What causes ED?

Occasionally, men have trouble getting an erection. It’s typically a temporary problem, but if it happens frequently you may have erectile dysfunction (ED).

An erection starts with physical or emotional stimulation. The brain sends signals throughout your central nervous system, increasing blood flow to the penis. Muscles within the penis relax to allow blood to enter. Pressure from the flow of blood makes your penis firm and erect.

Anything that disrupts blood flow to the penis can cause ED. It’s sometimes a symptom of an underlying illness such as diabetes, high blood pressure, or heart disease. It can also occur following surgery for cancer of the bladder, prostate, or colon.

Other possible causes of ED include:

  • Peyronie’s disease, which involves damage to the nerves near your penis
  • low testosterone
  • a neurological condition
  • drug or alcohol consumption
  • smoking
  • being overweight or obese

Stress, depression, and relationship issues can have something to do with ED. Having ED can bring on or intensify these problems. Sometimes there’s more than one factor involved.

The theory that caffeine can help treat ED may stem from studies on the subject.

One recent study found that men who drank about 170-375 milligrams (mg) of caffeine per day were less likely to report ED than those who didn’t. The researchers noted, however, that they weren’t able to find a connection between caffeine and increased blood flow. The study was also inherently biased. The data came from the National Health and Nutrition Examination Survey. More research is needed to confirm this study’s findings.

Drinking a few cups of coffee per day to treat ED would be an attractive solution for some people, but there isn’t enough evidence to conclude that caffeine is helpful in treating ED.

There are some lifestyle factors that can contribute to ED. You may be able to eliminate the need for medications or other treatments if you make a few changes:

Lose weight

If you’re overweight, examine your dietary habits. Make sure you’re eating plenty of nutrient-rich foods. Avoid foods that offer little nutritional value. Add some exercise into your daily routine. If you’re obese, ask your doctor for guidance on how to lose weight safely.

Limit alcohol consumption

Cut down or stop drinking alcohol to see if that helps. If you smoke, now would be a good time to quit. Get medical help if you have a substance abuse problem.


When stress and anxiety interfere with your quality of life, it may be beneficial to seek counseling.

Treating the cause and making lifestyle changes may be all it takes. If that doesn’t help, there are other options.

Prescription strength oral medications are designed to help muscles in your penis relax, which encourages blood flow. Three of these drugs are sildenafil citrate (Viagra), vardenafil HCI (Levitra), and tadalafil (Cialis). You only need to take them before you plan on having sex.

These drugs can cause mild side effects such as stuffy nose, headache, and muscle aches. Side effects are usually temporary. It’s rare, but some men have more serious side effects. These medications can be dangerous if you take nitrates or have kidney or liver disease.

If those medications don’t work, self-injected drugs or urethral suppositories may help. Another alternative is the vacuum erection device, which helps hold blood flow in the penis. Finally, you may consider surgical options, which include penile implants and blood vessel surgery.

If left untreated, ED can have a detrimental effect on self-esteem and interfere with intimate relationships. For that reason and because ED can be a symptom of a serious health problem, it’s important to see your doctor.

Be sure to explain all your symptoms to your doctor. Make a list of all the dietary supplements, and over-the-counter and prescription medications you take.

Your doctor will probably begin by taking a complete medical history, followed by a physical exam. Depending on the findings, you may be referred to a urologist or other specialist for further diagnostic testing.