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The first approach is to treat the underlying cause if one is identified. With an inflatable implant , fluid filled cylinders are placed lengthwise in the penis. Smoking is an independent risk factor for ED, because it causes vascular changes to the endothelium of blood vessels which interfere with nitric oxide production and signaling. In its tenth funding round, the Global Fund established a special reserve allocation for programmes for most at risk populations, including men who have sex with men. As many as 30 million American men have ED, and benign prostatic hyperplasia is the most common prostate problem for men older than age 50.

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