Causes of Erectile Dysfunction or
What are the Causes of Impotence?
There are many reasons why a man may suffer from erectile dysfunction and be unable to achieve an erection. In
the past, people thought that the main cause of impotence is
psychological factors. Research now shows that over 80% of the diagnosed cases of impotence can be traced to physical problems.
The causes of ED can be grouped into three main categories:
- aging, diabetes, nerve damage, heart and blood vessel diseases,
hormonal imbalance, poor circulation, pain and others.
- stress, anxiety, fatigue, depression, pain, lack of intimacy with sexual partner and others. Most of these factors are temporary. Fixing one or more of these problems may be enough.
- high blood pressure medications,
antidepressants, cholesterol-lowering medications, anti-anxiety drugs,
sedatives, illicit street drugs and
Causes of Impotence - A
The Myth of Aging and Erectile Dysfunction
age, you are more likely to suffer from erectile dysfunction. However,
the aging process in itself does not cause impotence although it may take a
longer period of time before the penis becomes fully erect. The facts
are, as you age, are more likely to suffer from atherosclerosis, high
blood pressure, diabetes and nerve damage. These factors all contribute
Atherosclerosis / Hardening of the Arteries
Hardening of the arteries blocks blood flow in the blood vessels throughout the body. If this happens in the coronary arteries (the blood vessels supplying blood to the heart), it can lead to angina and eventually a heart attack (myocardial infarction).
When this happens in the blood vessels supplying blood to
the penis, it can lead to erectile dysfunction. This condition is the second leading cause of impotence (about 25% of all physical impotence).
This condition is not just limited to the older populations. Young men are being diagnosed with atherosclerosis at a earlier age. Expert believes it is, in part, due to poor dietary habits.
Hypertension (High Blood Pressure)
Untreated high blood pressure speeds
up the hardening of the arteries. Over time, this will permanently reduce blood flow to the
penis and lead to erectile dysfunction.
Men suffering from
diabetes are at a high risk of developing erectile dysfunction. It is
that over 50% of men suffering from diabetes have partial impotence and
eventually, the majority of them will become impotent.
is a leading cause of impotence (about 33% of all physical impotence).
Damage to the
nerves can reduce the sexual
transmitted from the glans penis (head of the penis) to the brain. A
major cause of nerve damage is from people with diabetes that is poorly managed.
Fixing nerve damage caused by years of uncontrolled diabetes
may not be possible. But you can prevent further damage by controlling diabetes.
Another is from prostate cancer surgery (see section on the
next page on Prostate Cancer Surgery
Testosterone is required to create
the sex drive or libido. Low testosterone levels would reduce the sex drive and thus make a man not interested in engaging in sexual intercourse.
Presence of Pain
Libido / Low Sex Drive
If you experience pain during sexual intercourse (dyspareunia), you will be unable to enjoy the sexual sensation and the penis may become less firm.
If you are experience other pain such as lower back pain, it
will also interfere with your ability achieve a full erection.
If there is no sexual
then a man will
have difficulty in achieving and maintaining an erection. A low
testosterone (male hormone) level is one cause.
Low libido can be
caused by prescription medications, depression, other medical
conditions and a general lack of interest or attraction to the sexual partner.
during sexual intercourse prevents
of sexually transmitted disease and pregnancy. It is a
physical barrier that is placed over the entire shaft of the penis.
will reduce the sensation felt by the man during sexual intercourse.
This reduced feeling may be enough to cause the penis to become less
This is only a temporary problem and will improve with the
use of thinner condom made
with polyurethane. (Polyurethane is stronger than latex so the condom can be made thinner to allow the penis to feel more stimulation during sexual intercourse.)
Using tobacco products can cause a variety of health risks that
eventually will lead to permanent erectile dysfunction. Directly,
nicotine, a stimulant
found in tobacco smoke, causes blood vessels to constrict, reducing
blood flow to various parts of the body, including the penis. It also interferes with the nitric oxide pathway needed for erection to occur. Over time, smoking speeds up atherosclerosis (hardening of the
arteries) and reduces the amount of blood that can get to the penis.
