Vascular aging-driven erectile dysfunction: pathophysiological mechanisms and emerging therapies—a narrative review

Age-related ED is a manifestation of systemic vascular pathology. A deeper understanding of its mechanisms underscores its role as an "early warning signal" for overall vascular health. While current treatments like PDE5i and testosterone offer symptomatic relief, they have limitations. Promising future directions lie in novel targeted therapies, such as enhancing eNOS function, stem-cell therapy, and nanotechnology, which are currently in the experimental stage and require further clinical validation.