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With this in mind, no other investigations are generally required for patients with ED, although specialized testing may be helpful in selected individuals. Hypoxia from decreased corpora cavernosal oxygenation can cause a decrease in prostaglandin E1 levels, which normally inhibit pro fibrotic cytokines, such as transforming growth factor 1 TGF 1 43. Making lifestyle improvements may help improve symptoms or prevent the erectile dysfunction from getting worse. You can also drink a glass of lemon juice with less sugar after waking up in the morning. In circumcised men, the glans of the penis is left exposed.