ED can involve blood vessels, nerves, medicines, hormones or psychological factors. More than one cause is common. The pattern, onset and medical history help narrow it down. A medication that improves erections does not tell you why they changed.
Sildenafil has a shorter response window; tadalafil can improve erectile function for up to 36 hours. That does not mean an erection lasts that long. Food effects and daily-use options also differ. Both need sexual stimulation, and neither can be combined with nitrates.
An ED evaluation starts with your erection pattern, medical history, medicines and sexual health. A focused examination and selected tests can help identify the cause. Not everyone needs specialized testing. The goal is to explain the change, check related health risks and choose the next step.
ED can be an early sign of blood-vessel problems, especially alongside diabetes, smoking or high blood pressure. It does not mean you definitely have heart disease. New or persistent ED is a reason to review cardiovascular risk, rather than treating erections as an isolated concern.
