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Common Causes of Erectile Dysfunction


According to the Massachusetts Male Aging Study, 52 percent of men in the U.S. age 40-70 experience some sort of erectile dysfunction, or ED. However, it doesn’t just affect men in this age group. Another study on the prevalence of ED found that 26 percent of its participants were under the age of 40. So, why is it still such a difficult topic for many men to discuss? ED, also known as impotence, is distinguished by a man’s inability to keep an erection long enough to engage in sexual activity. Many men with ED are not capable of achieving an erection at all, and while this condition is not fatal, contagious or permanent, it can have damaging effects on one’s relationship, sex life, self-esteem, and overall quality of life.

The erection process is complex and involves a variety of physiological systems, making it difficult to pin point the exact origin of one’s dysfunction. However, doctors recognize many medical conditions and lifestyle factors as common causes of impotence. If someone is suffering from ED and doesn’t understand why, it could be one or any combination of these reasons.

Endocrine Disorders

The endocrine system is responsible for regulating the body’s natural hormone production. These hormones control everything from sexual function to metabolism, so, when one of them is not functioning properly, it is easy to see how an erection could be affected. Diabetes is one of the most common endocrine disorders affecting ED. When the body doesn’t adequately interact with insulin, it can result in nerve damage and impaired blood flow; two very important requirements for obtaining an erection.

Hypothyroidism is a condition characterized by a shortage in the thyroid hormone. This hormone regulates the body’s metabolism, thus, a decreased libido can often result from a slow metabolism or sudden weight gain. A testosterone deficiency can also play an important role in a man’s inability to get or maintain an erection. Symptoms of low testosterone levels include loss in hair, muscle mass and body fat.  

Neurological Conditions

Neurological conditions are those affecting the brain and nerves, which are needed to communicate with the reproductive system. The brain sends messages down the spinal cord to the nerves and blood vessels in the penis; any nerve damage, particularly Peripheral Neuropathy, can compromise the erection. Men with chronic illnesses involving the central nervous system, such as Multiple Sclerosis or Parkinson’s, are at a high risk of sexual dysfunction.    

Cardiovascular Problems

During an erection, the vessels and arteries expand, increasing blood flow to the penis. If something is blocking these vessels and there is not a sufficient amount of blood flow, an erection may not be able to occur. There are many heart and cardiovascular-related issues that can interfere with blood flow. Atherosclerosis, or clogged arteries, high cholesterol, heart disease, and hypertension are all very common in men over 40.

Certain Medications

Various prescription medications have been known to contribute to impotence in some men. Even if a medication is making it difficult to achieve an erection, it is important to consult a doctor before stopping it altogether. Some common prescriptions that can cause ED include:

  • Drugs used to treat BPH, such as Flomax and Avodart
  • Anxiety medications, such as Xanax and Valium
  • Opioid painkillers, such as Hydrocodone and Oxycodone
  • Anti-depressants, such as Cymbalta and Celexa 

Psychological Factors

Psychological factors such as stress, anxiety and depression, are the most common causes of ED because erections typically start in the mind. When there are underlying issues in one’s life, whether at work or in the home, arousal can become very difficult. The stress of being laid off at work, or the depression resulting from an unhealthy relationship for example, can cause a man to develop some form of sexual dysfunction. A feeling of hopelessness or general lack of interest in life can make it very tough to become sexually excited. Certain lifestyle choices such as drinking excessive amounts of alcohol or using tobacco products can make these psychological factors worse.

What are the Treatment Options?

Erectile dysfunction is an extremely treatable condition for most men, and there are endless options available to choose from. While some may be able to fix the problem on their own via natural methods, others may require more assistance. Either way, it is a good idea to consult a physician before considering any of the following options.

1. Behavioral Changes

The easiest and most important thing a person can do to boost their sex drive is to get their head on straight. If possible, cast out all the negative, stressful aspects of life causing anxiety and depression. Or, figure out a way to deal with them via counseling, medication or working more fun into the day. Eating a healthier diet, exercising more and smoking cessation are also highly recommended.

2. Natural Remedies

Some natural remedies have proven to be effective in reducing impotence, but should not be taken without a doctor’s approval. These remedies could have negative interactions with other health conditions or medications.

Herbs such as Panax ginseng and Rhodiola rosea, hormone supplements like DHEA and testosterone, as well as L-arginine and acupuncture have all shown promising results for ED patients.    

3. ED Medication

Often times, a prescription is needed to fully treat erectile dysfunction in males over 40. As long as there is no pre-existing heart condition or similar medical concern, medication can uplift one’s libido tremendously. Sildenafil (Viagra), Tadalafil (Cialis), and Vardenafil (Levitra) are the most commonly prescribed by urologists.      

4. Penile Surgery    

For many men, at-home remedies and prescription medications are not enough. Recent technological advancements in the field of urology have made procedures such as penile implants and vascular reconstructive surgeries possible. There have even been four cases of successful penile transplants; the first one in 2016.



Every man is different and has different underlying causes of ED; that’s why you should consult an experienced urologist to find out what yours are. If you think you need medication or would like to discuss surgery options, don’t hesitate to contact us today.