Erectile dysfunction (ED) is an important reason for impotence in men. It is the inability to achieve and maintain penile erection during sexual intercourse. It mainly affects the self-esteem and self-confidence of men, which can impair their personal relationships with their partners. To resolve this problem, one must be aware of its causes.

Sexual arousal in males is a complex process involving various physiological and psychological factors. It includes brain, nerves, hormones, emotions, blood vessels and muscles. Any disturbance in these factors can potentially lead to erectile dysfunction. Stressful lifestyle and mental health problems can directly or indirectly impact on sexual health and can cause ED.

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The causes for ED can broadly be discussed as follows:

Physical causes of erectile dysfunction:

  1. Cardiovascular diseases: Atherosclerosis (clogging of blood vessels), hypertension (high blood pressure) and high blood cholesterol levels are commonly responsible for cardiovascular diseases. If the blood supply of the heart is affected, it is termed as ischemic heart disease or coronary artery disease. These conditions adversely affect the blood supply to the genitals and therefore can cause ED.
  2. Diabetes: Diabetes is a condition associated with damage of small blood vessels and nerves in the form of angiopathy and neuropathy. It may affect the genitals causing ED.
  3. Obesity: Although being overweight doesn’t cause ED directly, the risk factors for obesity such as, diabetes, hypertension, and high cholesterol are also implied in ED. Hence obesity can indirectly cause ED by general negative health effects. Lack of physical activity is also a major cause for all these conditions.
  4. Substance abuse: Alcohol consumption and tobacco smoking are well known causes for damaging blood vessels and leading to cardiovascular diseases. Medications like antidepressants, antihypertensives and antihistaminics are also known to cause ED.
  5. Metabolic syndrome: It is a metabolic disorder which is characterised by overweight, insulin resistance, high insulin levels, high cholesterol levels and increased body fat deposition.
  6. Peyronie’s disease: It is a condition in which the scar tissue called plaque forms within the penis. This results in a bent and erect penis. The person has difficulty in having sax and may experience pain, eventually leading to ED.
  7. Insomnia: Inability to sleep can disturb the normal physiology of the body.
  8. Pelvic or spinal surgeries: These surgeries can damage the nerves supplying the penis leading to ED.
  9. Injury to penis: Either traumatic injury or surgical procedure over penis (like circumcision) can lead to painful erections and may cause ED temporarily.
  10. Parkinson’s disease: Patients with Parkinson’s disease are noted to have common saxual problems like decreased saxual drive, premature ejaculation, inability to achieve orgasm and erectile dysfunction. These saxual dysfunctions can be due to the disease itself or due to the associated psychological issues.
  11. Multiple sclerosis: This condition may damage the nerves supplying the genitals.

Psychological causes of erectile dysfunction:

The brain is responsible for emotions and feelings of saxual arousal. Following conditions can impair such saxual feelings leading to ED:

  1. Mental health conditions like depression, anxiety, etc.
  2. Stress
  3. Relationship issues with partner, which may be due to stressful life, poor communication or other concerns.

To conclude, various risk factors causing ED are as follows:

  • Medical conditions: Diabetes, hypertension, obesity, cardiovascular disease, kidney disease, etc.
  • Substance abuse: Alcoholism, tobacco smoking, long-term drug abuse.
  • Injuries: to the nerves and blood vessels supplying the genitals.
  • Medical treatment: like prostate surgery, radiation therapy for cancers.
  • Medications: Antihistamines, antidepressants, antihypertensives, analgesics, etc.

Psychological disorders: Depression, mental stress, anger, anxiety.