Erectile Dysfunction Causes

There are various causes of ED - it can be physical (a ‘hardware’ problem) or psychological (mental health effects - ‘the software’)

For an individual to have a healthy and sustainable erection, three aspects of the body’s process should be working well. The blood flow (BF), nerve supply, and the balance of sex hormones. Problems and/or disruptions in any of these processes can lead to ED. The following conditions give further details to the causes of ED.

Physical causes

Medical conditions

Health conditions such as peripheral artery disease, atherosclerosis, diabetes, hypertension, obesity, etc, can cause reduced blood flow to the penis due to artery narrowing. Furthermore, injury to the spinal cord or radiation therapy can disrupt or harm nerves present in the penis. 

Nerve damaging pelvic injury 

Hormonal disruption

- Increased or decreased testosterone production 
- Increased prolactin production 
- Increased steroid usage causes testosterone suppression 
- Increased or decreased thyroid hormone production 
- Increased growth hormone production
- Penis abnormalities
- Phimosis/Paraphimosis
- Peyronie’s disease

Men with low sexual desire such as in Hypoactive Sexual Desire Disorder (HSDD) can also present with arousal concerns such as ED.

Psychological causes

The smooth working of physical hardware or genitalia isn’t the only thing needed for sex to be satisfying and comfortable. The mind and body, together, affect the sexual arousal phases. Some mental health concerns that can lead to ED include

- Anxiety and/or anxiety disorders such as OCD
- Depression 
- Chronic stress: Stress hormones cortisol and adrenaline cause sex hormone suppression
- Performance Anxiety 
- Interpersonal concerns among couples
- Abuse


There are a variety of medication classes that can result in ED as a negative side effect. These classes of medications treat the following conditions:

- Hypertension drugs: some of these can negatively affect penis blood flow 
- Cholesterol drugs (specifically some of the Statins): can lower testosterone levels
- Psychiatric drugs: some medications in some people can disrupt brain chemical signaling which affects sexual function 
- Chemotherapy: can cause nervous system damage
- Cardiovascular drugs: can cause low testosterone production in some patients 
- Pain killers: Opioids can reduce testosterone levels in some patients 


Recreational drug usage can affect an individual’s ability to get and sustain an erection especially when people abuse them or are addicted to them in the following mechanisms 

- Alcohol: causes dehydration (reduces sensation in genitals), lowers testosterone (lowers sexual desire) levels and is a depressant (suppresses blood circulation and nerve sensitivity).
Nicotine: Disrupts blood circulation and negative effects on the arousal phase of the sexual response cycle.
Cannabis: Can prevent smooth muscle relaxation needed for penis blood flow and erection.
Cocaine: Post effects of the drug can cause delayed ejaculation, can lower sperm count, and can cause ED.
- Porn addiction can also be a cause of ED due to the stimuli desensitisation 

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Erectile Dysfunction
Erectile Dysfunction

Erectile Dysfunction is defined as the inability to sustain an erection sufficient for sexual intercourse. The condition can affect anyone at any age.


Remember - the blood flow (BF), the nerve supply, and the balance of sex hormones - a concern in any of these can lead to Erectile Dysfunction. Erectile Dysfunction can be caused by a physical (a ‘hardware’ problem) or psychological (mental health effects) - mental health can play a huge part.

Fact Check

Did you know that Erectile Dysfunction can be an indication of cardiovascular concerns? Chronic health conditions affecting blood flow can lead to Erectile Dysfunction.

Premature Ejaculation
Premature Ejaculation

If a man lasts less than 2 minutes after penetration (all or most of the time), and/or if it leads to frequent dissatisfaction for him or his partner, he may have Premature Ejaculation.


The causes of Premature Ejaculation include:
(1) Physical Factors: Medical conditions, chronic health conditions, or sexual disorders are some physical causes of Premature Ejaculation.
(2) Psychological Factors: Depression, Anxiety 

Fact Check

Did you know that Erectile Dysfunction can be a cause of Premature Ejaculation?

Premature Ejaculation can lead to other sexual dysfunctions, but that is not a wide-known fact.


Vaginismus is a condition in which the muscles in the vagina tighten up during penetration.


Vaginismus is commonly caused by psychological factors. Women don't have control over the tightening, and it can be uncomfortable. Due to the physical discomfort, the anxiety or fear response gets worse, and this can lead to a cycle of avoidance.

Fact Check

Did you know that there are four types of Vaginismus?

(1) Primary Vaginismus

(2) Secondary Vaginismus

(3) Situational Vaginismus

(4) Global Vaginismus

Low Sexual Desire
Low Sexual Desire

Low sexual desire, commonly referred to as low libido, is a decrease in sex drive.


Individuals that experience low sexual desire due to various causes are impacted physically, mentally, and emotionally by the symptoms the condition can cause.

Fact Check

Like other most common sexual disorders, low sexual desire can be influenced by many aspects, such as hormonal imbalance, increased age, side effects of medications, chronic illnesses, and addictive or compulsive behavior.

Couple Sex Problems
Couple Sex Problems

This would include concerns with infertility and/or conception. Sexual disorders such as Erectile Dysfunction, Premature Ejaculation, and Vaginismus can lead to challenges with pregnancy attempts.


There could be various causes of infertility, such as sexual dysfunctions, chronic illnesses, and mental health conditions leading to low sexual desire and a low sperm count. A sexual health professional should evaluate the causes of failed pregnancy attempts because there can be a variety of causes.

Fact Check
Porn Addiction
Porn Addiction

Porn addiction refers to a person becoming excessively dependent on pornography leading to a disruption in their everyday life. This could include their job, relationships and at times, their day-to-day lifestyle.


The causes behind porn addiction could be:

(1) Negative sexual experiences

(2) Incorrect understanding of porn and its uses

(3) Initially trying to learn about sexual experiences, resulted in dependency

(4) Experiencing mental health disorders such as OCD (an anxiety disorder) or depression

Fact Check

Watching porn isn’t a bad thing, nor should it be associated with any shame. However, compulsive porn watching can have negative effects on your sexual, physical and mental health.

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