Understanding ED and its causes

An erection requires a precise sequence of events, and ED can occur when any of the events is disrupted.

DISEASE

Damage to nerves, arteries, smooth muscles and fibrous tissues, often as a result of disease, is the most common cause of ED.

These diseases include:

  • Diabetes (between 35 and 50 percent of men with diabetes experience ED)
  • Kidney disease
  • Chronic alcoholism
  • Multiple sclerosis
  • Atherosclerosis
  • Vascular disease
  • Neurologic disease

Altogether, diseases account for about 70% of ED cases! Removal of the prostate and spinal cord injury can also cause ED.

LIFESTYLE CHOICES

Certain lifestyle choices that increase the risk of heart disease and vascular problems also raise the risk of erectile difficulties. Smoking, being overweight and avoiding exercise are all potential causes of ED. Overweight and obese men may be 30% to 90% more likely to experience ED compared to normal weight men. Some studies have suggested that prolonged cycling can lead to ED.

SURGERY

Surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder and pelvis can lead to ED.

DRUGS

In addition, many common medicines— such as blood pressure drugs, antidepressants, tranquilizers and appetite suppressants —may lead to ED as a side effect.

PSYCHOLOGICAL FACTORS

Experts believe that psychological factors (e.g., stress, anxiety, guilt, depression, low self-esteem and fear of sexual failure) may cause 10 to 20 percent of ED cases. Men with ED due to a physical cause frequently experience the same sort of psychological reactions. Other possible causes include smoking, which affects blood flow in veins and arteries, and hormonal abnormalities (e.g., low levels of testosterone).

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