What are the causes of erectile dysfunction?

Reasons why you may have erectile dysfunction.

You may well have thought for a long time about the causes of your erectile dysfunction. The inability to get an erection when you want to have sex seems grossly unfair - after all, the guys you see in pornographic material seem to thrust away in their ever-willing partners for what seems like hours, and yet erectile dysfunction can make it impossible to make love in any way, skillfully or otherwise, your partner is unsatisfied, and you are frustrated and unhappy about your loss of potency. So just what is causing your erectile dysfunction?

Well, the truth is that there are several causes of erectile dysfunction.

The first cause of erectile dysfunction is a physical cause such as occlusion of the penile arteries, diabetic induced neuropathy, or penile injury

Needless to say, these are the more intractable cases of erectile dysfunction, and they may need the helping hand of Viagra to produce a lessening of symptoms.

The second cause of erectile dysfunction is emotional - anxiety or anger

When you feel unconscious anger at your partner - or women in general - then you're not likely to want to have sex with her, unless this is the way that you express your anger.

Some sexual therapists suggest that men lose their erection because the withholding of sexual favors is like a punishment for their partner, depriving her of the satisfaction of orgasmic pleasure. This kind of passive-aggressive behavior plays a major role in sexual relationships.

In fact the mechanism by which a man loses his erection is probably more dependent on anger reducing desire than a passive-aggressive withholding of sexual favors: after all, why would you want sex with someone you didn't feel intimate with? Physical pleasure? Sexual release? The expression of anger?

In the latter case, you may be having sex to express anger; loss of erection suggest you are so angry you are turned off your partner.

The third cause of premature ejaculation - fear 

That is fear of having sex, or fear of having sex with a particular woman. In the work I have done with men, it has been very clear to me that loss of erection, especially when it occurs in young men, can be a clear sign that the man in question knows less about his real feelings of sexual attraction than his penis does!

Such loss of erection usually means that a man does not in fact want to have sex with his partner, and whatever the reason for this, the recognition that it is not necessary to feel sexually attracted to every woman with whom one could potentially have sex is a powerful insight.

This may well be an emotional challenge for all men who were brought up by a woman who used them emotionally, either as an emotional support or as a vehicle for the expression of their own sexual rage and frustration against men.

Erectile dysfunction is a great way to avoid the ultimate form of intimacy and to minimize the chance of an unappealing sexual encounter: erectile dysfunction is the almost inevitable result. 

The fourth cause of erectile dysfunction - you want to be with someone else

Not entirely unrelated to what we said above, when a man is with a woman with whom he would rather not have sex, erectile dysfunction is almost a certainty.

You need to be honest with yourself about this: simply ask, would you rather be with someone other than your partner? If the answer is "yes", that's a pretty good clue to the origins of your erectile dysfunction.

The fifth cause of erectile dysfunction - you are not sexually aroused

If you progress too fast from starting sex to the point of penetrating, not allowing enough time for sexual arousal to grow and develop, then you will find that your erection becomes more elusive, more challenging to maintain, and more difficult to keep firm.

You may have erectile dysfunction simply because you are not aroused enough, a problem which becomes especially apparent as you get older and require more stimulation and excitement before your erection begins to develop.

But I do know one thing - you can change the lack of sexual response - the lack of an erection in your penis - so that you always have a firm erection during sex. You don't need to have erectile dysfunction.

The sixth cause of erectile dysfunction - you are moving though the stages of sexual arousal too quickly

Men with sexual self-confidence understand the signals they receive from their bodies about how sexually aroused they are, but a lot of men who don't get erect simply do not understand how aroused (or not) they actually are.


There's one undeniable fact - more and more men are ageing and need help for erectile dysfunction. Men want sex, and they tend to get frustrated and unhappy when they can't have it. Not being able to get an erection seems like a disaster - and psychologically, for may men, it really is. Effective treatment for erectile dysfunction is essential to male sexual and emotional health. And erectile dysfunction is very common: about 1 man in 12 has an erection problem. And, even worse, up to 50 % of men with diabetes have some kind of erection problem.

Erectile dysfunction is often abbreviated to ED for short.

How can ED or erectile dysfunction be treated with drugs?

Impotence is more commonly known as erectile dysfunction: the inability to develop an erection hard enough to permit sexual intercourse. It can have a connection with low sex drive or lack of desire, and it is often associated with delayed ejaculation or premature ejaculation.

