While it's appropriate to talk about the factors that might cause erectile dysfunction (ED), it's important to know almost all men will experience ED at some point, particularly older men. Aging is the most common and most unavoidable cause of erectile dysfunction. One in five men experience ED, and multiple research studies with men around the world have demonstrated a clear relationship between age and erectile dysfunction.


So if you live long enough, chances are you're going to experience erectile dysfunction. This doesn't mean there aren't things you can do to reduce your risk of ED, and learning about the other causes of ED is a good place to start.

As research into sexual response and erections improves, and as researchers develop better tools with which to understand exactly how erections work, new erectile dysfunction causes are being discovered. Getting an erection involves multiple parts of your body, including your brain, nerves, hormones, muscles, and heart. Anything that interrupts any of these systems may result in erectile dysfunction. And as you might imagine, because erections involve multiple systems, there are often multiple causes of erectile dysfunction. But it can help to think about the causes by first breaking them down generally into causes that are primarily physical and causes that are primarily psychological.

Physical Causes of Erectile Dysfunction

Physical conditions that reduce blood flow, or cause interruptions in nerve messages getting form the brain or spinal cord to the penis can result in erectile dysfunction.

The most common ones include:

• diabetes
• high blood pressure
• multiple sclerosis
• Parkinson's disease
• heart disease
• conditions that affect thyroid function and/or interrupt hormones in the body

Some injuries are known to be associated with and thought to be a cause of erectile dysfunction. Surgeries and other treatments, particularly if they risk the cutting of nerve endings in and around the penis, may also be a primary cause of erectile dysfunction. More common ones include:

• spinal cord injuries
• injuries to the groin (recent research also points to consistent but mild trauma related to cycling)
• colon surgery
• hemodialysis
• prostatectomy
• other treatments for prostate, penile, and rectal cancers including some chemotherapy and hormone treatments

Both prescription medications and recreational drugs can impact ability to get an erection -- either immediately or slowly over time. Some of the more common ones include:

• medications for high blood pressure, heart disease, and some antidepressants
• alcohol
• marijuana
• cocaine
• tobacco

Read more about erectile dysfunction and medications.

Psychological Causes of Erectile Dysfunction

Psychological factors can also have an impact on erectile function, and may be a primary cause of erectile dysfunction. These include:

• depression
• stress
• sexual performance anxiety
• relationship problems (which may or may not be related to sex)