To understand the reasons for erectile dysfunction, it’s important to know how an erection occurs. When aroused, your brain sends signals to the blood vessels in your penis, relaxing the arteries and allowing blood to flow in. The veins then close to trap the blood in your penis, causing it to expand and harden.

Anything that interferes with this process can lead to erectile dysfunction. Causes of the condition can be broken down into two categories: physical and psychological.

Physical Factors

• Circulatory problems such as narrowing of blood vessels, high blood pressure, high cholesterol, or hardening of arteries (atherosclerosis)

• Diabetes

• Hormonal problems such as low testosterone, high prolactin or abnormal thyroid levels

• Medications such as antidepressants, sleeping pills or drugs to treat high blood pressure, pain or prostate cancer

• Obesity

• Injuries causing nerve damage from the brain to the penis such as spinal cord injuries, multiple sclerosis, pelvic or prostate surgery, radiation therapy or trauma from a bicycle seat

• Any chronic kidney and liver disease that affects the circulatory system, nervous system or hormone levels

• Smoking, or alcohol or drug abuse

Psychological factors

• Stress or being unhappy at work, home or in your relationship

• Anxiety or being self-conscious about sex, fear of failure or developing sexual performance, worsened for those who’ve experienced erectile dysfunction previously

• Depression where you feel guilty you are not satisfying your partner, low self-esteem or loss of interest in sex

Psychological factors can often be a secondary reaction to erectile dysfunction itself and can go on to cause subsequent episodes of erectile dysfunction. You may also often find you experience both physical and psychological causes of erectile dysfunction.

Anything that interferes with this process can lead to erectile dysfunction. Causes of the condition can be broken down into two categories: physical and psychological.

Physical Factors

• Circulatory problems such as narrowing of blood vessels, high blood pressure, high cholesterol, or hardening of arteries (atherosclerosis)

• Diabetes

• Hormonal problems such as low testosterone, high prolactin or abnormal thyroid levels

• Medications such as antidepressants, sleeping pills or drugs to treat high blood pressure, pain or prostate cancer

• Obesity

• Injuries causing nerve damage from the brain to the penis such as spinal cord injuries, multiple sclerosis, pelvic or prostate surgery, radiation therapy or trauma from a bicycle seat

• Any chronic kidney and liver disease that affects the circulatory system, nervous system or hormone levels

• Smoking, or alcohol or drug abuse

Psychological factors

• Stress or being unhappy at work, home or in your relationship

• Anxiety or being self-conscious about sex, fear of failure or developing sexual performance, worsened for those who’ve experienced erectile dysfunction previously

• Depression where you feel guilty you are not satisfying your partner, low self-esteem or loss of interest in sex

Psychological factors can often be a secondary reaction to erectile dysfunction itself and can go on to cause subsequent episodes of erectile dysfunction. You may also often find you experience both physical and psychological causes of erectile dysfunction.

Frequently Asked Questions

Is Erectile Dysfunction normal?

Erectile dysfunction is a common condition. However, it is not a normal part of aging – older men should still be able to get an erection and enjoy sex. With so many treatments available for the condition, there is no need to suffer in silence.

What are the symptoms of Erectile Dysfunction?

The main erectile dysfunction symptoms are the inability to achieve an erection or maintain an erection that is sufficient for sexual intercourse. Some men with erectile dysfunction cannot get an erection at all, while others are unable to sustain an erection for more than a short time. Loss of interest in sex or sexual performance anxiety can also be symptoms of the condition.

Can Erectile Dysfunction be prevented?

You can help prevent erectile dysfunction by maintaining a healthy lifestyle, which can include regular exercise, a balanced diet and keeping an eye on your blood pressure and cholesterol. Anything that is bad for your heart is also likely to be detrimental to your erectile function. You should look to quit smoking and make sure you’re getting enough sleep each night (at least seven hours) to achieve better health.

Is impotence the same as Erectile Dysfunction?

Yes, erectile dysfunction and impotence can be used interchangeably. The two are often confused with premature ejaculation, a condition where a man climaxes before or immediately after penetration during sex. This condition may accompany ED but treatment is not the same.

Do drugs like Viagra work?

Tablet medicines, known as phosphodiesterase-5 (PDE-5) inhibitors have been proven effective in treating erectile dysfunction. Viagra (sildenafil) at 50mg or 100mg has been shown to help around four out of five men achieve and maintain erections suitable for sexual intercourse . Other PDE-5 inhibitors that work in the same way include Cialis (tadalafil), Levitra (vardenafil) and Spedra (avanafil).

How is erectile dysfunction diagnosed?

Diagnosing erectile dysfunction is relatively simple and a process that should leave you with nothing to be embarrassed about. You will need to consult with a registered doctor, who will recommend a treatment based on your symptoms and your physical and mental health, among other things.

What you may be asked

• Whether you have difficulty obtaining an erection, if your erection is suitable for penetration, if your erection can be maintained and if ejaculation occurs

• Details of any medication you have taken during the past year, including vitamins and supplements

• Details of your tobacco, alcohol and caffeine intake, as well as any recreational drug use

• Any psychological issues such as lack of libido, problems in your relationship, anxiety and fatigue

• Details about your relationship with your sexual partner, including whether they know you are seeking help, if this is a major issue between you and whether they are willing to help in the treatment process. The condition affects both of you, so our partner’s guide to erectile dysfunction can help significantly with support during your treatment.

Tests that might be included

• Blood tests to check for signs of diabetes or hormonal conditions such as low testosterone

• Urine tests to check for signs of diabetes or other underlying health condition

• Ultrasound to check for blood flow problems (this might involve an injection of medication into the penis to stimulate blood flow and give an erection)

• Overnight erection test to be done at home – this can determine whether the causes of erectile dysfunction are psychological or physical and involves wrapping a special monitoring device around your penis while you sleep.