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Causes of erectile dysfunction

Aysha

Medically reviewed on October 10, 2019

by Dr. Aysha Butt, Medical director

Dr. Aysha Butt is the Medical Director of FromMars, and is a GP Partner at Woodcote NHS Medical Practice.... read more

For many men, erectile dysfunction is a very real thing. Problems getting or maintaining an erection can happen to anyone.

So, if it’s happened to you, it doesn’t have to be a big deal. Loads of guys go through it. But if the problem persists, it can interfere with your sex life and your mental health, plus it could also be a symptom of something much more serious.

That means it’s not something you should ignore.

Here we’ll help you understand what might be causing it and what you can do to overcome it.

ED symptoms

First it's important to know the symptoms of erectile dysfunction. They might include:

  • Trouble getting an erection
  • Trouble maintaining an erection during sexual activity
  • Reduced sexual desire

If you experience any of these symptoms regularly, it's likely that you have erectile dysfunction.

What causes erectile dysfunction?

To get and stay hard, you need a good circulatory system, a healthy brain and nerves, the right hormones at the right levels, a good mindset, and a decent lifestyle.

If you have issues with any of these, you can have problems with your erections. There are lots of possible causes of erectile dysfunction, both physical and psychological.

Physical causes of erectile dysfunction

You get an erection when more blood flows into your penis than leaves it, making it swell and fill with blood. Anything that interferes with the flow of blood inside your body can cause ED and is the main cause of erectile dysfunction in men over 40. This includes:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Obesity
  • Smoking
  • Heart problems

Being treated for prostate cancer can also cause erectile dysfunction, particularly if the blood vessels or nerves leading to the penis are damaged.

Erectile dysfunction can also be caused by neurological conditions, essentially physical issues with your brain and the nerves which carry signals around your body. You may want to get hard, but the signals from your brain might not be getting to the right place. Neurological conditions can include:

  • Damage to your spine
  • Brain damage, including strokes
  • Multiple Sclerosis
  • Parkinson’s disease

Getting aroused and sustaining an erection also requires the right levels of certain hormones, such as testosterone. Anything that interferes with your body’s ability to produce hormones can mess with your erections. These include:

  • Hypogonadism (a condition which causes your testes to produce lower levels of sex hormones like testosterone)
  • An overactive or underactive thyroid gland
  • Cushing’s disease (affects your adrenal glands)
  • Declining levels of testosterone as you age (particularly for men over 45)

Also, physical problems with your penis can affect your erections, such as:

  • Peyronie’s disease (the growth of hard tissue inside the penis which can change its shape and interfere with erections)
  • Having a foreskin that is too tight

Psychological causes of erectile dysfunction

Your mindset can have a big impact on your erections. For men under 40, the leading cause of erectile dysfunction is psychological; so take note. This can include:

  • Performance anxiety and doubting your sexual ability is one of the most common causes of ED. You need to be relaxed to get hard, and any worries you have about your ability to satisfy your partner can interfere with your erections.
  • Mental health problems which affect your mood, such as depression are related to erectile dysfunction.
  • Too much stress in areas of your life outside the bedroom, such as work demands and money worries, can distract you and lower your sex drive.
  • Problems in your relationship, outside of sex, can also affect your erections.

Lifestyle causes of erectile dysfunction

How you live your life can also play its part.

Poor diet and not enough exercise can lead to you being overweight and having high blood pressure, which can affect the flow of blood to your penis. Smoking can have the same effect. Quitting smoking and opting for healthy, nutritious foods can get you on the right track for ED recovery. 

Recreational activities can also cause ED. Drinking too much alcohol can have a temporary impact while viewing porn has also been associated with erectile dysfunction.

Drugs, both legal and illegal, can interfere with your circulatory and nervous systems, as well as your hormones, which can have a knock-on effect when it comes to ED. The following drugs have all been associated with erectile dysfunction, but this list isn’t exhaustive. Remember to check the side effects of any medication you’re taking and speak to your doctor if you think it might be causing you problems.

Medications and prescription drugs:

  • Antiandrogens
  • Anticonvulsants
  • Antidepressants
  • Antihistamines
  • Antihypertensives
  • Antipsychotics
  • Beta-blockers
  • Corticosteroids
  • Diuretics
  • Fibrates

Recreational drugs:

  • Marijuana
  • Cocaine
  • Heroin and methadone
  • Steroids

What are the top risk factors for erectile dysfunction?

We've looked at some of the main physical, psychological and lifestyle causes of ED, but what are the top risk factors that can cause erectile dysfunction in men of all ages?

  • Smoking
  • Being overweight or obese
  • Living a sedentary lifestyle
  • Drinking too much alcohol
  • Using illegal drugs
  • Medication side effects
  • Diabetes
  • High cholesterol
  • Stress/anxiety

How can I improve my erectile dysfunction?

First of all, don’t stress. Erectile dysfunction is a common problem and is curable. It’s something that you can handle and beat, often with simple lifestyle changes including:

  • Cutting down on unhealthy food, alcohol, cigarettes, and avoid recreational drugs
  • Making sure you exercise and get enough sleep

Erectile dysfunction treatments such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) are very effective at treating the condition in the short term. However, there are many possible causes of ED; some of them are more serious than others. If you are experiencing erectile dysfunction regularly make sure you speak to your doctor. They will check for underlying medical conditions that could be the source of the problem. They can also advise on whether any medication you’re taking could be an issue too.

If you’re given the all-clear and the problem’s still there, try speaking to a psychologist or a therapist to explore your mental state to see if the cause of your erectile dysfunction is psychological.

Even if you have a physical condition, it can still help to talk to a mental health professional, as there may be multiple causes, both physical and mental. If you think about it too much, ED can become a self-fulfilling prophecy.