Erectile Dysfunction Causes

There are many underlying physical and psychological erectile dysfunction causes. If you are experiencing ED symptoms it is important that you speak with your physician and determine if there is a more serious medical condition you need to be aware of. Common erectile dysfunction causes include:


For more information, check out our “Guide to Erectile Dysfunction“.


Vascular Disease

Arteriosclerosis, the hardening and narrowing of the arteries, causes a reduction in blood flow throughout the body and can lead to impotence. It is associated with age and accounts for 50% to 60% of impotence in men over 60.

Diabetes Mellitus

Chronic high levels of blood sugar associated with diabetes mellitus often damage small blood vessels and nerves throughout the body, which can impair nerve impulses and blood flow necessary for erection. About 60% of men with diabetes experience ED.


Over 200 commonly prescribed drugs are known to cause or contribute to ED including drugs for high blood pressure, heart medications, antidepressants, tranquilizers, and sedatives. A number of over-the-counter medications can also lead to ED. Long-term use of alcohol and illicit drugs may affect the vascular and nervous systems and are associated with ED.

Venous Leak

If the veins in the penis cannot prevent blood from leaving the penis during erection, the erection cannot be maintained. Venous leak can be a result of an injury, disease or damage to the veins in the penis.

Surgery, Radiation Therapy, Pelvic Trauma

Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk of erection difficulties. Radical cystectomy (for bladder cancer) and prostatectomy (for prostate cancer) require cutting or removing nerves that control penile blood flow. These nerves do not control the sensation of the penis responsible for orgasms; only the erection is affected by these procedures. Radiation therapy for prostate or bladder cancer also can permanently damage these nerves. Trauma to the pelvic region or spinal cord can damage the veins and nerves needed for erection.

Peyronie’s Disease (Penile Curvature)

Peyronie’s disease is a rare inflammatory condition that causes scarring of erectile tissue. Scarring produces curvature of the penis that can interfere with sexual function and cause painful erections.

Hormone Disorders

Hormone disorders account for fewer than 5% of cases of ED. Testosterone deficiency, which occurs rarely, can result in a loss of libido (sexual desire) and loss of erection. Hormone imbalances can also result from kidney or liver disease.

Neurological and Psychological Conditions

Spinal cord and brain injuries (e.g., paraplegia, stroke) can cause ED when they interrupt the transfer of nerve impulses from the brain to the penis. Other nerve disorders, such as multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease, may also result in ED.

ED Treatments Are Available

Depression, guilt, worry, stress, and anxiety all contribute to loss of libido and ED. If a man experiences loss of erection, he may worry that it will happen again. This can produce anxiety associated with performance and may lead to chronic problems during sex. If the cycle is inescapable, it can result in ED.