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Causes of Erectile Dysfunction

Tuesday 19 May 2020
Erectile Dysfunction

Table of Contents


I. Physical Causes

a. High Blood Pressure

b. Heart Conditions

c. Diabetes

d. Other Conditions

II. Psychological Causes

a. Mental Health 

b. Stress

c. Relationship Troubles

III. Risk Factors

a. Obesity

b. Alcohol and Smoking

c. Medication Side Effects


Erectile dysfunction (ED or impotence) is a common condition that prevents males from getting and maintaining an erection. Failing to get an erection occasionally is not unusual and typically does not require treatment, especially if it occurs less than 20 percent of the time. [1] However if it is more frequent than this, doctors may prescribe medication such as Viagra, Cialis or Levitra.

Many men believe that erectile dysfunction is a natural part of getting older. However, ED can affect men of any age and can be caused by several different things. Causes of erectile dysfunction can be physical, psychological or caused by an external risk factor. Erectile dysfunction may be caused by one or multiple factors.

Keep reading to learn about the most common causes of erectile dysfunction. 

Physical Causes

Erectile dysfunction can affect men of any age, although it is more common in older men, and this is often because of physical conditions that cause or worsen ED. 90 percent of persistent erectile dysfunction in men over 50 is a result of a physical cause. [2] Many parts of the body contribute to causing an erection, including the brain, muscles, nerves, blood circulation and hormones. A problem in any of these areas may cause or worsen ED. [3]

a. High Blood Pressure

A common cause of erectile dysfunction is high blood pressure (hypertension). High blood pressure can damage the arteries or cause them to burst. If the arteries to the penis are damaged, they may not open sufficiently to let blood flow in to make the penis firmer. [4] 

Additionally, a side effect of some blood pressure medications may be sexual dysfunction. These medications include diuretics (water pills) and beta-blocker medications.

b. Heart Conditions

Heart conditions and erectile dysfunction are often linked. Researchers believe this is a result of a problem in the lining of blood vessels and muscles. These problems can cause insufficient blood supply to the heart and penis. Occasionally, erectile dysfunction may be an early warning sign of heart problems. Erectile dysfunction testing will often include heart exams. [5]

Plastic model of a human heart

c. Diabetes

Another physical cause of erectile dysfunction can be diabetes. Both type 1 and type 2 diabetes may cause or worsen erectile dysfunction, especially when diabetic men have high blood sugar levels. This can be a result of damage to the nerves or blood vessels caused by blood sugar. Controlling blood sugar can be a key way for diabetic men to improve their sexual dysfunction. [6] 

d. Other Conditions

Although high blood pressure, heart conditions and diabetes are all common causes of erectile dysfunction, many other conditions can cause or worsen ED. These can include kidney disease, multiple sclerosis and Peyronie’s disease, amongst others. ED may also be caused by injuries to the prostate, pelvis, bladder, spinal cord or penis. [7]

Psychological Causes

a. Mental Health 

The brain plays a huge part in achieving an erection. Erectile dysfunction can be affected by mental health conditions, including anxiety and depression. In younger males, erectile dysfunction is more likely to be the cause of erectile dysfunction. Around 90 percent of teenagers and young male adults may be affected by psychological erectile dysfunction, although this is usually short-term. [8]

Anxiety, depression and other mental health conditions can affect ED by making it difficult for the brain to create nerve connections or release the appropriate hormones to cause or maintain an erection.

Black and white photo of a man sitting on a wall looking downwards

b. Stress

Stress can also be a psychological cause of erectile dysfunction and is the main cause of erectile dysfunction in middle-aged men. [9] Unfortunately, stress can also cause a vicious cycle of ED, as erectile dysfunction in itself can cause more stress.

When stress is the cause of erectile dysfunction, it can be related to life events including illness or loss of a loved one, financial burdens or job problems. [9]

c. Relationship Troubles

Existing problems in a relationship may also cause or worsen erectile dysfunction. These relationship problems can be a combination of other psychological causes such as depression or stress. This can put additional strain on a relationship. However, when a man’s sexual partner is involved in therapy as a treatment, erectile dysfunction is resolved 50 – 70 percent of the time, which is much higher than when a man completes therapy treatment alone. [8]

Risk Factors

As well as physical and psychological causes, there are other risk factors that may cause or worsen erectile dysfunction. Most of these causes are the result of an external or lifestyle factor and are typically reversible.

a. Obesity

You might be surprised to learn that obesity is more likely to lead to erectile dysfunction than aging. [10] Approximately 80 percent of men that are overweight or obese have erectile problems. As weight and BMI (body mass index) increases, so does the risk of erectile dysfunction. Obesity can often be a cause of heart disease, high blood pressure or diabetes and these physical conditions can directly cause erectile dysfunction. 

Erectile dysfunction that is caused by obesity is usually reversible and weight loss can improve erection quality. A doctor or dietician can help to plan a treatment program that includes diet and exercise to help with weight loss. 

A tape measure lying on top of a set of scales

b. Alcohol and Smoking

Alcohol can cause or worsen erectile dysfunction, especially frequent or excessive drinking. This is because alcohol can decrease blood volume and damage the nervous system. Blood circulation and the nervous system are both important parts in the process of achieving an erection. 

Smoking is also a risk factor and is often a cause of ED in younger men. As well as causing health problems that can cause ED, tobacco also restricts the blood flow around the body and to the penis. Smoking may also cause chronic health conditions such as heart disease or high blood pressure that can worsen ED.  Quitting smoking may improve erectile problems. [11]

c. Medication Side Effects

Some medications may also cause or worsen ED as a side effect. This can be caused by both prescription and over-the-counter medications.  Medications may be the cause of sudden erectile dysfunction if they have recently been changed. Erectile dysfunction as a side effect is more common in some types of medications than others including prostate medications, blood pressure medications and antidepressants. 

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.