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Erectile Dysfunction Causes

Causes of erectile dysfunction can be placed into two categories; physical causes such as surgery or underlining conditions or psychological causes such as mental health and past trauma. Physical causes are more likely, especially with the older generation whilst younger men tend to develop performance anxiety.

What is erectile dysfunction?

Erectile dysfunction - also referred to as impotence, ED or sexual dysfunction, although the latter is considered too vague - is classed as the inability to attain or maintain an erection long enough for sufficient intercourse. This must happen the majority of the time to be considered as erectile dysfunction.

This condition affects millions of men across the world, with both psychological and physiological causes contributing to the condition. Whilst young men tend to find psychological reasons to blame, in older men, it's often linked to the physical side linked to the aging process.

Erectile dysfunction can be treated with lifestyle changes and prescription medications such as Viagra, Cialis, and Levitra. You can find out more about the cause of impotence here, or begin your free consultation to be recommended a particular ED treatment. Once approved, you can get medication delivered discreetly straight to your door.

What causes erectile dysfunction?

The causes of erectile dysfunction can be split into two categories; physical and psychological. Physical causes range from surgical procedures to long-term conditions such as high blood pressure, whilst psychological can be past relationships, self-esteem or past trauma. It is not always one clear cause linked to erectile dysfunction, but a mixture or it can take time to discover the specific root cause of the condition.

Ageing is the top cause of impotence, and this is why the condition tends to affect older men, however, a growing number of younger men are experiencing erectile dysfunction and this is linked to psychological effects instead.

These are classed as the main causes of erectile dysfunction, however, there are many additional causes within these that we explored below:

Causes of Erectile Dysfunction

Physical causes of erectile dysfunction

The physical causes of impotence are more common than the mental causes, especially for older men; the demographic most at risk of developing this condition. It is also stereotypically easier to treat physical causes over mental factors, however, it's important to note that psychological issues can also develop from physical causes as well. For example, beginning to feel anxious when you can achieve an erection due to a condition such as diabetes.

WebMD has categorised physical causes of impotence into four sections:

Categories of Physical Impotence Causes
Vasculogenic Hormonal Anatomical Neurogenic
Conditions that affect blood flow such as high blood pressure Low testosterone levels or hyperthyroidism for example Conditions that directly affect the penis Any condition affecting nerves, the brain or the spinal cord

Other causes revolved around the link with arteries, veins and nerves. Below is a comprehensive list of physical ailments associated with erectile dysfunction:

Complete List of Physical Causes
Medications and medicines Herbal remedies and over-the-counter treatments Peripheral disease
Surgery procedures Hospital treatments (e.g. chemotherapy and radiation therapy) Diabetes
High blood pressure High cholesterol Heart/cardiovascular disease
Prostate cancer Low testosterone levels Other hormone imbalance (prolactin or thyroid – hyperthyroidism, hypothyroidism and hypogonadism)
Scleroderma (stiffening/hardening of the skin) Kidney failure/disease Liver cirrhosis
Hemachromatosis (too much iron in the blood) Chronic obstructive pulmonary disease (COPD) Epilepsy
Stroke Multiple sclerosis Alzheimer disease / Dementia
Parkinson's disease Trauma to the pelvic, spinal cord or penis Metabolic syndrome
Brain tumours Spinal tumours Temporal lobe epilepsy
Cerebrovascular disease Cushing's disease Hyperprolactinaemia
Peyronie's disease Head injuries Penis abnormalities

Whilst you'll need to adapt your current lifestyle (diet, exercise, etc) to minimise the effects of certain conditions associated with erectile dysfunction, you may need additional medication regardless of the changes you make.

Cardiovascular disease and erectile dysfunction

High Blood Pressure Stats

Out of all the physical causes of erectile dysfunction, approximately half of men will find that cardiovascular disease is the cause of their condition as damage to the arteries and veins directly affects the blood flow around the body. This includes the following conditions/causes:

Cardiovasular Causes
Sickle cell anaemia (and therefore priapism) Atherosclerosis (hardening/fatty deposits in the arteries) Pelvic fractures
Long-distance cycling Heart attacks Peripheral vascular disease (blood circulation issues)
High blood pressure Smoking (causes poor blood circulation) Leukaemia
Diabetes mellitus Radiation therapy Traumatic arterial injury

What is the most common physical causes of erectile dysfunction?

