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

Intermittent or occasional ED is common and many men experience it. It’s generally caused by stress or exhaustion. Occasional ED shouldn’t be a cause of concern.

However, men who experience ED frequently should talk to their doctors. Frequent ED may be a symptom of damage to the cardiovascular or nervous systems and this damage may need treatment.

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

There are several lifestyle factors that can cause or contribute to ED. In general, any behavior that can damage cardiovascular or nervous system health can also increase the risk of ED. 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 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. Other cardiovascular conditions related to ED include:

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:

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

Finally, medications can increase the risk of ED, including:

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

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 doesn’t 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.

Occasional erectile dysfunction can be common in men, but frequent ED can be cause for concern. Many things can contribute to it, both physical and psychological issues, as can lifestyles and certain medications and medical conditions. If you experience frequent ED, see your doctor.