Along with worry and sadness, stress was a significant predictor of ED. According to the research, long-term stress may reduce testosterone levels or lead to sleep disorders, both of which may exacerbate ED. However, other studies suggest that it is still unclear how stress affects ED. In 2020, research discovered no link between stress and ED.
Another activity that probably contributes to ED is smoking. Smoking may harm blood vessels and prevent enough blood from getting to the penis to produce an erection, which may contribute to this. Smoking may also decrease the body's capacity to produce nitric oxide, which is necessary for the involuntary relaxing of muscles and an increase in blood flow that contribute to erections.