This is an excellent question and let me offer my humble opinion. I would say it does not cause it but the needed use of it may indicate underlying problems such as heart disease. And, in fact it may indicate other blood problems such as MGUS, SMM or even MM. In 1998 I went to my doctor and she said your BP and cholesterol is sky high. That interfered with other functions and I was then put on the blue pill. I distinctly remember over the years my blood numbers were not all in the acceptable range but were so close no one took issue. My feeling is if something is off kilter even just a little further research and investigation is warranted and insurance should pay for it!

The reason I think you brought up a good point here is how many men of the 170,000 of us need viagra? Can ED indicate MM? Let’s go researchers!