15 Causes of Erectile Dysfunction

⚠ Important Note:
This content is based on clinical guidelines (AUA/EAU) for educational use. It does not replace a professional medical consultation. Please consult a specialized doctor before starting any treatment mentioned.

15 Causes of Erectile Dysfunction

To achieve an erection, the penis needs adequate amounts of blood flowing into it, slowing the drainage of blood from it, the efficiency of the function of the incoming and outgoing nerves from the penis, appropriate amounts of the male hormone testosterone, and sufficient sexual desire.

Therefore, any defect in any of the above may lead to erectile dysfunction. The causes of erectile dysfunction are diverse and include the following:

1- Lowered level of testosterone hormone:

The primary male hormone is testosterone. After forty years, a man's testosterone level gradually decreases. About 5% of men that doctors see for erectile dysfunction have low testosterone levels.

In many of these cases, low testosterone causes lower sexual interest, premature ejaculation, and erectile dysfunction.

2- Physical and mental stress:

Physical and mental stressors, including long hours in the office, extensive travel, workplace stress, home stress, insufficient sleep, anxiety, and depression, can lead to fatigue in both the body and mind.

The physical and mental stress drains the body's energy and causes fatigue. Fatigue lowers sexual energy and libido, causing erectile dysfunction.

3- disliking the sexual partner:

A non-cooperative sexual partner makes a man feel inferior, and he may suffer from guilt. These psychological changes may cause erectile dysfunction.

4- Neurological disorders:

Nerves play an important role in the flow of signals from the brain to target organs or from sense organs to the brain. When there is a disruption to the flow of signals due to diseases of nerves, the flow of signals is interrupted.

Neurological diseases such as Alzheimer's disease, brain or spinal tumors, multiple sclerosis, stroke, and Parkinson’s disease can block this flow, causing erectile dysfunction.

5- Anemia:

Anemia is a reduced amount of hemoglobin. Reduced hemoglobin causes fatigue. Fatigue makes a man have a low libido and can cause erectile dysfunction.

6- Hypothyroidism:

Men with hypothyroidism may lose interest in sex and have trouble getting erections. Low energy and tiredness caused by this condition lower sexual libido and may cause erectile dysfunction.

In a recent study, when men with hypothyroidism were compared with men without hypothyroidism, men with hypothyroidism had a higher rate of erectile dysfunction compared to men without hypothyroidism.

7- Arthritis:

Arthritis and joint pain may hinder the movement of men during sexual acts. These painful movements disturb the attention and can cause a loss of erection.

8- Diabetes:

Men with diabetes usually have erectile dysfunction. About 75% of diabetic men complain of erectile dysfunction. Erectile dysfunction develops earlier in diabetic men than in nondiabetic men.

Diabetes damages penile blood vessels and penile nerves (neuropathy) throughout the body. When penile blood vessels and nerves, which control erection, are damaged, they do not communicate properly, and the blood flow to the penis tissue is impaired; this condition causes erectile dysfunction.

9- Heart diseases:

The most important mechanical process of creating and maintaining an erection is the cardiovascular system. When a man is sexually aroused, the arteries to the penis open up and allow more blood to flow into it. At the same time, the valves in the penile veins close off to maintain this blood in the penis.

As the man continues to be aroused, the heart keeps pumping blood into the penis, and an erection is produced. This continual blood pressure helps maintain this erection. This process is how an erection is produced and controlled.

If the heart is weak, there is a chance that such conditions might have an ill effect on creating and maintaining an erection, especially if there are some restrictions on the vasculature to the penis.

10- Smoking:

It is common knowledge that smoking causes a restriction of blood vessels, which ultimately leads to artery blockages. If a penis receives little blood, it may be unable to achieve or maintain an erection.

Smoking is one of the most common causes of erectile dysfunction. Clinical studies have shown that being a smoker may increase a man’s risk of erectile dysfunction in men between 30 and 50 years by 50 percent.

11- Chewing Tobacco:

Chewing tobacco harms sexual function in many ways:

1. It reduces blood flow through arteries. Little blood flow to the penile arteries causes erectile dysfunction.

2. Tobacco chewing decreases sexual energy levels and causes erectile dysfunction.

3. It lowers testosterone levels. Lowered testosterone levels plummet sperm count, sperm motility, and libido.

12- Alcohol drinking:

Chronic alcoholics develop long-term erectile dysfunction. Chronic heavy alcohol use has been linked to a higher risk of long-term erectile dysfunction.

Men who are dependent on alcohol have a 60 to 70 percent chance of complaining of sexual problems. The most common of these are erectile dysfunction, premature ejaculation, and loss of libido.

13- Medicines:

Certain medications can increase your risk of erectile dysfunction, including:

Antihypertensives. Antihistamines. Antidepressants. Tranquilizers. Antipsychotics. Antihistaminics. Anticholesterol, like statins. Nicotine.

If you suspect a drug may be affecting your sexual functioning, speak with your doctor. Do not stop taking a drug without talking to your doctor first.

14- Pelvic trauma:

Trauma, whether through an accident or surgery, can increase your risk of erectile dysfunction. Trauma includes:

Spinal cord injury.
Vascular operations.
Urologic operations, such as prostate surgery.
Pelvic operations (particularly for prostate cancer).

15- Obesity:

Obesity affects the blood vessels of the penis. Obesity leads to the accumulation of cholesterol on the inner walls of the penile artery (atherosclerosis). The diameter of the penile artery is tiny. Atherosclerosis reduces the penile artery’s diameter, leading to low blood flow. Low blood flow to the penis tissues causes erectile dysfunction.

Obese men experience a decrease in testosterone hormone production. The testosterone level is usually below average for overweight men. Low testosterone levels lead to erectile dysfunction and low libido. This condition is known as hypogonadism.

This article was written and reviewed by Dr. Hassan Ali - Urologist