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Causes
By Mayo Clinic staff
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health problems can cause or worsen erectile dysfunction. Sometimes a combination of physical and psychological issues cause erectile dysfunction. For instance, a minor physical problem that slows your sexual response may cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
Physical causes of erectile dysfunction
In most cases, erectile dysfunction is caused by something physical. Common causes include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High blood pressure
- Diabetes
- Obesity
- Metabolic syndrome, a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Parkinson's disease
- Multiple sclerosis
- Low testosterone
- Peyronie's disease, development of scar tissue inside the penis
- Certain prescription medications
- Tobacco use
- Alcoholism and other forms of substance abuse
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
Psychological causes of erectile dysfunction
The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
- Depression, anxiety or other mental health conditions
- Stress
- Fatigue
- Relationship problems due to stress, poor communication or other concerns
- AUA guideline on the management of erectile dysfunction: Diagnosis and treatment recommendations. Linthicum, Md.: American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=ed. Accessed Nov. 21, 2009.
- Kolodny L. Erectile dysfunction. In: Rakel RE, et al. Conn's Current Therapy. 1st ed. Philadelphia, Pa.: Saunders; 2009. hhttp://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-5974-5..00177-5--s0090&uniq=172836296&isbn=978-1-4160-5974-5#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-5974-5..00177-5%3Bfrom%3Dtoc%3Btype%3DbookPage%3Bisbn%3D978-1-4160-5974-5. Accessed Nov. 21, 2009.
- Ghanem G, et al. An evidence-based perspective to commonly performed erectile dysfunction investigations. Journal of Sexual Medicine. 2008;5:1582.
- Selvin E, et al. Prevalence and risk factors for erectile dysfunction in the U.S. The American Journal of Medicine. 2007;120:151.
- Spark RF. Treatment of male sexual dysfunction. http://www.uptodate.com/home/index.html. Accessed Nov. 21, 2009.
- Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 17, 2009.
- Park J, et al. Complementary and alternative medicine in men's health. Journal of Men's Health. 2008;5:305.
- Bauer B. Mayo Clinic Book of Alternative Medicine. New York, N.Y.: Time Inc. Home Entertainment; 2007:174.
- Bauer B. Mayo Clinic Book of Alternative Medicine. New York, N.Y.: Time Inc. Home Entertainment; 2007:63.
