MetS is a combination of maladies that can cause ED. The five hallmarks of MetS are: hypertension, elevated fasting glucose levels, elevated triglycerides, central obesity, and reduced high-density lipoprotein levels of cholesterol. MetS cause inflammation and hormonal imbalances that can lead to ED. Treatment for MetS can include lifestyle changes, testosterone replacement, pharmaceuticals, and bariatric surgery – such as gastric bypass.