There are various causes of ED – it can be physical (a ‘hardware’ problem) or psychological (mental health effects – ‘the software’). In order for sexual activity to be physically and mentally satisfactory, both physical and mental health should be considered.
Besides this however, biological processes also need to be at their optimum – as essentially, these processes are what make up the sexual response cycle.
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) or blood supply
- Nerve supply and blood vessel health
- The balance of sex hormones
Problems and/or disruptions in any of these processes can lead to ED
How Common Is Erectile Dysfunction?
It has been said that said that one in 10 adult males experience ED on a long-term basis. Besides popular belief, ED is not only common in older ages, rather affects younger men as well. It has been researched that not being able to achieve an erection at least 50% of the time generally correlates to an ED diagnosis.
Understanding how sexual dysfunction can affect sexual performance is key. With this in mind, there are various factors that can lead to Erectile Dysfunction symptoms. Breaking them down into different possibilities allows you to get a clearer picture on the different types of situations that can lead to ED symptoms.
Sexual and medical history is important to diagnose and treat erectile dysfunction – but determine the right cause, is a key as well. Here are the most common causes of ED broken down into sections that can make it easy to understand.
Physical Causes of Erectile Dysfunction
Health conditions such as peripheral artery disease, coronary artery disease (any heart or cardiovascular disease), atherosclerosis, diabetes (increased blood sugar), hypertension (high blood pressure), obesity (due to lack of physical activity for example), etc, can cause reduced blood flow to the penis due to artery narrowing. This can affect sexual function and activity as this can lead to sexual dysfunction. In fact, ED can lead to other sexual disorders such as low sexual desire.
Furthermore, spinal cord injury or radiation therapy can disrupt or harm nerves present in the penis.
Nerve-damaging pelvic injury
Physical injury to the pelvic area can damage pelvic nerves which can reduce flow to the pelvic area. Optimum blood flow is required for a sustainable erection – damage to this area can lead to negative effects to erectile function.
Surgeries – such as prostate surgery, or any surgery in the pelvic region – has a risk of affecting the pelvic nerves. In some cases, therefore, any injury to this area through reproductive surgery can result in damaged pelvic nerves or decrease blood supply to penile arteries.
Sex hormones – testosterone (androgens), estrogen and progesterone – play a critical role in sexual health. The abnormal variations of these hormone levels – through increased production or suppression – can result in concerns with erectile function.
- 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
- 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.
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Psychological Causes of Erectile Dysfunction
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
- Chronic stress: Stress hormones cortisol and adrenaline cause sex hormone suppression
- Performance Anxiety
- Interpersonal concerns among couples
Can Addictions Cause Erectile Dysfunction?
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 has 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’ desensitization.
What Medications Could Cause Erectile Dysfunction?
There are a variety of prescription medication classes that can result in ED as a negative side effect. These classes of intravenous or oral prescription drugs 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
Is medication induced erectile dysfunction permanent?
No, medication induced ED isn’t permanent. If a medical health professional determines that certain prescription medications are causing your Erectile dysfunction symptoms, then there are ways to go about it. It is not advised that you stop your medications before consulting with your doctor. They will be able to help you understand if you need to change your medications or vary their dosage.
What Is Age-Related Erectile Dysfunction?
Age is a risk factor for ED because as age increases, the levels of testosterone decrease naturally. Testosterone is significant in sexual health, however, commonly causes of ED are not related directly to the age of an individual. In fact, medical conditions and medication side effects are the most common causes of ED.
Myths vs. Facts: Causes of ED
- Myth: Masturbation causes Erectile Dysfunction
- Fact: No, masturbation – a normal and healthy sexual activity – does not directly cause ED. However, excessive masturbation can result in masturbation-induced erectile dysfunction. This is because those that masturbate excessively are used to one type of stimulation, and therefore are unable to can an erection when presented with other types of stimulation during sexual intercourse.
- Myth: Erectile Dysfunction does not affect those that are young
- Fact: Sexual disorders are specific to age – even though age is presented as a risk factor due to biological processes such as decreasing levels of estrogen and testosterone. Young individuals can posses risk factors of developing ED such as excessive smoking and drinking, inherited vascular conditions, diabetes etc.
