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Common causes of erectile dysfunction include: Vascular conditions atherosclerosis, hypertension, and diabetes can impair blood flow Neurological disorders multiple sclerosis, Parkinson's disease, or spinal injuries Hormonal imbalances low testosterone, thyroid disorders Psychological factors anxiety, depression, stress, relationship difficulties Medications certain antihypertensives (e.g., thiazide diuretics, some beta-blockers), antidepressants (particularly SSRIs), antipsychotics, and 5-alpha-reductase inhibitors Lifestyle factors smoking, excessive alcohol, obesity, sedentary behaviour According to NICE Clinical Knowledge Summary guidance, ED is often an early marker of cardiovascular disease, as the penile arteries are smaller than coronary vessels and may show atherosclerotic changes earlier

Byrne CD, Targher G

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Serious Side Effects: When to Contact Your Doctor Immediately These are rare but serious