It’s not at all uncommon for men to occasionally have difficulty getting an erection or keeping an erection. The problem comes into play when a man is dealing with these issues far more often than he is having a successful time getting hard.
If a man is not able to get an erection at all or is unable to keep an erection long enough to have sexual intercourse – and this happens surprisingly frequently – then it’s highly likely that this man is suffering from a sexual disorder called erectile dysfunction, or impotence.
If you are a man living with erectile dysfunction as a part of your everyday life, you are not alone. Studies show that in men over 40 years old, up to 40 percent of them experience at least moderate erectile dysfunction in their lives. This number only gets higher with age. An estimated 70 percent of men over 70 years of age are said to be living with impotence. Over 70% of men that live with erectile dysfunction are not receiving treatment for their problem. 
While age is certainly a factor in the prevalence of erectile dysfunction, this sexual disorder is not something you need to put up with just because you’re getting longer in the tooth.
In addition to the growing number of candles on your birthday cake, there are a variety of other issues to point a finger at if erectile dysfunction is a problem you are enduring on a day-to-day basis.
Other Causes of Erectile Dysfunction
Erectile dysfunction has been linked to myriad other chronic health problems. Impotence can be caused by a singular issue though it is more commonly caused by multiple ailments. Erectile dysfunction is most frequently a symptom of an underlying problem or the result of lifestyle choices you have made. There are both physical and psychological causes for impotence as well.
Lifestyle choices that can be factored in as causes for erectile dysfunction are smoking, illicit drug use and alcohol consumption. The use of any of these can have an impact on testosterone levels which can in turn have an impact on your ability to achieve an erection.  
Anxiety, stress, relationship problems, depression… These are all psychological causes for concern when it comes to impotence. Depression has been repeatedly linked to erectile dysfunction and it can be a real grind to treat both issues. Depression can be a cause of ED but experiencing ED can cause depression.  Anxiety is another psychological issue that is a double-edged sword when it comes to impotence. Again, it can be the cause of the impotence or the impotence can cause sexual anxiety preventing a man from achieving an erection.  Stress and relationship problems are no *better as they can both hinder a man’s sexual drive and ability to be aroused or get an erection.
Some physical causes of impotence can be more easily treated than others. Obesity is a major cause of erectile dysfunction and making some simple lifestyle changes can have a significant effect on sexual health. Losing weight can *increase a man’s self-confidence and it can *boost his production of hormones, including testosterone.
High blood pressure and high cholesterol can also be the cause of erectile dysfunction. Anything that causes problems with the endothelial system or the flow of blood throughout the body can have a negative impact on a man’s ability to get an erection.  It is important to note that problems getting an erection can be an early warning sign for heart disease as well. So, if you notice you are having problems with the function of your sexual organs, you should speak with your doctor so that they can check you for other, more serious problems.
Testosterone and Erectile Dysfunction
In males, testosterone is the primary sex hormone but it plays a role in far more than just that…
Testosterone is produced in the testicles and the adrenal glands. Testosterone is the hormone that creates the male genitals while in the womb and it’s the hormone responsible for turning a boy into a man during puberty. It fuels the fire that brings on a deeper voice and body hair. As men age, testosterone levels tend to wane.
Testosterone is also responsible for helping to develop and *increase muscle growth in men. Some men use testosterone therapy to help them *gain more muscle and burn more fat.
In order for a man to achieve an erection, he must become aroused. If there are inadequate levels of testosterone in the body, this cannot happen and the man will be unable to achieve an erection. Testosterone helps the flow of nitric oxide which is essential for achieving an erection.  Low testosterone definitely plays a role in a man’s inability to get or sustain an erection but can excess levels of testosterone play a part in this dysfunction?
Solid research is not conclusive on this topic. We do know that excess testosterone can cause many problems in a man’s body, though. Among them are things like swelling of the prostate, fluid retention, sleep problems, *increased red blood cells, enlargement of breasts, *decreased testicle size and *decreased sperm count.
But why would more testosterone cause problems with the male genitals?
Well, we know that excess testosterone that cannot be used by the body is converted into estrogen. 
A man who has higher than normal levels of estrogen has a higher risk of diabetes  and this imbalance in sexual hormones *increases the chance that he will experience sexual problems such as erectile dysfunction. 
While it might not be possible to come to a concrete answer to this question just yet, scientists are continuing to work on it. Each day there is more and more research being carried out on erectile dysfunction and everything that goes along with this sexual disorder.
Rest assured there are answers out there and more forthcoming!
 Kubin M, Wagner G, Fugl-Meyer AR (2003) Epidemiology of Erectile Dysfunction. Int J Impot Res 15(1): 63-71
 English KM, Pugh PJ, Parry H, Scutt NE, Channer KS, Jones TH (2001) Effect of Cigarette Smoking on levels of Bioavailable Testosterone in Healthy Men. Clin Sci (Lond) 100(60: 661-5
 Sarkola T, Eriksson CJ (2003) Testosterone Increases in Men After a Low Dose of Alcohol. Alcohol Clin Exp Res 27(4): 682-5
 Seagraves RT (2000) Depression and Erectile Dysfunction. Postgrad Med 107 (6 Suppl Educational): 24-7
 Kaplan HS (1988) Anxiety and Sexual Dysfunction. J Clin Psychiatry 49 Suppl: 21-5
 Nunes KP, Labzai H, Webb RC (2012) New Insights into Hypertension-Associated Erectile Dysfunction. Curr Opin Nephrol Hypertens 21(2): 163-70
 Zvara P, Sioufi R, Schipper HM, Begin LP, Brock GB (1995) Nitric Oxide Mediated Erectile Activity is a Testosterone Dependent Event: A Rat Erection Model. Int J Impot Res 7(4): 209-19
 Ishikawa T, Glidewell-Kenney C, Jameson JL (2006) Aromatose-Independent Testosterone Conversion into Estrogenic Steroids is Inhibited by a 5 Alpha-Reductase Inhibitor. J Steroid Biochem Mol Biol 98(2-3): 133-8
 Jasuja G, Travison T, Davda M, Rose A, Zhang A, Kushnir M, Rockwood A, Meikle W, Coviello A, D’Agostino R, Vasan R, Bhasin S (2013) Circulating Estrone Levels Are Associated Prospectively with Diabetes Risk in Men of the Framingham Heart Study. Diabetes Care 36(9): 2591-2596
 Wu F, Chen T, Mao S, Jiang H, Ding Q, Xu G (2016) Levels of Estradiol and Testosterone are Altered in Chinese Men with Sexual Dysfunction. Andrology 4(5): 932-8