Most experts now agree that up to 80 percent of all ED cases may be due to physical conditions1. However, there are both physical and psychological reasons. Below are some of the risk factors or causes of ED1.
Risk factors and causes of ED
Physical causes
Vascular Disease: Arteriosclerosis (hardening of the arteries caused by high cholesterol or high blood pressure), heart disease, stroke, and hypertension (high blood pressure) all affect blood flow in and out of the penis. Vascular disease is the most common physical cause of ED1.
Diabetes: This chronic condition can cause nerve damage (neuropathy) and damage to the blood vessels that supply the penis. About 50% of men with diabetes can develop ED2.
Nerve diseases: Neurological conditions include spinal cord injury, multiple sclerosis, and nerve damage due to diabetes or alcoholism2.
Hormonal problems: Low levels of the male hormone testosterone can result in ED1.
Surgery: Surgery for colon, rectal or prostate disease and even radiation therapy in the pelvic area can damage nerves and blood vessels, which may result in ED1.
Trauma:
Spinal cord injuries2
Pelvic fractures1
Chronic medical conditions: If you have a chronic medical condition, ask your doctor or men's sexual health professional whether it might be affecting your sexual health.
Side effects of medications: There is a long list of prescription medications and over-the-counter medications that have the potential side effect of ED. If you observe problems with your erection after starting a new medication, ask your doctor or men's sexual health professional about possible side effects of the medication and possible alternatives and solutions. Do not stop or change the dosage of any medication without advice from your doctor.
Lifestyle factors
Alcohol: Heavy drinking may immediately reduce your ability to have a strong erection. Long-term, excessive drinking can cause nerve and liver damage.2
Sedentary lifestyle: Lack of exercise can lead to ED.3
Smoking: Men who smoke have a greater chance of developing ED than men who don't smoke.3
Psychological causes
These can occur alone or in combination with one or more of the physical causes of ED2.
Performance anxiety: When a man is anxious about his sexual performance, his erectile function can be affected.2
Stress: Stress can affect sexual performance.2
Depression: Men with ED can have some degree of depression and men with depression can also have ED2.
Relationship problems: Tensions with your sexual partner, whether related to sexual issues or other issues2.
1. Miller TA. Diagnostic evaluation of Erectile Dysfunction. American Family Physician, viewed 1 Jan 2000, http://www.aafp.org/afp/20000101/95.html
2. Lue TF. Erectile Dysfunction. N Engl J Med 2000;342:1802-1813.
3. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence JAMA. 1993;270(1):83-90.
