 Hello, I am Dr. Varshan. I am a Euro-andrologist practicing at Manipal Hospital's Bangalore. We are supposed to be the diabetic and hypertensive capital of the world. We have a huge diabetic population and we are poised to be one of the hypertensives or BP capital of the world. Consequently, what does diabetes do? Diabetes affects the microvascular supply Penal artery is the smallest artery in the body, even smaller than the cardiac or coronary artery. So, also, diabetics are prone for dyslipidemia. What is dyslipidemia? It is excessive cholesterol at triglyceride, which happens in the body, which quotes the blood vessels and narrows it. So, consequent to that, any further narrowing of the smallest artery, even by 10%, causes erectile dysfunction. So, the primary reason for erectile dysfunction is diabetes, hypertension. How does hypertension cause erectile dysfunction? Vesels become stiff. What happens in an erection? The blood flow, the vessel relaxes. Consequently, it is like a balloon. More air comes into the balloon. Similarly, more blood comes into the system. Penis becomes thicker. Penis becomes longer. That mechanism goes away. So, the primary reason for an erectile dysfunction is what we call arteriogenic erectile dysfunction, which is loss of elasticity of the blood vessels because of hypertension or any other disease like renal failures or because of diabetes because of narrowing of blood flow. So, these are the two primary reasons for erectile dysfunction. Earlier erectile dysfunctions will need to be a major, mainly psychogenic or psychological. Now, we believe 70% of the problems are because of arteriogenic or stiffness of the blood flow. It is no longer psychological, though we do have psychological problems causing erectile dysfunction.