FAQs

What Are the Causes of Erectile Dysfunction?

In 90% of cases involving men older than 35, the causes are physical in nature. In men who are younger than 35, it is generally a psychological issue. However, even in the cases of those patients for whom the psychological issues are the primary factor, medical means may be used to help solve the problem.

There are four main causes of erectile dysfunction:

• Vascular: A man must be able to move blood into the penis and maintain it there in order to achieve an erection. Arteries are the vehicles which bring the blood into the penis. Any process which damages the arteries and increases the chances of vascular disease would make a man more likely to have erectile dysfunction. A history of arterial disease (e.g. coronary artery, heart disease, strokes, or peripheral vascular disease) indicates that the penile arteries are also at risk. In fact, erectile dysfunction may often appear before any of these more severe manifestations of vessel disease. Thus, smoking is one of the most common contributing causes to erectile dysfunction. Other causes include high blood pressure (especially if it uncontrolled), heart disease, high cholesterol, and diabetes.
• Neurological: A man must have an intact neurological system in order for an erection to occur. Thus patients with multiple sclerosis or those who have had damage to their peripheral nerves from diabetes may also suffer from erectile dysfunction.
• Hormonal: Significantly, low testosterone and thyroid hormones or a very high prolactin may cause problems with erections.
• Psychological: This can be a primary (or initial) problem or a secondary problem. In some cases, men may not achieve an erection primarily because of psychological issues. Additionally however, many men have a significant psychological response (or secondary reaction) to what is initially a primary physical problem. Once a man loses confidence in his erections, his attitude and interest level may change and diminish. At that point he may develop increasing difficulty achieving and maintaining an erection.