Causes of erectile dysfunction
Erectile dysfunction (ED) can have many causes, such as certain medical conditions, medications and stress.
It's important to identify the cause of erectile dysfunction and treat any underlying conditions.
When a man becomes sexually excited (aroused), his brain sends signals to the nerves in his penis. The nerves increase the blood flow to the penis, causing the tissue to expand and harden.
Anything that interferes with the nervous system or the blood circulation could lead to erectile dysfunction.
Anything that affects the level of sexual desire (libido) can also cause erectile dysfunction because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals produced by the body).
There are four main types of health conditions that can cause physical problems resulting in erectile dysfunction. These are:
Injuries and surgery
Penis injuries or surgical treatment of the penis, pelvis or surrounding areas can sometimes lead to erectile dysfunction.
Erectile dysfunction is also thought to occur in up to 15-25% of people who experience a severe head injury.
Examples of vasculogenic conditions that cause erectile dysfunction include:
Erectile dysfunction is strongly associated with cardiovascular disease. For this reason, it may be one of the first causes your GP considers when making a diagnosis and planning your treatment.
Examples of neurogenic conditions that cause erectile dysfunction include:
Examples of hormonal conditions that cause erectile dysfunction include:
Peyronie's disease, which affects the tissue of the penis, is an example of an anatomical condition that can cause erectile dysfunction.
In some men, certain medicines can cause erectile dysfunction, including:
Speak to your GP if you are concerned that a prescribed medicine is causing erectile dysfunction. Alternative medication may be available. However, it is important never to stop taking a prescribed medicine unless you are advised to do so by a qualified healthcare professional who is responsible for your care.
Possible psychological causes of erectile dysfunction include:
Erectile dysfunction can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of erectile dysfunction.
There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include:
Other possible causes of erectile dysfunction include:
Men who cycle for more than three hours per week may be recommended to try a period without cycling to see if this helps improve erectile dysfunction.
Riding in the correct position with a properly fitted seat may also help to prevent regular cycling from leading to erectile dysfunction.
Symptoms of erectile dysfunction
The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse.
ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly.
Inability to get an erection
Sometimes ED only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.
In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related). However, if you are unable to get an erection under any circumstances, it is likely that the underlying cause is primarily physical.
Seek medical advice
See your GP if ED persists for more than a few weeks. They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the heart's blood supply is blocked or interrupted).
Many websites offer treatments for ED but their use is not recommended. The medications that are offered by these sites could be fake and may be dangerous. Even if the medications are genuine, they may not be suitable for you.
It is important that you only take medication for ED that your GP has prescribed for you.
Read more about treating erectile dysfunction.