Common Causes of Erectile Dysfunction

Causes of erectile dysfunction or ED are often associated with disorders such as diabetes, high blood pressure, heart disease, nervous system disorders, and psychological factors. Erectile dysfunction can also be a side effect of certain medications. The ability to achieve and sustain erections requires a healthy nervous system that conducts nerve impulses in the brain, spinal column, and penis. It also requires healthy arteries in and near the corpora cavernosa. Similarly, healthy smooth muscles and fibrous tissues within the corpora cavernosa are important. Adequate levels of nitric oxide in the penis must be present. Erectile dysfunction can occur if one or more of these requirements are not met.

The more complete causes of erectile dysfunction include aging, diabetes mellitus, hypertension, cardiovascular diseases, cigarette smoking, nerve or spinal cord damage, substance abuse, low testosterone levels, medications, and depression or anxiety. There are two reasons why older men are more likely to experience erectile dysfunction than younger men. First, older men are more likely to develop diseases such as heart attacks, angina, strokes, diabetes mellitus, and high blood pressure. All of these are associated with erectile dysfunction. Second, the aging process alone can cause erectile dysfunction in some men; primarily by decreasing the compliance of the tissues in the corpora cavernosa. It has been suggested, but not proven, that there is also decreased production of nitric oxide in the nerves of elderly men that innervate the corporal smooth muscle within the penis.

In the case of diabetes mellitus, erectile dysfunction tends to develop 10-15 years earlier for diabetic men than it does for nondiabetic men. In a population study of men with diabetes, erectile dysfunction was reported by 55% of the men between the ages of 50 to 60 years. The increased risk may be due to the earlier onset and greater severity of atherosclerosis. When insufficient blood is going to the penis, it is not possible for a man to achieve an erection. Diabetes mellitus also causes impotence by damaging sensory and autonomic nerves. This is a condition called diabetic neuropathy.

Cardiovascular diseases are another cause of impotence. The most common cause of cardiovascular diseases is arterioscleroses, which is the narrowing and hardening of arteries that reduces blood flow. Atherosclerosis typically affects arteries throughout the body. When coronary arteries that supply blood to the heart muscle are narrowed, heart attacks and angina can occur. Similarly, when arteries to the penis and the pelvic organs are narrowed, insufficient blood is delivered to the penis and it is much harder to achieve an erection.There is a very close correlation between the degree of arterioscleroses in the coronary arteries and erectile dysfunction. Cigarette smoking can also increase the problem of erectile dysfunction because it aggravates arterioscleroses and thereby increases the risk for impotence.

Nerve or spinal cord damage in the pelvis can also cause erectile dysfunction. Nerve damage can be due to disease, trauma, or surgical procedures. Examples of this include an injury to the spinal cord from car accidents, pelvic nerve injury from prostate surgery, multiple sclerosis, etc.

Substance abuse is another common cause of erectile dysfunction. Marijuana, cocaine, heroin and alcohol abuse can all contribute to impotence. Alcoholism, in addition to causing nerve damage, can lead to atrophy of the testicles. This can then lead to lower testosterone levels in men. Testosterone is the primary sex hormone and is not only necessary for a strong libido but also maintains the nitric oxide levels in the penis. Therefore, men with this condition, known as hypogonadism, can have a lower sex drive and erectile dysfunction.

Besides the typical “street drugs” that cause ED, there are many prescription drugs that will produce erectile dysfunction as a side effect. Medicines that can cause erectile dysfunction include many of those that are used to treat high blood pressure. Also included are antihistamines, appetite suppressants, antidepressants and tranquilizers. Examples of common medicines that can cause erectile dysfunction include beta-blockers such as propranolol. Elavil, Pepcid, Tagamet, Reglan, Indocin and lithium are also included.

Psychological factors may very often be responsible for erectile dysfunction and are the last cause that we will discuss. Psychological factors are the cause approximately 10% of the time. This is commonly due to anxiety, stress, depression, excess fatigue or dissatisfaction with the relationship with the partner. Other factors include guilt, low self-esteem, and fear of sexual failure. All of these conditions produce a change in the chemical balance of the body that can contribute to impotence.

When considering the large list of types and causes of impotence, it seems clear that a person should consult a specialist before deciding to take some medication or other course of treatment. Unfortunately, this is often not the case with most men who wish to keep the condition private. Misdiagnosis can often result in further damage and continuing problems. It is always best to consult a physician in the case of any sexual dysfunction.