Causes of Erectile Dysfunction – 2024 Review

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Erectile dysfunction (ED) is the chronic inability to attain and sustain an erection firm enough for sex. Intermittent episodes of erectile problems is not a cause of concern. However, recurrent episodes of dysfunction can be a sign of underlying health issues. The physiology of an erection relies on the vascular, endocrine and nervous systems.

Compromise to any of the systems may lead to erectile dysfunction. Although the probability of developing erectile dysfunction increases with age, aging itself is not a cause of ED. According to here are some common causes of erectile dysfunction.

Disease Conditions

There are several diseases that are associated with erectile dysfunction. These disease processes compromise the normal physiology of an erection and lead to dysfunction. Some of the common diseases include 

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Diabetes type II

Diabetes is one of the most prevalent non-communicable diseases worldwide. Over 422 million people have diabetes. Diabetes type II has a strong association with erectile dysfunction. Men with diabetes are three times more likely to develop ED than other men.Diabetes causes microvascular organ damage. Unfortunately, the penis is not spared from damage and the result is erectile dysfunction

Heart and blood vessel diseases

Any compromise to the heart and blood vessels is bound to compromise the blood supply to the penis. Without adequate blood supply, any attempts to achieve an erection will be futile. Patients suffering from heart failure often develop ED.


Persistently elevated blood pressures damage blood vessels around the body. Asa result, one of the complications of hypertension is erectile dysfunction. It’s important to maintain blood pressures withinacceptable levels to maintain the physiological integrity of biological processes around the body. 

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Peyronie’s disease

This is a condition where scar tissue forms under the penile skin. The tissue expands within the tunica albuginea, a membrane that keeps the penis stiff during an erection, and causes the penis to bend. Consequently, erections and intercourse become painful or impossible. Peyronie’s disease is benign and can result from traumatic injury to the penis. Treatment options for the disease include medical management with drugs like verapamil and collagenases, mechanical therapies and surgical management. Treatment relieves erectile dysfunction and restores complete function to the penis.

Direct Nerve Damage

Injury to the nerves supplying the penis has a direct effect on erection. Injury can result from trauma or radiation therapy. Trauma to the spinal cord, the pelvis or the peripheral nerves supplying the penis impairs afferent and/or efferent nerve stimulation making an erection impossible. 

Lifestyle and Behaviour

Particular behaviours are associated with increased risk of erectile dysfunction. Here are some that top the list.

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Smoking is bad for sexual health. Tobacco smoking causes vascular damage around the body and predisposes users to innumerable health conditions including erectile dysfunction. Smoking is the leading cause of erectile dysfunction in men under 40.  Smoking marijuana has also been shown to increase the risk of developing erectile dysfunction.

Chronic alcohol use

Alcohol dependence is linked to numerous medical conditions ranging from liver diseases to heart problems. 60%-70% of men dependant on alcohol also develop sex related problems: erectile dysfunction, loss of sexual desire and premature ejaculation. Temporary erectile dysfunction often occurs following heavy drinking, even in healthy men. However, chronic ED develops after prolonged alcohol use due to vascular compromise to the penis and disruption of endogenous hormones like serotonin. 

Obesity and sedentary lifestyles

The risk of developing ED increases by 40-90% in overweight and obese individuals. Obesity causes ED by damaging blood vessels and lowering testosterone levels. Obesity is also a risk factor for medical conditions that have a direct association with erectile dysfunction. A sedentary lifestyle is known to reduce sexual performance and cause erectile dysfunction. 

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Erectile dysfunction is a common side effect of several medical drugs and recreational drugs. Antidepressants are top of the list of drugs that cause erectile dysfunction. These drugs modify the levels of serotonin and dopamine in the body and affect the physiology of penile erection. Other medications that may cause E.D include antihypertensives, antidiuretics, antihistamines and chemotherapy drugs. Fortunately, not all drugs that fall in these classes of medication cause erectile dysfunction. Some are free of the side effects and dual prescriptions may be given to prevent the side effects. Therefore,  it’s important to seek medical advice before using certain medical drugs.

Psychological and Emotional Stress

More often than not, erectile dysfunction develops as a result of psychological and emotional stress. Response to sexual stimulation is reduced when a man is stressed. Stress hormones produced in the body during periods of emotional or psychological agitation inhibit the physiological cascade that results in an erection. Men who experience sexual performance anxiety fall into a vicious cycle where fear makes their erectile dysfunction worse causing more fear. Patients who suffer mood disorders also get erectile dysfunction and reduced sexual desire. 

It’s important to optimize all the factors that affect sexual health in order to achieve the desired results in the management body ED. Most causes of erectile dysfunction are modifiable and reversible. One of the simplest ways to reverse erectile dysfunction is to lead a healthy and active life. Physical exercise restores hormonal levels to homeostatic levels. Moreover, good cardiac activity is achieved and the penile organ gets sufficient blood supply to attain a functional erection. Other steps you can take to reverse erectile dysfunction is quit smoking and alcohol abuse

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Medical management of erectile dysfunction is also available for patients with underlying conditions. Sildenafil, popularly known as Viagra, is a common drug used in ED. It’s a phosphodiesterase type 5 (PDE5) inhibitor used to increase blood flow to the penis. Other medications include alprostadil, avanafil and tadalafil.

Since testosterone (the male sex hormone) reduces with age, doctors often prescribe testosterone for old male patients suffering from ED. Drugs used in the management of erectile dysfunction are used with caution since they have numerous side effects and fatal adverse effects. Moreover, the use of particular ED medications is contraindicated in patients suffering from other health conditions like heart disease.  

Erectile dysfunction is a prevalent problem in the world. Seek early treatment for the best long-term outcomes.