Erectile Dysfunction Causes

Written by the Healthline Editorial Team | Published on July 30, 2014
Medically Reviewed by Kenneth R. Hirsch, MD on July 30, 2014

Causes of Erectile Dysfunction

Erectile dysfunction (ED) occurs when a man is unable to get or sustain an erection firm enough for sexual intercourse.

Intermittent ED is common. Many men experience occasional ED. It is generally caused by stress, exhaustion, or similar causes. Occasional ED should not be a cause of concern.

However, men who experience frequent ED should talk to their doctors. Frequent ED may be a sign of damage to the cardiovascular or nervous systems. This damage may need treatment.

Frequent ED may also be a sign of serious emotional or relationship difficulties. These can often benefit from professional treatment.

Lifestyle Factors Associated With Erectile Dysfunction

There are a number of lifestyle factors that can cause or contribute to ED. In general, any behavior that can damage cardiovascular or nervous system health can also increase ED risk. Some risk factors include:

  • smoking
  • alcohol use
  • cocaine use
  • being overweight or obese
  • failing to control your diabetes
  • lack of exercise

In addition, any activities that cause physical damage to the nerves or blood vessels around the base of the penis can also increase ED risk. For example, prolonged bicycling is associated with ED. However, this type of ED is usually temporary.

Medical Factors Associated With Erectile Dysfunction

Medical conditions can cause ED in several different ways.

Some of the most common medical causes of ED are diseases or injuries to the cardiovascular system. These can reduce blood flow to the penis. Some cardiovascular conditions related to ED include:

  • high blood pressure
  • diabetes
  • atherosclerosis

Nervous system problems can affect how signals travel to the blood vessels of the penis. This can then affect blood flow and make it difficult to achieve an erection. Some nervous system conditions associated with ED include:

  • spinal cord injury
  • Parkinson’s disease
  • multiple sclerosis

Hormonal and other systemic problems can also affect a man’s ability to get and sustain an erection. So can certain types of surgery. Other medical factors associated with ED include:

  • prostate cancer
  • end-stage kidney disease
  • radiation therapy
  • surgery on the prostate, bladder, or other organs near the penis
  • injury to the penis, testicles, or surrounding area

Finally, many medications can increase the risk of ED. Medications known to be associated with ED include:

  • blood pressure drugs
  • antihistamines
  • antidepressants
  • tranquilizers
  • appetite suppressants
  • cimetidine (an ulcer drug)

Other Causes of Erectile Dysfunction

Mental health can affect your risk of ED. Psychological factors linked to ED include:

  • depression
  • anxiety
  • stress

Incorrect expectations about sex can also cause ED. For example, as men get older they often need more direct stimulation of their penis to get an erection. A man may think he has ED if he does not get an erection just by thinking about sex. However, he may just need to adjust his behaviors to get the stimulation he needs.

Experiencing ED can sometimes contribute to ED. Anxiety about a previous episode of ED can make it more difficult for a man to get an erection the next time he has sex. This can then reinforce fears about ED and establish it as a pattern.

Finally, relationship factors can cause ED. Loss of interest in a partner can make it more difficult to get an erection. When sex becomes a chore, it can also cause ED.

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