What was your first step in addressing erectile dysfunction in midlife?

[Frank.M]

I've been experiencing issues with erectile dysfunction for several months now, and it's starting to affect my confidence and relationship. I'm in my late forties and otherwise healthy, so I'm hesitant to immediately jump to medication without understanding the potential underlying causes. For others who have addressed this, what was your first step in seeking help? Did you start with your primary care physician or go directly to a urologist, and what diagnostic tests or questions helped identify whether it was more likely physiological or psychological? I'm also curious about experiences with lifestyle changes, therapy, or other approaches before considering prescription options.