If you were asked to list the essential components of a successful marriage or relationship, chances are, “regular, satisfying sex” would be somewhere on that list. It may even be at or near the top. But for as many as forty percent of American men in their forties, regular sex can be daunting or even seem impossible due to a condition known as erectile dysfunction (ED). Erectile dysfunction involves difficulty developing or sustaining an erection, and it may happen occasionally or become a persistent issue, at which point it could signal a bigger underlying health problem.

Because erectile dysfunction has many causes—both physiological and psychological—there are many approaches to treating it, and an approach that works for someone else may not work at all for you. It all depends on the underlying cause of your erectile dysfunction, and figuring that out could mean improving both your sex life and your overall health.