Erectile dysfunction, or ED, is defined as the “inability to get and keep an erection firm enough for sex.” According to the Mayo Clinic, over 50% of men over the age of 40 experience symptoms of ED. Just hearing the words “erectile dysfunction” may provoke anxiety, but having occasional trouble getting an erection shouldn’t be cause for alarm. However, if problems persist, it may be time to reach out for help.
One of the first steps in treating ED is understanding its causes. In this blog, we outline seven of the most common causes of ED. Your doctor can help you determine if any of these issues are contributing to your ED symptoms and recommend the most appropriate treatment plan for you.
1) Heart and Vascular Diseases
ED occurs when a man’s genitals do not receive enough blood flow to help maintain an erection. Because the heart pumps blood throughout your body, any condition that affects your heart could potentially cause ED. Coronary artery disease, or clogged arteries in the heart, is one of the most common heart-related issues that can be related to ED.
Similarly, vascular conditions that affect the blood vessels in other parts of the body can result in ED. For example, atherosclerosis blocks blood vessels, which can reduce blood flow to the genitals. Hypertension, congestive heart failure, and peripheral artery disease are other conditions that can limit blood flow throughout the body.
2) Metabolic Issues
Obesity, or being overweight, can cause ED by decreasing testosterone levels, causing damage to blood vessels, and increasing inflammation. Obesity is associated with an increased risk of hypertension, cardiovascular disease, high cholesterol and diabetes, all of which are common causes of ED.
High body fat, particularly around the waist, can result in decreased testosterone levels, which can affect sex drive and cause difficulty achieving an erection. Fortunately, weight loss with healthy diet and exercise can significantly decrease the risk for ED, as well as the other chronic health conditions that are brought on by obesity.
3) Neurological Conditions
Your nervous system and brain are both vital to getting and maintaining an erection. Nerve disorders, prostate surgery, or repeated pressure can cause damage to the nerves around the genitals. The nerves must be able to respond to stimuli for a man to achieve/maintain an erection.
Likewise, neurological disorders can affect the brain’s ability to communicate with the nerves that are responsible for sexual function. Without the proper triggers being received from the brain, the penis will not respond. Common neurological disorders that can result in ED include Alzheimer’s, Parkinson’s, multiple sclerosis, stroke, and spinal cord injuries.
4) Drug, Tobacco, and Alcohol Abuse
Alcohol is known to cause ED, both temporarily and long-term. Alcohol is a depressant, so in the short term, drinking alcohol decreases blood flow to the genitals, which means that it takes longer and is more difficult to get and maintain an erection. Long term alcohol abuse carries a very high risk of ED.
The negative effects of smoking are well known. Smoking restricts blood flow to arteries and veins, and greatly increases the risk for hypertension and cardiovascular disease, which lead to ED.
Other illicit drugs, such as cocaine, marijuana, and amphetamines, can negatively affect sexual performance as well. These substances can damage blood vessels, which reduces blood flow to the penis. Like alcohol, they can also alter mood and dampen sexual drive.
5) Anxiety or Depression
Not all causes of ED are simply physical. In fact, psychological factors result in 10-20% of all cases of ED. Depression and anxiety can contribute to ED, along with some of the medications used to treat them. Performance anxiety can develop once a man experiences ED, creating a vicious cycle due to fear of not being able to perform sexually. Stress can also have a significant effect on sexual function. Therapy can be helpful for men who are experiencing ED due to psychological issues.
6) Prescription Medications
Men who are confused as to why they’re experiencing ED should take a look in their medicine cabinet. Numerous prescription medications have been linked to ED and its symptoms – including certain blood pressure drugs, pain medications, and antidepressants. If you are concerned that your medications may be causing ED symptoms, make an appointment with your doctor. Never stop taking any medications without talking to your doctor first!
The endocrine system is a collection of glands that produce hormones to regulate metabolism, growth, development, sexual function, and reproduction. Any disorder affecting the endocrine system can result in ED.
The most common and well-known endocrine disorder is diabetes, affecting the body's ability to create insulin, which regulates blood sugar levels. Chronically elevated blood sugar levels can lead to nerve damage and increase the risk of cardiovascular disease, which reduce the ability to get an erection.
Whether you are experiencing symptoms of ED now, or are worried about developing problems in the future, understanding these common causes of erectile dysfunction may help identify your risk. Identifying and treating underlying causes can help decrease your risk and increase your overall health. Your doctor can help pinpoint the problem and recommend the most appropriate treatment for you.