3 days ago
Erectile dysfunction could be an early sign of serious health problems — here's why you shouldn't ignore it
Erectile dysfunction (ED) is still a topic that carries a lot of stigma for men, despite how common it is. By the time men hit their 40s, about 40 per cent of them experience some form of ED, with rates increasing by about 10 per cent per decade.
Though ED's effects on intimacy can be devastating, it can also be one of the earliest signs of more serious health concerns, including cardiovascular disease, diabetes or hormonal imbalance. The most common physical cause of ED is poor blood flow, but it can also be related to nerve damage, structural problems, or hormones — all issues that need to be checked by a healthcare provider.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.
Though ED is a shared experience among men, many are hesitant to speak up about it, even to their doctors. According to Canadian urologist Dr. Yonah Krakowsky, this silence is deeply rooted in shame. 'Men experiencing ED might feel that it's an indictment of their manhood or masculinity,' he explains. 'These harmful misconceptions will prevent men from speaking about it openly or getting medical help.'
In some cases, practical barriers like long wait times, lack of a family doctor, or even not being able to take time off work can push people away from getting proper care. And in smaller towns, where you might bump into your doctor at the grocery store, the idea of opening up about ED can feel even more daunting.
Men experiencing ED might feel that it's an indictment of their manhood or masculinity,' he explains. 'These harmful misconceptions will prevent men from speaking about it openly or getting medical Yonah Krakowsky
Instead of speaking to a healthcare provider, many men turn to quick-fix solutions like gas station 'boosters,' unregulated pills sold online, or over the counter supplements that promise results without the awkward conversation. But Krakowsky says these types of workarounds come with their own risks.
When struggling with the mental and emotional challenges of ED, many men may not realize it can be the body's way of sounding an alarm. 'One of the first signs of diabetes or cardiovascular disease can be ED,' says Krakowsky. It might seem like a just a performance issue, but it's often a circulation or blood sugar problem.
ED is strongly linked to reduced blood flow, and that can signal the same kind of artery damage that leads to heart attacks or strokes. A 2025 review in Sexual Medicine Reviews urged healthcare providers to screen men with ED for early signs of heart disease — since the systems are so closely connected.
As well, roughly 34-45 per cent of adult men with diabetes experience ED, regardless of age, according to the Canadian Journal of Diabetes.
Krakowsky recalls a patient who came in for ED, who, after testing, was found to have dangerously high blood sugar levels and advanced diabetes. Without that initial visit, it might have gone unnoticed.
"Most people might not think of that," he notes. "There's no expectation that a patient would connect ED to cardiovascular, hormonal changes or endocrinological changes."
Recognizing ED as a health issue, not just a sexual one, can mean uncovering bigger problems early, when they're most treatable.
Sometimes ED is a symptom of hormonal shifts or metabolic health problems.
"As men age, testosterone levels can drop to a level that causes symptoms such as low energy, low libido and sexual dysfunction," explains Krakowsky. This process, sometimes referred to as 'anabolic decline,' is part of aging, but it doesn't mean men have to live with the symptoms in silence.
Another major factor is metabolic syndrome, a cluster of conditions that includes high blood sugar, high cholesterol and abdominal weight gain, which damages blood vessels and increases inflammation throughout the body. 'High blood pressure from metabolic syndrome also causes chronic inflammation, affecting vascular health and damaging blood vessels,' Krakowsky notes. This affects blood flow everywhere, including to the penis.
Addressing these root causes early is key. That's why Krakowsky emphasizes the need for regular lab work and full-body check-ups when ED appears, especially for men between 40 and 60.
"It's important to draw the bigger picture for patients in terms of their overall health," he says.
Ads for 'natural' erection pills or stamina boosters that claim to work instantly are rampant online. They look like an easy fix, let you stay anonymous and are often cheaper than seeing a doctor, but they aren't risk free.
Health Canada warns the public about unauthorized sexual enhancement products sold online and on shelves in convenience stores and vape shops. Some contain undeclared ingredients, including versions of real medications like sildenafil (Viagra) or tadalafil (Cialis) — but without clear labeling or regulated dosages.
Even if the active ingredient is in there, you don't know how much, or what else it's mixed with, Krakowsky explains. "In some cases, the real medication might not be present at all, and ultimately, this is not helpful as they won't do anything, making it a waste of time and money," he says. On the flip side, dosages that are too high or unmonitored by a doctor can lead to life-threatening low blood pressure, heart attack or stroke.
Many of the same habits that support heart health also protect sexual function, Krakowsky notes. That means staying physically active, managing stress, cutting back on alcohol and smoking and eating a balanced diet high in fibre and low in processed foods.
He also encourages men to be proactive, not reactive, about their health. Annual physicals, blood tests and check-ins with a healthcare provider can catch small changes before they turn into major problems.
"Understand the transition and changes your body will undergo, seek help when you need it, and don't be afraid to access care on your own terms," he cautions. That can mean increasing your health literacy and awareness and finding forms of care that are convenient for your living situation.
If you're looking into an ED clinic, it's essential to know who runs it and if the treatment is based on solid evidence, he warns.
"Men should ensure that care is being delivered by a licensed healthcare practitioner licensed in their province, whether that's a medical doctor or nurse practitioner," the doctor explains.
The practitioner you choose should meet with you for a detailed consultation, explain the recommended treatment plan and answer any questions or concerns you may have.
While many men think of ED as a bedroom issue, it's often a helpful warning sign. And when approached early, with the right treatment and lifestyle tweaks, the outcomes are sure to be safer and more effective.
