it offers never-ending novelty. You can have virtual sex with a new partner every 5 minutes (or every 30 seconds), you can be with a white woman, black, asian, old, young, have a threesome, group sex, sex in public – there are no limits.

As a result, pornography can produce incredible sensations in a man with almost no effort.

Watching Pornography Erectile Dysfunction

The key problem is that when you watch porn and masturbate frequently, your brain produces large amounts of dopamine.

With too much dopamine floating around in your brain, your dopamine receptors start to become desensitized to the dopamine 

Now you will need more extreme forms of pornography to achieve the same pleasurable sensations as before.

As you consume more extreme forms of porn, your brain gets further desensitized to dopamine, and you need even more extreme forms of porn.

This can cause a vicious cycle that 1) can lead to porn addiction, and also 2) it will make the dopamine reward mechanism in your brain so numb, that it can be almost impossible to get an erection when you are with a real person.

Man Woman Bed Erectile Dysfunction

In other words, if you watch porn and masturbate frequently, you brain can get so numb to sexual stimulation that it causes erectile dysfunction (called porn induced erectile dysfunction).

Lack of Sleep

If you don’t sleep enough, you are also in the danger zone for erectile dysfunction.

Sleep is necessary for your body to recover after a day’s use and to restore functions that have been used extensively throughout the day.

And you know the feeling of not getting enough sleep? You get tired, slow, sluggish and fatigued. Which means that several of your bodily functions work much slower than usual.

If sleep deprivation goes on for long enough, bodily functions will not only slow down, but they will shut down. And taken to the extreme, sleep deprivation will lead to death.

Lack Of Sleep Mobile Erectile Dysfunction

You will normally be less interested in sex when you are tired, and you will also normally find it more difficult to get erections. Your body is simply less keen on sex.

However, the most important reason why lack of sleep can cause erectile dysfunction, has to do with testosterone production.

Because it is when you sleep that you produce testosterone. So if you don’t get enough sleep, you won’t be able to produce enough testosterone.

And with inadequate testosterone levels, it will normally be much more difficult for you to get and maintain erections.

To learn about my experiences with sleep, please go here.

Tired Erectile Dysfunction

Lack Of Sunshine

You may not be aware that you need sunshine to be able to function optimally sexually. But you do.

Let me explain:

When sunshine lands on your skin, your skin is able to produce vitamin D3.

And why is vitamin D3 so important?

Vitamin D3 is an essential building block of testosterone. So if you don’t have enough vitamin D3, it will be impossible for your body to produce enough testosterone.

And with low testosterone levels, it will normally be very difficult for you to get and maintain erections.

Lack Of Sun Erectile Dysfunction

Yes, you can get some vitamin D3 from foods, but it is practically impossible to get enough vitamin D3 from foods in the long run. Therefore you need the sun to fill up the balance.

You can also take a vitamin D3 supplement, however, I always prefer to get nutrients the natural way, if possible.

But sunshine is not only important for testosterone production. Sunshine is a life-giving force that is essential for our bodies in so many ways.

Your immune system needs sunshine to function optimally, sunshine increases serotonin levels and is necessary for you to be happy. Sunshine also reduces many diseases and cancers, increase fertility, and much more.

To learn about my experiences with sun exposure, please go here.

Sunshine ED Vitamin D3


Significant time spent cycling can also lead to erectile dysfunction.

Sitting on the saddle for long periods of time may cause a lot of pressure on the nerves and arteries going to the penis. This may weaken the functioning of these nerves and arteries, and a possible outcome is erectile dysfunction.

Nerve Or Spinal Cord Damage

An injury to the back causing spinal cord damage, or an impaired prostate as a result of prostate surgery (for instance), can damage the nerve system.

This can cause the pathways of communication from the brain to the penis to break down or falter.

As a result, the required signals sent from the brain may not arrive at all, or may arrive in a different form. This may make it more difficult to get erections.

Medication Erectile Dysfunction

Side Effects From Medications

Many common medications will often cause erectile dysfunction as a side effect.

This is normally so because they affect a man’s hormones, nerves, increase blood pressure, or weaken blood circulation.

These medications are often antihistamines, tranquilizers, appetite suppressants, hair loss drugs, painkillers and hypertension medication.


Some men are genetically more likely to suffer from erectile dysfunction than other men.

Genetics Erectile Dysfunction

It has been discovered that variations in a specific place in the genome near the SIM1 gene, have a high correlation with an increased risk of erectile dysfunction.

One research study indicated that this was associated with a 26% increased risk of erectile dysfunction.

Psychological Factors

Psychological factors such as anxiety, guilt, depression, widower syndrome, low self-esteem, post-traumatic stress disorder, fear of sexual failure, indifference, etc., may also cause erectile dysfunction.

If you suffer from a psychological issue, you will normally not be in an optimal mental state, and will often as a result be preoccupied with negative thoughts. And these negative thoughts can occupy a significant amount of mental space. 

Depression Erectile Dysfunction

As a consequence, you may not have sufficient mental space to focus on sexual activity.  Or you may develop an unhealthy relationship to sexuality. And you may therefore suffer from erectile dysfunction.

Research has indicated as many as 20% of all erectile dysfunction cases may be due to psychological factors.

Venous Leak

Venous leak is a condition that will normally also cause erectile dysfunction.

An erection takes place when blood flows into the penis and it fills the penis completely.

Venous leak describes the situation where the blood is not being retained in the penis, but rather quickly flows back out of the penis.

Therefore, even if there is adequate bloodflow to the penis, you are not able to maintain an erection because the blood flows out and away.

Venous Leak Erectile Dysfunction

Research Studies

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Erectile Dysfunction Form

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Erectile Dysfunction Fill Out

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Erectile Dysfunction Consultation

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Erectile Dysfunction Doctor

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