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What Causes Erectile Dysfunction (ED)?

ED can result from health problems, emotional issues, or from both. Some known risk factors are:

  • Being over age 50 
  • Having high blood sugar (Diabetes)
  • Having high blood pressure 
  • Having cardiovascular disease
  • Having high cholesterol
  • Smoking
  • Using drugs or drinking too much alcohol
  • Being obese
  • Lacking exercise

Even though ED becomes more common as men age, growing old is not always going to cause ED. Some men stay sexually functional into their 80s. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.

Physical Causes of ED

ED happens when:

  • There is not enough blood flows into the penis
    Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (Diabetes) and smoking.
  • The penis cannot trap blood during an erection
    If blood does not stay in the penis, a man cannot keep an erection. This issue can happen at any age.
  • Nerve signals from the brain or spinal cord do not reach the penis
    Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis.
  • Diabetes can cause small vessel disease or nerve damage to the penis
  • Cancer treatments near the pelvis can affect the penis' functionality
    Surgery and or radiation for cancers in the lower abdomen or pelvis can cause ED. Treating prostate, colon-rectal or bladder cancer often leaves men with ED. Cancer survivors should see a Urologist for sexual health concerns.
  • Drugs used to treat other health problems can negatively impact erections
    Patients should talk about drug side effects with their primary care doctors.

Emotional Causes of ED

Normal sex needs the mind and body working together. Emotional or relationship problems can cause or worsen ED.

Some emotional issues that can cause ED are:

  • Depression
  • Anxiety
  • Relationship conflicts
  • Stress at home or work
  • Stress from social, cultural or religious conflicts
  • Worry about sex performance 

Updated June 2018