Edit: After posting, I checked out two of the original studies cited in the article, and I think the author of the Canadian Affairs article was off-base with the things I've since struck out. I don't believe data exists to say that physical vs psychological factors are greater contributors to ED - they both seem relevant.

A recent study of thousands of American men under 40 found nearly 15 per cent struggled with erectile dysfunction. Most cases were strongly linked to psychological, rather than physical, causes.

Other studies have suggested psychological or emotional factors may explain as many as 85 per cent of ED cases.

A 2018 review of 49 international studies found that men with depression were 39 per cent more likely to experience erectile dysfunction than men without depression.

And yet, mental health is rarely assessed in ED clinical trials or included in treatment plans. A 2025 Canadian evaluation of more than 450 ED clinical trials found that fewer than eight per cent mentioned mental health issues.

There may be multiple components in fertility, but the majority of erectile dysfunction is rooted in metabolic health. The penis getting enough blood to form and maintain a erection is a early bell weather for cardiovascular function.

ED is a very common, and often ignored, sign of poor metabolic health. 96% of westerns have sub-optimal metabolic health. Which is driven principally by diet, lots of sugars and processed foods lead to a condition of insulin resistance but not too far down that root is ED.

There may be multiple components in fertility, but the majority of erectile dysfunction is rooted in metabolic health.

Do you have data to support that, specifically in young men? Nocturnal tumescence studies would be necessary to conclude ED issues are primarily vascular in origin

Here is a good review article on it: Erectile dysfunction, metabolic syndrome, and cardiovascular risks: facts and controversies

I don't have data on young men.

Impaired metabolic health impacts not only the vascular system but also the hormonal system, it touches almost every aspect of ED.

The question was about the relative effect sizes of psychological and physiological factors on ED in young men. The article you shared just characterizes one set of risk factors. It doesn't address the question

I can just give you the bits and pieces that ED is a very common symptom of poor metabolic health and 96% of westerners (I don't have the breakdown by age) have impaired metabolic health.

Thank you for clarifying that when you proclaimed in your original comment "the majority of erectile dysfunction is rooted in metabolic health" - that that's just a personal opinion of yours that you can't provide any specific supporting evidence for. Please note that this community is dedicated to health science information, not armchair speculation, etc.

This is a discussion forum, everything we say is opinion, i've given you my perspective on the issue to the best of my ability.

You might find these previous posts interesting:

• Male fertility: optimizing reproductive health, treating infertility, & navigating TRT - MD Attia, MD Turek

• The Metabolism of Male Infertility - 56m - Ben Bikman

Actually, the closest this community gets to describing its purpose is a) Link to high-quality, original research whenever possible and b) low-effort posts or comments are not allowed.

If you want to share an opinion here, it should be clearly labelled as such. In contrast, here's what you've since clarified is you just stating your opinion:

"There may be multiple components in fertility, but the majority of erectile dysfunction is rooted in metabolic health."

That is opinion masquerading as a scientifically informed assertion. It's a waste of time to people reading it, but it'd be fine if clearly labelled as an opinion.

I don't think you're malicious, you just seem unfamiliar with the hows and whys of science