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Sci Transl Med 3(70):70ra13 Guevara-Aguirre J et al (2015) GH receptor deficiency in Ecuadorian adults is associated with obesity and enhanced insulin sensitivity

In men, libido, blood vessel dysfunction, mental health, relational issues, and a history of erectile dysfunction each affect one another and have inherent interdependency.[4] We see the prevalence of ED increasing with age due to declining hormones and vascular dysfunction, while mental health and psychogenic dysfunction are more common factors at a younger age.[5],[6] Several medications can contribute to ED, including antidepressants (in particular, selective serotonin reuptake inhibitors, an issue which is discussed further in the article Ashwagandha and Saffron: Key Tools for a New Era of Living[CD1] ) and antihypertensives (thiazide diuretics, beta blockers and spironolactone), which are among the most commonly prescribed medications in the U.S.[7] Perhaps not surprisingly, the use of substances and recreational drugs, including alcohol,[8] nicotine,[9] marijuana,[10] and cocaine,[11] are also associated with increased rates of ED