Atherosclerosis, a condition in which fatty deposits build up inside arteries, may restrict blood flow to the penis and cause erection difficulties. "The small blood vessels that go to the penis can become diseased much earlier than the vessels that go to the heart," Maxtane Male Enhancement, a urologist at Johns Hopkins School of Medicine, tells WebMD. "In younger or younger middle-aged men, ED is often the first sign of atherosclerosis."

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