This will ultimately lead to permanent erectile dysfunction.
Excessive Alcohol Use
Excessive alcohol prior to sexual
intercourse can make it
difficult for a man to achieve an erection. It changes the way the
sexual sensation and thoughts are perceived by the brain.
the long term, excessive drinking damages the liver, increases the
levels of triglycerides (a type of fat) in the blood and can increase
blood pressure and heart failure.
Excessive Caffeine Use
There is debate whether the use of caffeine (found in coffee and tea) will limit the ability for a man to achieve a full erection. Too much
caffeine over stimulates the nervous system and that would interfere
with the process of achieving an erection. As well, excessive
caffeine use may be linked to stress at work, lack of adequate sleep
and other factors that may cause impotence.
Excessive Fatigue / Overworking
If you are very tired from work, you may not have the necessary physical energy or interest to achieve an erection. In other words, you rather go to sleep rather than have sex.
Lack of Sleep
If you do not get enough sleep, you will be overly tired the next day. Sexual intercourse requires physician energy. Moreover, not getting enough rest is unhealthy.
Psychology of Stress
It is not surprising that the sexual partners setup up the mood
before they engage in sexual intercourse. These activities are designed
to relax the partners and take away any stress that may be present. For example, after a very stressful day at work, it may be difficult for a man to relax and “wind down” enough to achieve an erection. Overall, chronic stress has a negative impact on your entire body
system, not just on your ability to achieve an erection.
Anxiety or Fear
Anxiety or fear is one of the major contributing factors that causes erectile dysfunction. This can include fear of:
- not sexually pleasing your partner,
- getting her pregnant,
- not being able to achieve
orgasm (or ejaculate)
- not being able to maintain a firm
enough erection and
- your kids coming into your bedroom by
accident (because you forgot to lock your bedroom door!)
Depression and Though Disorders
If a man is suffering from
depression, he will
not be mentally prepared for sexual intercourse.
Other disorder such as schizophrenia can cause erectile dysfunction as
well as the
mind is not in the mental state required for achieving an erection.
If you are angry with your partner or about some other event, you
will have difficulties in achieving a full erection.
prostate not only causes difficulties
it can also prevent the penis from achieving a full erection. There
are studies to show that men with an enlarged prostate have a higher
rate of impotence.
After Prostate Cancer Surgery
During the surgical removal of the prostate (radical
prostatectomy), nerves in that area may be damaged. This will lead to
some amount of impotence. There are surgical procedures that can reduce
the amount of nerves that a surgeon has to cut through. Look for medical clinics and surgeons that specialize in this.
As well, prescription medication used
in prostate cancer or after prostate surgery can cause erectile
dysfunction and a reduced
sex drive (libido). Also, radiation therapy afterwards may
slowly damage the blood vessels providing nutrition to the nerves in
Excessive Bicycling Riding (Cycling Impotence)
When riding the bicycle, the seat can put pressure on surrounding
tissue and reduce the blood flow to the penis. This can cause temporary numbing and discomfort.
Over time, in theory, this will permanently damage the tissue. This condition is reversible
when biking stops or is reduced.
This unfortunate condition does not
everyone who rides bicycle but research estimates that it does for 5% of the men surveyed. Getting a different bicycle seat design will prevent this problem.
The Myth of Excessive Heat
This is more a myth than fact. You would have to be exposed to extreme heat, like in sitting in a hot tub for an very long time practically every day for
this to be a permanent problem.
However, in order for sperm production to occur, the testis (where sperms are made) need to be
at a lower temperature than the rest of the body. Excessive exposure to heat does lead to a decrease in sperm count but is reversible when temperature is brought back to normal.
The Myth of Vasectomy and Impotence
Vasectomy does not cause erectile dysfunction. Vasectomy involves
tube that conducts the sperms during orgasm (ejaculation).
It does not affect the testis (the male sex organ) in making testosterone. As well, it takes away the fear of getting your sexual partner pregnant, thus making love making more enjoyable.
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