Erectile dysfunction is a condition that makes it difficult to get or sustain an erection long enough to have sexual intercourse. It can affect your life in many ways. Erectile dysfunction can cause loss of intimacy with your partner and result in strained relationships. It could also cause issues like low self-esteem, depression, and anxiety.
Some men who suffer from erectile dysfunction might feel embarrassed about seeking help. Yet it’s a common enough condition, with estimates suggesting that around 30 million men in America are affected.1
So what causes erectile dysfunction? A variety of factors, in fact. Let’s take a closer look at them here – after all, finding out what’s causing a problem is a critical step in resolving it.2
Factors That Can Cause Erectile Dysfunction
Usually, when a man gets sexually aroused, his brain sends signals to nerves in the penis which increase blood flow. This causes the penis to expand and become firm. A disruption of this process can be caused by various factors. For instance, factors that interfere with blood circulation or the nervous system, as well as factors that can lower your libido (like depression or hormonal imbalances), can lead to erectile dysfunction. Here are some specifics.3 4
Injuries to the penis, prostate, bladder, spinal cord, or pelvis can cause erectile dysfunction. Injuries in these areas may also result from treatments for prostate or bladder cancer – for instance, surgery or radiation therapy. It is also estimated that erectile dysfunction occurs in around 15 to 25% of people who experience a serious head injury.
2. Vasculogenic Factors
Vasculogenic conditions are those which affect blood flow to the penis. They include:
- Diabetes, which affects both blood flow as well as the nerve endings of your penis.
- High blood pressure.
- Cardiovascular disease. It can entail the hardening and narrowing of your arteries in a condition known as atherosclerosis. Arteries that supply blood to your penis are also affected.
- Chronic kidney disease.
3. Neurogenic Factors
Erections develop as a response to tactile, visual, auditory, and olfactory stimuli. Excitatory signals travel from the brain to nerves which cause muscles in the penis to relax. This leads to increased blood flow and an erection.5 So damage to the nervous system, comprising the spinal cord, nerves, and the brain, can lead to erectile dysfunction. Some conditions that affect your nervous system and can lead to erectile dysfunction include:
- Parkinson’s disease, which develops when you don’t produce enough of a neurotransmitter known as dopamine. It affects your brain’s coordination of the way you move, walk, talk, write etc.
- Multiple sclerosis, where damage to the nervous system results in the slowing down of messages between your brain and body. This causes problems with balance and movement.
- Stroke, which is caused by the interruption of blood supply to the brain, resulting in damage to or the death of brain cells.
4. Hormonal Factors
Your hormones are messengers that play a role in intricate processes of your body, including sexual functioning. Some conditions which cause a hormonal imbalance are associated with erectile dysfunction. They include:
- Hyperthyroidism, a condition where an overactive thyroid gland causes the overproduction of thyroid hormone.
- Hypothyroidism, a condition where an underactive thyroid results in too little thyroid hormone being produced.
- Hypogonadism, a condition where you don’t produce enough of testosterone, the male sex hormone.
- Cushing’s syndrome, a condition where you produce abnormally high levels of a hormone known as cortisol.
5. Peyronie’s Disease
Peyronie’s disease is a condition where scar tissue builds up in the penis, making it curve unnaturally. This can make erections painful and lead to erectile dysfunction.
6. Psychological And Emotional Factors
Psychological and emotional factors too can play a role in erectile dysfunction. In fact, even when erectile dysfunction is triggered by a physical condition, psychological factors can compound the situation and worsen things. Some psychological factors that may cause erectile dysfunction include:
- Depression, a condition which results in a feeling of extreme sadness and hopelessness, can lower your sex drive.
- Anxiety and stress can impact your sex drive and cause problems. In fact, even anxiety about not being able to perform sexually can lead to erectile dysfunction.
- Low self-esteem can sometimes be responsible.
- Feelings of guilt can impact your sex drive and cause problems.
- Relationship problems can impact your sex drive. Issues in your relationship such as lack of trust, poor communication, or unresolved conflicts may lower your libido and lead to erectile dysfunction.
- Unresolved issues related to sexual abuse may cause erectile dysfunction.
7. Lifestyle Factors
Various lifestyle factors may also increase your risk of erectile dysfunction. These include:
- Excessive alcohol consumption can cause erectile dysfunction. Not only is alcohol a depressant, but excessive alcohol consumption is associated with psychological stresses and health issues like heart disease that can impact your sexual life. 6
- Smoking increases your risk of erectile dysfunction considerably.7
- The use of illegal drugs like heroin, cannabis, cocaine etc. can result in erectile dysfunction.
- Excessive cycling, say, for more than 3 hours a week, is associated with erectile dysfunction. While sitting on a bicycle seat, you exert pressure on an area called the perineum through which arteries and nerves to the penis pass. This can damage nerves as well as reduce blood flow to the penis.8
- Being overweight is a factor that contributes to erectile dysfunction.
- Being tired and feeling exhausted can lower your libido and result in erectile dysfunction.
Many medications, including some blood pressure medications, ulcer medications, antidepressants, antihistamines, tranquilizers, and appetite suppressants, can cause erectile dysfunction. Talk to your doctor and find out if any medication you’re taking has this side effect.
What Can You Do About It?
Erectile dysfunction is usually treated by addressing its root cause. For instance, your doctor may advise lifestyle changes such as losing weight as well as prescribe medication to deal with atherosclerosis. Cognitive behavioral therapy or sex therapy may be recommended to address psychological issues. Medications as well as devices that target erectile dysfunction can be helpful too. For instance, a vacuum pump can encourage blood flow to the penis.
Do seek medical attention if you’ve been facing erectile dysfunction – it’s important not only to address the problem but also because it can point to serious underlying health issues like heart disease.9
|↑1||Erectile Dysfunction. Harvard Health Publications.|
|↑2, ↑4||Erectile Dysfunction. National Institutes of Health.|
|↑3||Causes of erectile dysfunction. National Health Service.|
|↑5||The Central Mechanisms of Sexual Function. Boston University.|
|↑6||Arackal, Bijil Simon, and Vivek Benegal. “Prevalence of sexual dysfunction in male subjects with alcohol dependence.” Indian Journal of Psychiatry 49, no. 2 (2007): 109.|
|↑7||Mirone, V., E. Ricci, Vincenzo Gentile, C. Basile Fasolo, F. Parazzini, and The Società Italiana di Andrologia SIA Group. “Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics.” European urology 45, no. 1 (2004): 87-91.|
|↑8||Biking and sex—avoid the vicious cycle. Harvard Health Publications.|
|↑9||Erectile dysfunction (impotence). National Health Service.|