With so many physical causes of erectile dysfunction, it can seem like an uphill battle to discover the causes for you if you are in any way unclear. However, the majoirty of impotence cases will be caused by the same factors, or it will be obvious what is causing impotence for you.

Physical causes of impotence

Medications that cause erectile dysfunction

Classed as a physical cause of erectile dysfunction, there are a number of medications linked to erectile dysfunction. For some, the choice not to take a particular medicine for a condition is not an option. In this case, speaking to your doctor about what options you have for combating ED is advised. There are certain ED medications that are highly tolerable for example.

  • Antidepressants (alprazolam, diazepam, codeine)
  • Antipsychotics
  • Antiulcer (cimetidine)
  • Hypertension medications (diuretics and beta-blockers)
  • Prostate cancer medications (goserelin, leuprolide, finasteride and dutasteride)
  • Other chemotherapy medications
  • Statins (atorvastatin)
  • Alpha-adrenergic blockers (tamsulosin)
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Synthetic hormones (leuprolide)

Recreational drugs and excessive alcohol consumption can also cause erectile dysfunction through nerve damage, lowering libido and altering hormone levels.

Surgery and injuries that causes erectile dysfunction

Surgery associated with the penis, pelvic, brain, and spinal cord all pose a risk when it comes to developing impotence. These procedures include:

  • Radical prostatectomy
  • Proctocolectomy
  • Abdominal perineal resection
  • Low anterior resection
  • Aortoiliac or aortofemoral bypass
  • Radiation therapy for certain cancers*
  • Brachytherapy
  • Cryosurgery of the prostate
  • Cystectomy (removal of the bladder)
  • Prostate gland surgery

*Cancers include prostate, bladder, colon and rectal.

There have been reports linking cycling with erectile dysfunction. Whilst this is connected to men to cycle frequently, and over long periods of time, you can invest in special seating and clothing that may reduce the chances of experiencing ED. Once you reduce the amount you cycle or take additional precautions, ED is temporary.

Other injuries that may cause impotence are pelvic trauma/fracture and Peyronie's disease.

Peyronie's disease can cause repetitive penis trauma resulting in the penis curving in a certain direction. This causes erections to be more painful and difficult to achieve. Treating Peyronie's disease can also eliminate erectile dysfunction.

Psychological causes of erectile dysfunction

Mental causes of erectile dysfunction can be linked to physical causes as one cause can influence or prompt another to materialise, and these include some of the following:

Complete List of Psychological Causes
Anxiety Depression Stress
Self-esteem Past trauma Past relationships
Sexual abuse Sexual abuse during childhood Low sex drive / Lack of interest
Issues in your current relationship Unresolved sexual orientation Addiction to porn

Psychological ED causes are often linked to 'performance anxiety' with a number of emotions running through the mind of the men affected. It can result in a pattern of anxiety and stress, which ultimately leads to the physical causes and vice versa. Breaking this cycle can mean significant progress in combatting the condition.

Lifestyle factors that cause erectile dysfunction

The link between getting an erection and your mind frame is strong, as you can tell with a number of medications from the list above being associated with mental health (antidepressants for example). This means that psychological factors and how you live your life can have a direct effect.

Performance anxiety is a significant cause of erectile dysfunction and this could be linked to porn-induced erectile dysfunction and over-masturbation. Other lifestyle choices include:

Alcohol can cause temporary erectile dysfunction. You can be diagnosed with the condition if it is continually and/or permanently affecting your erections. Having a clear idea about the units in various alcoholic drinks is a good starting point for reducing your alcohol intake:

Alcohol consumption guideline for men 2016

Common causes of erectile dysfunction in older men

Impotence Age Statistics

Erectile dysfunction is often associated with age as conditions such as diabetes and high blood pressure typically affect individuals in later life. Any condition associated with limiting blood flow around the body can be the cause of impotence. In addition, medications associated with conditions that tend to be linked with later life can cause ED. This includes cancer medications or mental health issues such as depression.

Lifestyle habits that you've adopted throughout your life may begin to catch up with you and cause health problems later in life. This includes excessive alcohol consumption, smoking, and drug use. Whilst reducing or stopping these bad habits may limit symptoms of impotence, sometimes the damage has already been done.

Common causes of erectile dysfunction in younger men

Whilst physical conditions that have developed over a period of time cause impotence, especially in older generations, there has been an increasing number of young men experiencing the condition.

This can be down to physical conditions such as poor lifestyle choices as well, but many cases have been linked to psychological causes.

