Erectile dysfunction can be caused by a combination of psychological and physical issues. Physical causes include heart disease, high cholesterol and high blood pressure while psychological causes include depression, stress, anxiety, and other mental health issues. ED can be diagnosed with a physical examination, a mental health examination and sexual and medical history. The first warning signs and symptoms may include difficulty attaining and maintaining an erection, lack of sexual desire, Early morning erections. You can consult with our ED doctor online for more help.