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Serena Norr
Written by Serena Norr

Reviewed by Dr Andre Budihardjo, MM

Erectile Dysfunction: What Are Its Causes and Natural Ways to Treat it?

Erectile dysfunction is extremely common in the U.S. The good news is it's typically temporary and treatable. Learn more here.

A happy man and woman cuddling on the bed wearing white shirts

Erectile dysfunction (ED) is a cause for much concern for many men as its the inability to maintain an erection during intercourse. While this ailment feels extremely personal, it is actually very common. In fact, according to the National Institute of Diabetes and Digestive and Kidney Diseases 30 million men in the U.S. experience ED.

Some men experience this from time to time, which isn’t a reason to be concerned. Complications arise when someone constantly experiences ED. This leads to stress, relationship problems, anger, anxiety, and depression, which can only worsen if it’s not treated. The degree of its impact varies from person to person.

But there’s good news! There are various treatments available, which start by having an awareness of your symptoms, which in some cases might be related to an underlying more serious disease or ailment. Read on to learn more about erectile dysfunction, its causes, and treatment options.

What is Erectile Dysfunction?

Erectile dysfunction is classified into three categories: reflexive, psychogenic, and nocturnal (happens during sleep). This, of course, can be different per person, but, ED generally leads to reduce or no sexual interest. Over time and if untreated, symptoms can worse. This ailment also causes embarrassment, shame, and confusion to those impacted.

What are the Causes of Erectile Dysfunction?

A sad thoughtful man suffering from erectile dysfunction sitting on the edge of the bed
Feeling stressed and anxious about your sexual performance can actually trigger erectile dysfunction.

There are many factors that cause ED. Male sexual arousal involves the brain, hormones, emotions, nerves, muscles, and blood vessels. Thus, ED can result from problems with any of these functions, or be caused by injury, stress, mental health issues, or a combination. In some instances, it can be the symptom of an underlying issue, which is why it is crucial to see a doctor when you are experiencing ED. Below, we are highlight some of its causes to better understand this ailment:

Distruption of blood flow into the penis

A disruption of blood flow to the penis can prevent it from getting erect. This can be the impact of stress, drugs, drinking, smoking, and serious illnesses like heart disease and diabetes.

Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (diabetes), and smoking.

Age plays a factor

An old man hugging his old wife while laughing together
As men get older, their risks of being affected by erectile dysfunction increase.

As men get older, they tend to have more issues with ED. According to studies, approximately 40% of men are affected at age 40 and 70% of men are affected at age 70.

Hormonal imbalances

The use of certain medications and steroids can cause low male hormone production, increased pituitary hormone levels, abnormal levels of thyroid, and ED.

Physical causes or chronic diseases

Chronic diseases can also contribute to ED. Common chronic diseases such as heart disease, clogged blood vessels, obesity, diabetes, and high blood pressure can be factors. Additionally, radiation from cancer treatments and some mediations have been known to make patients suffer from ED. There are some instances when ED is actually connected to an underlying issue such as prostate, colon-rectal, or bladder cancer As of late, ED has also been a symptom of COVID-19 in some patients.

Psychological issues

Men who experience ED might also be experiencing anxiety, depression, sleep disorders, low self-esteem, stress, or body dysmorphia. When the body is under stress, the brain releases adrenaline, and cortisol. These stress hormones cause muscles to tense and the heart to speed up rapidly. This reduced blood flow to the blood vessels can prevent an erection, and even decrease testosterone levels.

A recent study showed that 25% of men with ED also had depressive disorders and 33% of men reported higher levels of depression and anxiety when experiencing ED.

Additionally, many suffer from mental issues related to social upbringing, as some men raised in culturally conservative environments perceive sex as something shameful. Their negative attitude toward sex could cause them to experience ED.

The kidney and liver connection

The Traditional Chinese Medicine (TCM) perspective sees the kidney and the liver as organs primarily responsible for erections, or the lack thereof. Therefore, the kidney houses an essence called jing, which includes making a new life and controlling sexual instinct. This is why, according to TCM, deficiencies of kidney jing, yin, or yang will result in ED. 

The kidney and the liver also manage erections, as its meridians – pathways of energy – go around the external genitals. A disturbance or stagnation in the liver’s qi (energy) is one of the causes of ED. 

Apart from the liver and kidney, the heart and spleen also play an essential role in male sexuality. Mental stress reduces heart blood or qi and causes difficulty in maintaining erections.

Unhealthy lifestyle

Obesity, caffeine, cigarette smoking, excessive consumption of alcohol, and recreational drugs like marijuana can cause health problems related to impotence. Additionally, common medications such as blood pressure medications, steroids, chemotherapy for cancer, antihistamines, and diuretics can also cause ED.

What are the Treatment of Erectile Dysfunction?

While a challenging illness, it is important to seek professional assistance. A doctor will go through your history, conduct tests such as blood and urine, conduct a psychological exam, or perform an ultrasound. Through testing, they will guide you on a personal path to recovery. Additionally, TCM can be a part of an ED recovery plan. Below, you’ll find traditional and TCM approaches to healing:

Physical activity

Physical activity, such as running, lifting weights, and other forms of exercise can stimulate the production of male hormones and improve libido. Additionally, exercise improves blood circulation in the body and boosts flow to the penis.