The difficulty with mental causes of any condition is that there is no quick fix. Whilst you can take medications such as Viagra, without addressing these causes directly, these thoughts may remain throughout life unless you seek other treatment options. This includes altering factors in your life to de-stress and relieve pressure or arranging counselling.

Another difficulty is that psychological causes can be a vicious circle. If you know you become anxious about sex, you begin to feel more nervous. Breaking this cycle is key to helping combat the condition.

Cause Overview Possible Treatment
Anxiety and stress The most common cause of impotence in men under 40 is anxiety or performance-related stress. This is usually because of insecurities regarding their sexual ability and failing to perform. As the process of gaining an erection is entirely controlled by enzymes released by the brain, as are emotions and feelings, if enough anxiety or stress is experienced, it may well cause erectile dysfunction in young men.
  • Counselling
  • PDE-5 inhibitor medications like Viagra, Cialis or Levitra
  • Anxiety medications
  • Stress management methods
Depression Depression has an influence on many functions in the body. Research has shown that men who are depressed are twice as likely as men without depression to have impotence.
  • Counselling
  • PDE 5 inhibitor medications like Viagra, Cialis or Levitra
  • Anti-depressants
Lifestyle Smoking, drinking and drugs have all been linked to impotence and other sexual problems.
  • Lifestyle adjustments
  • Adopting healthier habits
  • The use of PDE-5 inhibitors like Viagra, Cialis and Levitra
Medications Some medications, such as some anti-depressants, antihistamines, blood pressure medications and muscle relaxants, can all result in an increased likelihood of a patient developing impotence.
  • Speaking to a doctor about alternative medication options
  • Change of dosage
Sexual trauma or abuse Past sexual abuse, recent sexual trauma, problems with gender identity and sexual preferences can all affect how a man feels about sex, which can make impotence more of a possibility.
  • Counselling
  • The use of PDE 5 inhibitors like Viagra, Cialis and Levitra

For more information on treating erectile dysfunction and impotence causes for younger men, you can visit our dedicated page.

Treating erectile dysfunction depending on the cause

There is no miracle cure for erectile dysfunction and it may take time to pinpoint a cause to begin improvements. Whilst there might be one dominant cause, it is common to have a mixture of physical and mental causes of ED. For example, the development of type 2 diabetes could have caused erectile dysfunction, and you may be feeling of anxiety and stress from this.

Treatments for psychological causes of ED

Medications to combat erectile dysfunction are popular and well-known, the most recognisable being Viagra. These are often taken only when needed and can be used for a variety of erectile dysfunction causes. Whilst this has a lack of spontaneity, these tablets often take effect within an hour or less. Other medications include Cialis, Cialis Daily, Spedra, Levitra, Levitra Orodispersible, Sildenafil, and Tadalafil. Cialis Daily is a good option if you prefer taking medication continually.

Improvement to your lifestyle may provide significant changes without the need for additional medication. This can be especially useful for men with psychological causes of impotence.

For example, if you have pinpointed stress at work as one cause of ED, finding a new job, speaking to management about your stress levels or going on a holiday may improve matters. You can also consider de-stressing techniques such as yoga, meditation, aromatherapy or simply reading.

If past trauma or relationships are linked to your experiences of ED, then counseling may be recommended. Until you rewire your brain to think about sex differently, the pattern with ED is likely to continue.

Treatments for physical causes of ED

Whilst unpleasant, erectile dysfunction can be a good indication that you need to adjust certain factors in your life. Once you've reviewed these then the condition may disappear altogether. ED is also a warning that you have another underlining illness such as diabetes or cardiovascular disease, which often don't show any clear-cut symptoms on their own.

Improving your lifestyle linked to physical causes revolves around a number of simple factors:

  • Quit smoking
  • Reduce alcohol consumption
  • Exercise weekly
  • Review your diet
  • Improve your sleep routine
  • Reduce factors that prompt stress and other emotions

Improving one or all of these factors could be enough to combat erectile dysfunction without the need for additional medications or counseling. However, if you do combat one or more of these factors and still have erectile dysfunction, you should not be disheartened. Not only is your quality of life improved, but it may take time for ED to improve or another factor such as age might be the main cause, which can't be helped.

Other treatment options for erectile dysfunction

If you have tried lifestyle changes and other treatment options but they're not working for you, there are other routes that you can discuss with your doctor. This includes surgery, penile implants and vacuum devices. These options are considered the last resort. For the full in-depth list of ED treatment options, check out our dedicated page on just that.

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