Early Signs and Diagnosis of Erectile Dysfunction

Saima Andrabi   by Saima Andrabi, MS, Clinical Biochemistry    Last updated on February 29, 2020,

Erectile dysfunction (ED) is a condition found in men which makes them unable to get or keep an erection firm enough to go for sexual intercourse.

Uncommonly, this condition is also referred to as impotence. Age can be a risk factor for erectile dysfunction in men but it doesn’t cause ED.

Why Does Erectile Dysfunction (ED) Occur in Men?

Erectile dysfunction mainly occurs due to issues in the erection process of men. Erection in men is caused due to an increased blood supply to the penis which can be stimulated by various factors such as sexual arousal, direct physical contact with the penis, etc.

Heavy blood supply to the penis during sexual excitation causes relaxation of the muscles present in it which fills the penile chambers with a sufficient amount of blood as the excess blood flow passes through the arteries of the penis. All this eventually results in the penile erection in men which is important for sexual intercourse.

Any kind of interruption in this normal process of penile erection causes erectile dysfunction (ED) in which the penis is unable to get or maintain an erection and therefore the person fails to satisfy his sexual needs.

How can you Detect Early Signs of Erectile Dysfunction?

Men with ED suffer from many sexual issues which makes them sexually inactive. ED in some cases is temporary and can be treated with some medications but an adverse case of ED highly affects the sexual life of males and results in failure of sexual intercourse.

Males with ED often suffer from psychological problems because they are not able to satisfy the sexual needs of their partners which in turn make the symptoms of erectile dysfunction even more disruptive.

Penile erection and sexual arousal play an important role in the sexual life of men. Several factors are involved in arising of the sexual desire in males such as hormones, nerves, blood vessels, emotions, muscles, and brain. All these play an intricate role in the erectile process and should be in line for a normal healthy sexual life. Any kind of disruption in any of these factors may cause erectile dysfunction in males.

Occasional or intermittent sexual issues do not always indicate erectile dysfunction. Some early warning signs may be helpful in detecting ED if they are persistent over a long period. These include:

  • Lack of desire for sex (libido)
  • An occasional erection (not necessarily at the time of sex)
  • Complete lack of penile erection
  • Inability to retain an erection


Early symptoms and warning signs of erectile dysfunction (ED) may either develop suddenly or gradually over time. When ED is sudden, it may be due to various psychological issues (stress, anxiety) or side effects of some medications. ED which develops gradually is mostly caused due to a lack of proper blood supply to the penis or some issue in the penile nerves.


Eight Major Indications for Identifying the Early Signs of Erectile Dysfunction (ED)

Penile problems should never be ignored as they may be an indication of some serious underlying problems like erectile dysfunction.

Following are some of the early signs found in males that can point to erectile dysfunction down the line:

1. No Morning Wood

Night and early morning erections in males are very common and have nothing to do with sexual arousal. Nocturnal penile tumescence (NPT), also called morning wood (early morning penile erection), occurs frequently in some males and is a good thing which indicates that the blood vessels responsible for supplying blood flow to the penis are healthy and normal.

If you start noticing that there is less or no morning wood, it could be a sign that your penile blood vessels are not working properly and therefore you should visit a doctor.

Although lack of morning wood is not always an indication that you are in trouble but it may be a symptom of erectile dysfunction.

2. Less or no Sexual Thoughts

If you suddenly stop developing sexual thoughts as much as you used to before, it may be an indication that your body is not producing enough testosterone (the hormone responsible for sexual drive).

Lack of sufficient testosterone levels in your body can cause many symptoms such as fatigue, mood changes, difficulty in muscle building and developing of the gut, and lack of sexual thoughts, etc. All these symptoms can be an early sign of erectile dysfunction.

3. High Blood Pressure or Cholesterol

If your lab results show high cholesterol levels and high blood pressure it may be an indication that you can be at risk of ED.

High blood pressure and high cholesterol can damage the blood vessels of the penis due to which they lose their elasticity and are unable to get pass sufficient blood into your penis which in turn leads to the failure of penile erection.

4. Using Antidepressant and Blood Pressure Medications

Antidepressants and blood pressure medications can be the real culprits behind erectile dysfunction. Some antidepressant medicines like SSRIs (Prozac or Paxil) and SNRIs (Effexa XR and Cymbalta) result in erectile dysfunction as they make it harder for hormones (norepinephrine) and chemical signals to reach your brain and make you feel aroused.

People may typically develop these symptoms within couple weeks of starting the medicines.

Blood pressure medications decrease the blood flow to the penis and may ultimately lead to failure of penile erection.

5. Dental Problems

Gum problems like swollen, painful, and bleeding gums may also lead to ED in males, although not directly.

Gum diseases are often associated with severe inflammation throughout the body which may destroy the blood vessels. Any kind of damage to the blood vessels may result in a lack of blood flow to the penis which can interfere in its normal erection process.


More for Your Reading: Do you know hemorrhoids can also cause erectile dysfunction, according to a recent study?


