Other factors that “stress” the body can also increase your risk for ED. These include: substance abuse, using marijuana, smoking cigarettes, depression, anxiety and low self esteem. Cigarette smoking — or using nicotine — leads to constricted blood vessels, which has negative effects for sexual health. Other mental/emotional obstacles can cause less desire for sex and decrease testosterone. Several ways to help manage stress include:

Enlargement of the prostate gland, another condition that occurs with increasing frequency in men as they age, can also cause ED. In a 2012 Swiss study, 82 men with moderate to severe symptoms of prostate enlargement, who were also experiencing problems such as ED or loss of libido, took 320 mg of saw palmetto extract daily for 8 weeks. At the end of the study, the men’s ‘International Prostate Symptom Score’ (IPSS), a method of measuring prostate health based on a questionnaire, was reduced by an average of 51 percent. In addition, their ED, libido, and other sexual functions had also improved by an average of over 40 percent. Unlike the drug approaches used in conventional medicine, which can even cause ED as a side effect, saw palmetto is very effective in treating prostate problems and is free from side effects.
These underrated kernels are rich in zinc, and people with higher levels in their system have been shown to have a stronger drive than those with lower levels. They’re also a good source of magnesium, which boosts testosterone and keeps sperm healthy and viable. Pine nuts are the primary ingredient in pesto, so go Italian on your next date night, or sprinkle them on a salad with avocado, tomatoes and salmon.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
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