What are the main causes of erectile dysfunction?

How physical, psychological and lifestyle factors can affect your ED


Erectile dysfunction (ED) can be caused by a number of physical and emotional factors including disease, injury, medication, stress, diet, lifestyle and even regular use of pornography.  This common condition affects millions of men in the United States, and occurs when a man isn’t able to achieve or keep an erection that is firm enough for sex. ED doesn’t just impact your performance in the bedroom, it also dents your confidence. The condition usually occurs in men over 40, but the truth is that no matter what your age, erectile dysfunction can be downright frightening. In most cases, ED is nothing to worry about and there is no cause for panic.  If it keeps on happening however, it’s important to seek help.  Erectile dysfunction is often embarrassing to discuss, but the good news is that while ED can be difficult to talk about, it is often very treatable.  The causes of erectile dysfunction vary greatly. In older men, physical factors such as high blood pressure, diabetes and heart disease are more common.  In younger men, lifestyle choices and emotional issues like anxiety can be a key factor.  Regardless of the cause of your ED, effective treatment may be available. 

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Physical factors that cause erectile dysfunction

Erectile dysfunction can be a short term condition that causes frustration, or a long term issue with more serious consequences.  In most cases, ED resolves on its own.  Prolonged ED can be a sign of underlying medical issues, and a visit to your GP will help you rule this out for your own peace of mind.  Heart disease, clogged arteries, low testosterone, high blood pressure and diabetes are common causes of erectile dysfunction.  Parkinson’s disease, multiple sclerosis and Peyronie’s Disease are also conditions that can inhibit your ability to achieve an erection.  Prescription medications can also contribute, and you’ll want to make sure that you mention any that you are currently taking to your doctor prior to evaluation.


How your lifestyle puts you at risk of erectile dysfunction

Lifestyle factors like smoking, drinking, drugs and diet can cause erectile dysfunction.  In these cases a few modifications to your diet, exercise regimen and lifestyle habits could put you back on track.  Tobacco, excessive alcohol and being overweight are common culprits that lead to ED.  Smoking directly damages blood vessels and disrupts proper blood flow, including to the vessels in your penis.  As proper blood flow is essential for achieving an erection, smokers are more likely to develop ED early.  Alcohol can cause a one-off case of erectile dysfunction while persistent heavy drinkers and drug users can develop long-term or permanent ED.  Being overweight can lead to significant hormonal and vascular disruptions.  Regular exercise and a healthy diet can reverse weight gain, and is generally excellent for your physical, mental and sexual health.


Emotional and psychological causes of Erectile Dysfunction

Erectile Dysfunction is complex, and when diagnosing the causes of the condition, emotional factors should also be considered.  10 – 20% of erectile dysfunction cases are caused by psychological conditions like stress, anxiety or depression.  A prior epidode, or prior episodes of ED, can further impair esteem and increase anxiety about sex.  This in turn increases your risk of longer-term ED.  Relationship issues can contribute to ED, and not being able to satisfy your partner sexually can add to your anxiety.  It’s important to know however, that medications for conditions like stress, depression and anxiety can also contribute to ED and should be mentioned when seeking treatment.  


How is erectile dysfunction treated?  

Starting a conversation about erectile dysfunction with your doctor is a great first step towards effectively treating ED.  Highly effective medications such as Viagra, Cialis or Levitra are widely available with a prescription.  For men who suffer from low testosterone, hormone replacement therapy will help with low libido and therfore, with ED. Smokers, drinkers and drug users should consider a change in lifestyle, while underlying issues like stress, anxiety and depression can be treated with a combination of medication and therapy.  If the cause of your ED is an underlying medical condition, your doctor can take this into consideration when determining the right treatment plan for you.



  1. Web MD, 'Erectile dysfunction: Psychological Causes,' Web MD [Web document] (2017), <>, accessed 21 August 2019.
  2. Mayo Clinic, ‘Erectile Dysfunction,' Mayo Clinic [Web document] (2018), < >, accessed 21 August 2019.
  3. NHS, 'Erectile dysfunction,' NHS [Web document] (2017), < >, accessed 21 August 2019.
  4. Medline Plus, 'Erectile dysfunction,' Medline Plus [Web document] (2019), < >, accessed 21 August 2019.

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