What Is the Main Cause of Erectile Dysfunction?

Doctors first analyze your medical history and perform a complete physical examination, including your genitals. The type of treatment they advise can be broadly divided into two categories:

Temporary treatments

These treatments include medications and devices, such as penile pumps. Since they only offer short-term relief, they fail to address the underlying cause. However, they do help most people with conditions such as diabetes and atherosclerosis.

• Medications: Over-the-counter medications, such as Viagra (sildenafil), are the most commonly used treatment for erectile dysfunction. These effectively help most men to achieve or maintain erections.
• Penile pumps: Not all men with erectile dysfunction benefit from over-the-counter medications. Some benefit from penile pumps, which are cylindrical devices in which the penis is placed to help it get turgid and filled with blood by creating a vacuum.

Targeting the underlying cause

These treatments address the underlying cause of ED since they’re focused on treating the underlying condition (such as diabetes and atherosclerosis). Treatments may include testosterone therapy and other medications or surgeries.

• Treatment of clogged arteries: Using medications and making lifestyle changes can clear the obstruction in clogged arteries and improve cardiovascular health.
• Psychotherapy: Psychotherapy in the form of counseling may help address the underlying mental blocks, such as anxiety, stress and low self-esteem.
• Surgery: Men with severe ED due to physical trauma (to the penis), prior pelvic surgery or cancer often require surgery that involves inserting a penile implant that is inflated by pumping in pressurized liquid to achieve and sustain erections, which carries the potential of offering a permanent solution to men with persistent ED.

Erectile dysfunction is very common and affects up to one-third of adult men. ED can be cured in most cases through the use of various treatments and lifestyle changes.

Erectile dysfunction (ED) is the inability to get or maintain an erection firm enough for penetrative sex. It is a common symptom, affecting up to one-third of adult men.

Whether ED can be cured and the time required to cure it depends on the type and cause. There are two types of ED (primary and secondary):

• Primary ED is when a man has never achieved or sustained an erection. 
• Secondary ED is when a man who once was capable of getting or sustaining an erection is not able to do so later.

Many cases of secondary erectile dysfunction are temporary and can be cured. A study published in the Journal of Sexual Medicine found that about 29% of the men diagnosed with erectile dysfunction experienced remission after 5 years.

Even when erectile dysfunction cannot be cured, getting the right treatment from a doctor helps improve the symptoms.

Addictions, such as smoking and alcohol abuse, damage the lining of the blood vessels and hamper the flow of blood to the penis. Smokers are almost two times more at risk of ED than nonsmokers. Being overweight and having a sedentary lifestyle also contribute to erectile dysfunction.

Often men with ED can improve sexual function by making a few, effective lifestyle modifications, such as:

• Quitting smoking
• Limiting alcohol intake
• Losing weight
• Exercising regularly

All these factors improve cardiovascular health and thus, improve blood flow to the penis. Particularly, men who quit smoking experienced significant improvements in their erectile dysfunction.

Including colorful vegetables (bell peppers, broccoli, spinach and kale), fruits (berries, apples, kiwis, oranges, grapes, pineapples and olives) and green tea to your diet can also help improve the blood vessel lining of your organs, which will in turn help improve your ED.

A problem in a person’s mental health is one of the most common contributing factors of erectile dysfunction.

• Anxiety: Anxiety can stem from anything—worrying about not being able to perform in bed (performance anxiety), finances, family responsibilities and more. This anxiety can come in the middle of the sexual act and cause the person to lose an erection early.
• Stress: Everyday stress wreaks havoc on not only a person’s heart and digestive system, but also their penis. Sex can work as a stress-buster and stress itself can cause problems in sex.
• Depression: Erectile dysfunction can have its root in depression as well. Depression is a potent dampener of desires, including a person’s sexual desire. Some medications used in the treatment of depression can also have erectile dysfunction as a side effect.
• Anger: Having frequent arguments and getting angry may make a person lose interest in sex. Although these flush the person’s face, they reduce blow flow to the penis, resulting in erectile dysfunction.

Lifestyle factors contribute to erectile dysfunction in the following ways:

• Unhealthy lifestyle: Having a lot of fatty food and being physically inactive can make a person gain extra (unhealthy) pounds. Being overweight, particularly obese, lowers the amount of sex-boosting hormone known as testosterone, which ultimately affects the person’s sexual performance. It is also linked to hypertension (high blood pressure) and atherosclerosis (hardening of the arteries), which can reduce blood flow to the penis.
• Alcohol: While getting in the mood with alcohol is OK, doctors advise against overindulging. Doctors recommend drinking no more than two drinks per day for men.
• Smoking: Tobacco smoking can damage a person’s blood vessels and reduce arterial blood supply to the penis. This can lead to erectile dysfunction.
• Recreational drug abuse: The use of illegal drugs such as marijuana and cocaine can cause erectile dysfunction by damaging the blood vessels. These drugs can also restrict blood flow to the penis.

Atherosclerosis and diabetes are common causes of long-standing erectile dysfunction. Other health issues that can significantly contribute to the problem of erectile dysfunction include

• Heart disease
• Obesity
• Hypertension (high blood pressure)
• Hyperlipidemia (high lipid or cholesterol level)
• Benign enlargement of the prostate
• Parkinson’s disease
• Sleep disorders
• Chronic kidney disease
• Liver disease
• Injury to the penis or prostate
• Accidents involving trauma to the spinal cord
• Multiple sclerosis
• Peyronie’s disease (formation of scar tissue under the skin of the penis)
• Treatments for prostate cancer
  • Radiation therapy
  • Prostate surgery
• Surgery for bladder cancer

While treating an illness, certain medications can have erectile dysfunction as one of their side effects. These include

• Antihypertensive medicines (medicines for blood pressure)
• Antidepressants (medications for depression)
• Sedatives (medicines that make a person sleepy)
• Antiandrogens (medicines used for prostate cancer therapy)
• Medications for ulcers
• Antihistamines (medicines for cold and allergies)
• Appetite suppressants

If you develop any side effects, including erectile dysfunction, after taking certain medications, consult your doctor. Do not stop taking the medications unless your doctor tells you to do so.