6. Lack of Erection or Maintaining an Erection

If you have a problem with getting an erection or maintaining it for a longer time, it can be an early sign that you are at risk of developing erectile dysfunction.

Lack of erection or maintaining an erection is a slowly progressive problem and should be taken care of as early as possible. If it is occasional then you need not to worry but if it occurs frequently then you should consult a doctor.

7. Sleep Issues

Sleep-related issues like sleep apnea can also affect your normal functioning of penis and may lead to problems in erection.

According to the “International Society for Sexual Medicine”, 70% of guys with sleep apnea also have erectile dysfunction. Deprivation of sleep decreases the testosterone levels in your body which in turn leads to various psychological issues and loss of libido which ultimately makes it difficult to get an erection.

8. Kidney Diseases

Males with kidney diseases may find it difficult to maintain their erections because kidney diseases often affect hormone levels, energy levels, and blood circulation in the body.

Every time kidney problems may not interfere with your penile erection but if it does, you should consult a doctor for the kidney problems and the associated ED.

Early Diagnosis of Erectile Dysfunction

Erectile dysfunction (ED) has become a problem of high prevalence in our milieu. Its early diagnosis should be proactively focused because it adversely affects the quality of life of both males as well as their partners.

Assessing the clinical history of the patients with erectile dysfunction (ED) can be a cornerstone for early diagnosis. The identification of early signs of ED mostly involves a physical examination, basic lab tests, and problems in sex life.

Clinical History

Patients should be assessed for any previous medical history as well as other diseased conditions that may increase the risk for erectile dysfunction. This also includes investigating the use of drugs that may affect normal sexual functioning and erectile function.  Read about drugs that may cause erectile dysfunction.

Patients are usually assessed for the following conditions:

  • Heart Diseases
  • Kidney problems
  • High cholesterol
  • Diabetes
  • Multiple sclerosis
  • Psychiatric disorders
  • Peripheral Neuropathies

Physical Examination

Physical examination of various health conditions and clinically relevant diseases can be really helpful in the early diagnosis of erectile dysfunction. These conditions include high blood pressure, liver alterations, thyroid enlargement, etc.

People should also go for neurological examinations including penile and testicular sensitivity, perineal sensitivity, anal sphincter tone, as well as the bulbocavernosus reflex. The physical examination for early diagnosis of ED may also include:

  • Determining the hormonal levels
  • Digital rectal examination for prostate cancer which can be a reason for ED
  • Determining testosterone levels and lipid profile
  • Monitoring nocturnal erectile activity
  • Analyzing drug-induced erectile testing

Nocturnal Penile Tumescence (NPT) Testing

This test is used for the early diagnosis of ED in males and the cause of the lack of nocturnal penile tumescence (NPT) in males.

Normally males have NPT (penile erection) when they wake up early in the morning. But men with ED show less or no NPT. The NPT testing is used to measure penile erections in patients with or without ED and the underlying cause.

Other tests that may be important for early diagnosis of ED may include:

  • Psychological testing for screening various psychological issues (like depression, anxiety) that may lead to ED
  • Ultrasound examination for determining the blood flow to the penis
  • Urine analysis for determining diabetes or other related conditions responsible for ED

Frequently Asked Questions

Different diagnostic tests can help you in checking for your erectile dysfunction. Some of them may include:

  • Physical examination
  • Urine analysis
  • Ultrasound
  • Blood tests
  • Psychological testing


Many factors may lead to weak erection in your penis. Some of these include injury to the penile blood vessels, loss of blood supply to the penis, psychological factors, prostate surgery, side effects of some drugs, alcohol drinking, smoking, etc.

Erectile dysfunction is not the end of your sex life. You can take the following measures to help your partner with ED:

  • Make him stress-free and try to make him relax
  • Communicate with your partner as much as possible and look for the possible ways
  • Encourage your partner for consulting a doctor. Ask him to be open to his doctor and do not hesitate in mentioning his sexual issues.
  • Find some alternatives for satisfying the sexual needs of your partner
  • Encourage him to exercise regularly and avoid unhealthy habits
  • Help your partner in managing his psychological issues and encourage him to visit a psychological counselor

Yes, lack of sexual attraction to your partner may be one of the causes of ED, but it is the least common cause. Mostly, ED in males is caused due to some physical or psychological issues.

Men with ED face many difficulties such as lack of libido, depression, fatigue, anxiety, stress, lack of self-confidence, social issues, etc. You should help your partner in overcoming all these problems and encourage him for visiting a gynecologist.

Saima Andrabi

Saima Andrabi is a clinical biochemist and is passionate about driving knowledge platforms for creating health awareness in the general public. She pursued her master’s degree in clinical biochemistry from University of Kashmir, Srinagar followed by an internship from National Institute of pathology, New Delhi. Her areas of interest include molecular biology, immunology, medical physiology and forensic medicine. Saima is very much interested in writing medical content and wants to create awareness in public through this platform.


Currently, Saima Andrabi is working at Maxinov Solutions Private LTD as a research associate and is associated with DiseaseFix as a medical content writer.

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