What Causes Erectile Dysfunction?

In order for an erection to occur, a precise series of events must take place. If any of these events do not occur, ED is a result. As the nerve impulses move from the brain, down the spinal cord and into the area of the penis, the muscles, veins, fibrous tissue and arteries all react at the corpora cavernosa to create an erection.

One of the most common reasons for ED is damage to the smooth muscles, nerves, fibrous tissue or arteries in the area, often as the result of a disease of the body. In fact, diseases, such as heart disease, diabetes, chronic alcoholism, neurological disease, kidney disease, multiple sclerosis and atherosclerosis make up approximately 70 percent of ED cases. About 35 to 50 percent of diabetic men will suffer from ED.

Certain lifestyle choices, such as consuming alcohol, smoking and eating unhealthy foods, each of which can contribute to heart disease, can also increase the risks of developing ED.

If you need to undergo surgery for a condition, such as prostate or bladder surgery due to cancer, you are at risk for damage to the nerves and arteries in this area. Any injury that impacts the spinal cord, penis, bladder, prostate or pelvic area can contribute to the development of ED. This is due to damage that occurs to the smooth muscles, arteries, nerves and fibrous tissue located within the corpora cavernosa.

Medications can also be a common cause of ED. Blood pressure drugs, appetite suppressants, antihistamines, tranquilizers, antidepressants and ulcer drugs can alter the way your body works in a way that can cause ED.

Psychological problems, including stress, depression, guilt, fear of failure in bed, low self-esteem and anxiety can all impact your sexual function. About 10 to 20 percent of all ED cases are due to these psychological factors. Even if there is a physical cause for ED, men can often experience some of these psychological factors that make curing ED a vicious cycle. Even smoking due to these feelings can continue that cycle because of the decrease in blood flow and hormonal problems that often create low levels of testosterone.

How Do You Diagnose Erectile Dysfunction?


Many doctors will ask you numerous questions about your health history, as well as your sexual history, to the nature and extent of your ED. This medical history can pinpoint health problems that may be the cause, while a sexual history can indicate which types of problems you experience, including premature ejaculation, desire or erection issues. If you have been using certain drugs, either prescription or recreational, there can be a chemical cause. These drug interactions cause about 25 percent of cases. Eliminating the drugs or substituting something else can alleviate the ED.

Physical Exam

In addition to the history, the doctor will complete a physical examination to identify any potential causes. For instance, a lack of sensitivity in the penis can indicate nerve issues, while an unusual hair pattern or enlarged breasts can indicate a hormonal issue involving the endocrine system. A doctor can identify problems with circulation by checking pulse in the wrists and ankles. Unusual physical characteristics of the penis can also indicate a specific condition that is contributing to the ED.

Lab Tests

Some lab tests can identify some of the causes of ED. These tests will include a lipid profile, blood counts, measures of creatine and liver enzymes and a urinalysis. The free testosterone numbers in the blood can indicate a problem within the endocrine system, which is often the result for patients who suffer from a lack of desire.

Other Tests

One of the additional tests that may be performed is monitoring erections during the night, which can rule out psychological causes. This is because a healthy male is incredibly likely to experience erections in his sleep. If he isn't getting nocturnal penile tumescence, the cause is more likely something physical. However, it is important to remember that this type of test is not fully reliable. These tests are not standardized and doctors disagree on when they should be performed.

Psychosocial Exam

To determine whether the cause is psychological, certain tests will be performed, including an interview and questionnaire. In some cases, the male's partner may be interviewed as well to help determine the cause.