Atherosclerosis, a condition in which fatty deposits building up internal arteries, may also limit blood flow to the penis and reason erection difficulties. "The small blood vessels that go to the penis can become diseased a lot in advance than the [larger] vessels that visit the heart," Karen Boyle, MD, a urologist at Johns Hopkins School of Medicine, tells WebMD. "In younger or younger middle-aged guys, ED is often the first sign of atherosclerosis."
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