Vacuum erection device

A vacuum erection device, or a penis pump, maybe a course of treatment. Before intercourse, a device is placed on the penis that is used to suck out the air and create a vacuum on the penis. However, bruising, and sensitivity to the cold are possible side effects.

Diet and lifestyle

A healthy diet, particularly a Mediterranean diet, is critical for many ailments, including ED. A diet rich in vegetables, fruits, nuts, whole grains, beans, and legumes can help. Additionally, this diet is rich in fish, poultry, and virgin olive oil. A 10-year study from the American Journal of Clinical Nutrition shows that plant compounds found in fruits and vegetables called flavonoids are associated with the reduction of ED. Health supplements can also aid in ensuring that you get all of the daily nutrients.


Dry cordyceps and capsules on top of a green banana leaf
Cordyceps is one possible solution to help with erectile dysfunction.

Interestingly, TCM can also help with ED by using herbs like pure Cordyceps that can boost energy, support the immune system, strengthen the kidney meridians, and enhance fertility. Another option is by drinking the essence of chicken with American ginseng, and huaishan — a nutritious supplement that uses select extracts from fresh chicken. A premium tonic, Cordyceps can boost energy, support the immune system, strengthen the kidney meridians, and enhance fertility. Additionally, it can tonify your qi and jing.

Specifically, cordycepin, a component of Cordyceps, can help to improve ED. It works by increasing sexual stimulation, erectile, ejaculatory, orgasmic, and other responses. Cordyceps also possess antioxidant, anti-inflammatory, and immunomodulatory properties. These properties help to regulate altered oxidative defense systems, spermatogenesis-related factors, and the production of sex hormones. can help to improve ED in men by increasing sexual stimulation, and erectile, ejaculatory, orgasmic, and other responses.

Red Ginseng

Slices of dried red ginseng to treat erectile dysfunction laid on a table
Red ginseng is a powerful herb that can help men who are suffering from ED.

Commonly known as red ginseng, Chinese ginseng, or panax ginseng, TCM links this herb to improved stamina, better libido, and its ability to help maintain erections. It also has antioxidant and anti-inflammatory properties to strengthen the immune system, enhance brain function, and regulate blood sugar. Studies have also indicated that red ginseng can be an effective herb in treating erectile dysfunction.


Maca (Lepidium meyenii Walp) is a root vegetable that is used as a fertility enhancer. Found in supplement or powder form, studies show that it also helps with rheumatism, respiratory disorders, anemia, and improves sexual function. Additionally, it helps with energy, stamina, and increasing libido.

Tongkat Ali

Studies have shown that Tongkat Ali, also known as Eurycoma Longifolia Jack or simply longjack is an effective herb to assist with sexual dysfunction. Traditionally used as a natural aphrodisiac, Tongkat Ali also improves endurance, aids in exercise recovery, diabetes, and improved energy and strength.


Oats have been touted for their health benefits. A nutrient-dense food, oats are rich in fiber, protein, antioxidants, and polyphenols. Oats also contain zinc, a nutrient that can aid in enhancing your sex drive. A great start to your day, consuming oats are an easy way to enjoy ED-boosting foods every day.

A common condition, erectile dysfunction is typically temporary and treatable. When signs or symptoms occur, consult a doctor who can give you a personal and specific course of action. Lifestyle changes and the addition of TCM herbs can also help you on your journey to treating erectile dysfunction.

This is an adaptation of an article, “Erectile Dysfunction: Addressing the Hard Issues with TCM”, which first appeared on Eu Yan Sang website.


  1. Mayo Clinic. 2020. Erectile dysfunction. [Accessed on December 3, 2021]
  2. University of Utah. 2021. COVID-19 and Erectile Dysfunction: Fact or Fiction?. [Accessed on December 3, 2021]
  3. NIMH. 2018. Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the United States. [Accessed on December 3, 2021]
  4. Cleveland Clinic. 2018. Erectile Dysfunction. [Accessed on December 3, 2021]
  5. Memorial Sloan Kettering Cancer Hospital. 2015. Halt the ED-Depression Spiral. [Accessed on December 3, 2021]
  6. Medical News Today. 2021. What foods can help combat erectile dysfunction?. [Accessed on December 3, 2021]
  7. National Institute of Diabetes and Digestive and Kidney Diseases. 2017. Definition & Facts for Erectile Dysfunction. [Accessed on December 3, 2021]
  8. NCBI. 2016. Dietary flavonoid intake and incidence of erectile dysfunction. [Accessed on December 3, 2021]
  9. NCBI. 2010. Maca (L. meyenii) for improving sexual function: a systematic review. [Accessed on December 3, 2021]
  10. NCBI. 2010. Maca (L. meyenii) for improving sexual function: a systematic review. [Accessed on December 3, 2021]
  11. NCBI. 2008. Red ginseng for treating erectile dysfunction: a systematic review. [Accessed on December 3, 2021]
  12. NCBI. 2016. Review on a Traditional Herbal Medicine, Eurycoma longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology. [Accessed on December 3, 2021]

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