ED or erectile dysfunction is more common among older men. This is perhaps because of increasing levels of circulation problems, nerve problems, drug use (i.e. prescription drug use), age-related decrease in levels of testosterone, or a combination of these factors.

The classification of erectile dysfunction varies as does the degree of erection loss: from an erection that is not hard enough for sexual intercourse to an erection which permits penetration but then gradually loses hardness or is short-lived.

Surgery is possible but tends to produce unsatisfactory results over time; prosthetic inflatable devices have a high failure rate. Nowadays, Viagra can produce a fairly quick erection, and a rapid boost to an impotent man's self-esteem and sexual self-confidence. Of course, sexual success also reduces anger, depression and low self-esteem.

How does drug treatment for Erectile Dysfunction (ED) work?

The two corpora cavernosa which run along the length of the penis to the coronal ridge are made up of spongy tissue and smooth (unstriated) muscle. These muscle fibers are normally slightly tense and so regulate the blood flow into the expandable tissues.

When these muscles relax, blood is allowed to enter, whereupon the tissues swell, thereby squeezing the veins between the tunica albuginea and the corpora cavernosa. As the blood flowing in is now not able to drain away, the tissues swell and become harder and more rigid. It's a complicated process and disruption to any aspect of the erectile mechanism causes the whole process to fail.

The various factors involved in impotence or erectile dysfunction

As we said before, a common cause of erectile dysfunction is a problem with either the veins or the arteries which feed the penis with blood and then drain it away. Arterial insufficiency or veno-occlusive disease both cause erectile dysfunction; but the ultimate cause of such problems is smoking, hyperlipidemia, hypertension and diabetes.

And neurological damage is a frequent cause of impotence; the release of essential components of the erectile mechanism, namely nitric oxide and prostaglandins from the tissues of the penis, can be inhibited by damage to the neural network - damage that can be caused by injury, surgery, multiple sclerosis and diabetic neuropathy .

Testosterone levels fall as the years go by, and a man will have fewer night-time erections and a lower sex drive. SSRIs, sedatives, anxiolytics, antihistamines, antidepressants and, antihypertensives are common medications which have been all been associated with erectile dysfunction.

Stress can induce erectile dysfunction by increasing blood catecholamine levels and causing smooth muscles to remain tense. And on an emotional level, fear of sex, or women, or pregnancy, or fear of sexual failure can all cause erectile dysfunction.

Remedies for Erectile Dysfunction

Vacuum devices

The vacuum device is a kind of penis pump which draws blood into the penis by creating a partial vacuum in a plastic tube placed over the penis. Passive dilation of the arteries draws blood into the erectile chambers of the penis, then a constricting band is quickly placed around the penis and left in place to hold the blood in the penis, thereby maintaining the man's erection. Unfortunately a man's physical pleasure tends to be rather low with this method.

Penile prostheses

Semi-rigid devices or other inflatable devices implanted into a man's penis suffer from a fairly high failure rate and a high infection rate. A support sleeve which fits around the penis may be a better solution and allow penetration.

Pharmacologic agents and the treatment of ED

Of course the best answers are Viagra and other vasoactive agents which promote the accumulation of blood in the corpora cavernosa. The drugs which preceded Viagra were injected into the corpora cavernosa and tended to work within ten minutes. Viagra takes rather longer to work but is safer and more effective for the majority of men.

Psychological or physiological erectile dysfunction?

Emotional issues surround all cases of erectile dysfunction. How could they not? But when a case of erectile dysfunction has a purely emotional origin it can happen suddenly and without any previous experience or warning. In the case of erectile dysfunction with a physiological cause, the onset is more gradual. Tests for high levels of cholesterol and high blood pressure can indicate the cause of erectile dysfunction in some cases.

Home ] Introduction to ED ] Beliefs which cause erection problems ] Background information on ED ] Background information on erectile dysfunction ED ] Physical causes of ED ] Personality and relationship issues as a cause of erectile dysfunction (ED) ] Endocrinological causes of ED ] Vascular disease and ED ] What's causing your erection problems? ] Emotional & psychological problems in ED ] [ More on causes of ED ] Sleep apnea and erectile dysfunction ] How to control the risk of ED ] Lack of arousal and ED ]

Guidelines for the treatment of Erectile Dysfunction (1)