- Myth: Diet and exercise do not affect or lead to Erectile Dysfunction
- Fact: Physical health has a significant impact on sexual health – chronic conditions such as diabetes, high cholesterol, obesity, high blood pressure (hypertension) hi etc. A good diet and a regular exercise routine is key during treatment for erectile dysfunction.
- Myth: Medical treatment is not required for Erectile Dysfunction
- Fact: While popular sexual wellness products and influencer based treatments have taken over, experts suggest that medical intervention is key to treating all sexual disorders. This is done only after a through evaluation, and treatment is determined based on your symptoms, its severity and its impact on your health.
- Myth: Erectile Dysfunction symptoms happen because of the lack of sexual stimulation
- Fact: In some cases, partners might feel that the lack of sexual stimulation many be the reason behind their partners ED symptoms. While that could be the case in some conditions, ED can be cause from a variety of different reasons – biological, physical and psychological. However, understanding the sexual response cycle and how sexual stimulation works can greatly help partners in the bedroom.
- The prevalence of erectile dysfunction is high due to many reasons such as lack of education, increased stigma and lack of sexual health professionals. However, treating erectile dysfunction is possible.
- Both physical and psychological causes can lead to Erectile Dysfunction.
- Besides medicative interventions, therapy for Erectile Dysfunction is considered to be a positive factor in an individual’s ED treatment journey.
- Anything that affects blood flow, nerve supply or hormone production/suppression can lead to symptoms of Erectile Dysfunction.
- Determining the exact cause is imperative for effective treatment for Erectile Dysfunction.
- Chronic medical conditions such as atherosclerosis, diabetes or hypertension can result in ED.
- Medications is one of the most common causes of ED symptoms. Understanding if your course of treatment affects your erectile function can help treat the underlying cause. Changing or varying doses of medications – or completely changing them – can help relieve ED symptoms. This should only be done under the evaluation and guidance of a sexual health professional.
- The management of Erectile Dysfunction should be guided through sexual health experts – using over the counter medications can do more harm than good to sexual health.
Frequently Asked Questions
(1) Can anxiety lead to Erectile Dysfunction?
Yes, performance anxiety can lead to symptoms of ED – this is because the nervousness or fear of failing can lead to a bad mental space. Its important to remember that psychological health impact sexual health – there must be a health balance.
(2) Can Erectile Dysfunction greatly affect your sex life or sex drive?
Untreated erectile dysfunction can affect both your physical, mental and sexual health. This is because the cause of your ED symptoms could be due to medical conditions, psychological conditions, medications or any physical injury. While ED symptoms can affect you sex life and lead to conditions such as Low Sexual Desire or Performance Anxiety, it could also be an indicator that it’s time to get your physical and mental health on track.
(3) Why is sexual history taking needed for sexual disorder diagnosis?
The symptoms that a patient experiences should be properly understood by a sexual healthcare provided. Part of their holistic evaluation requires both medical and sexual history taking. This allows the professional to understand how long you’ve been experiencing your symptoms, its intensity, its impact on your physical and mental health, and how to best approach treatment.
(4) Is the management of Erectile Dysfunction challenging or hard?
While ED symptoms can take a told on physical and mental health, it is possible to get reliable solutions and effective treatment. Sexual health expert are trained in both theory and practice, and can help you through all your queries and challenges and provide you with efficient medical advice. Needless to say, your treatment is catered to your comfort.
(5) Are prescription drugs always need in the management of Erectile Dysfunction?
Treatment for erectile dysfunction is highly dependent on the cause – in most cases medical intervention leads to the prescription of PDE-5 inhibitors or SSRIs. However, if the cause of your ED is a medical or psychological conditions – then treating that becomes first priority.
(6) How is Erectile Dysfunction diagnosed?
Erectile Dysfunction is diagnosed through a series of diagnostic tests and in some cases a physical exam. This is done to procure the accurate cause behind a patients ED symptoms. Diagnostic tests could include blood tests, hormone level checks, urine analysis etc.