How would a person know if their ED is from poor blood flow or from making less nitric oxide? How can a person tell if they have endothelial damage?

Anne Truong MDMen's Sexual Health Doctor

ED Explained The Hidden Damage Behind Losing an Erection

19 Oct 2026 · 1 min

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0:53

In this segment of her YouTube explainer, Dr. Anne Truong addresses a viewer’s question about how to differentiate erectile dysfunction (ED) caused by poor blood flow from that caused by reduced nitric oxide production, and how to recognize endothelial damage. She explains that the most common presentation of ED—being able to achieve an erection but losing it during penetration—reflects endothelial leakage. The endothelium, a thin lining inside blood vessels, can develop holes (damage) that allow blood or toxins to seep through, impairing proper erection physiology. Dr. Truong emphasizes that ED itself is a sign of existing endothelial damage rather than a separate condition.

Questions this video answers

Dr. Truong explains that the most common ED presentation—being able to get an erection but losing it during penetration—reflects endothelial leakage. The endothelium is a thin film inside blood vessels; damage creates holes that allow blood or toxins to seep through, indicating that ED itself signals existing endothelial damage rather than a separate cause.

Chapters

How would a person know if their ED is from poor blood flow or from making less nitric oxide? How can a person tell if they have endothelial damage? That's a good question, King Garnet, because when you have ED already, and ED usually presents as you can get an erection, but it's hard for you to maintain it, or you lose it during the act, or you lose it penetration, the most common presentation of ED, and that's endothelial leakage. Okay, so endothelial damage, the blood vessel, which is think of it like a pipe, And inside the blood vessel, it is a thin film that's called the endothelium. And endothelial damage means that that film has holes in it and blood kind of like seeps through or toxins seep through. So when you already have ED, you already have endothelial damage. So ED, you already have endothelial damage. So it's not a separate thing.