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NHS Choices Condition

Content supplied by NHS Choices

To understand more about the possible causes of erectile dysfunction (ED) it is useful to know how erections occur.

When you become sexually aroused, your brain sends signals to the nerves in your penis. The nerves increase the blood flow to your penis, causing the tissue to expand and harden.

Therefore, anything that interferes with your nervous system, or the circulation of your blood, can potentially lead to ED.

Psychological factors, such as stress, or depression, can also reduce your libido (your interest in sex) making it harder for your brain to trigger an erection. Changes in hormonal levels can also affect your libido.

Physical causes of erectile dysfunction

Health conditions

There are four main types of health condition that can cause ED. These are described below.

  • Vasculogenic - health conditions that can affect the flow of blood to your penis.
  • Neurogenic - health conditions that can affect your nervous system.
  • Hormonal - health conditions that can affect your hormone levels.
  • Anatomical - health conditions that can affect the physical structure of your penis.

Vasculogenic conditions

Examples of vasuclogenic conditions include:

  • heart disease,
  • arteriosclerosis - hardening of the arteries,
  • high blood pressure (hypertension), and
  • diabetes - which can affect both the blood supply and the nerve endings in your penis, so it also a neurogenic condition.

Neurogenic conditions

Examples of neurogenic conditions include:

  • multiple sclerosis,
  • Parkinson’s disease,
  • spinal injury, or disorder, and
  • tumours.

Hormonal conditions

Examples of hormonal conditions include:

  • hypogonadism - a condition that affects the production of the hormone testosterone,
  • over-active thyroid gland (hyperthyroidism),
  • under-active thyroid gland (hypothyroidism), and
  • Cushing's syndrome - a condition that affects the production of a hormone called cortisol.

Anatomical conditions

Examples of anatomical conditions include:

  • Peyronie's disease - a condition that affects the tissue of the penis, and
  • hypospadias - a congenital condition that causes the urethra (the urine tube) to develop abnormally.

Medicinal causes of erectile dysfunction

In some men, a number of medicines can cause ED, including those that are listed below.

  • Diuretics - medicines that increase the production of urine, and are often used to treat high blood pressure (hypertension), heart failure, and kidney disease.
  • Antihypertensives - medicines, such as beta-blockers, that are used to treat high blood pressure (hypertension).
  • Fibrates - medicines that are used to lower cholesterol levels.
  • Antipsychotics
  • Antidepressants
  • Steroids
  • Immunosuppressants - medicines that are used suppress the immune system.
  • H2-antagonists - medicines that are used to treat stomach ulcers.
  • Anticonvulsants - medicines that are used to treat epilepsy.

If you are concerned that a prescribed medication is causing ED, you should speak to your GP about it because an alternative medication may be available.

However, do not stop taking a prescribed medication without first consulting with your GP.

Psychological causes of erectile dysfunction

Possible psychological causes of ED include:

  • depression,
  • anxiety,
  • stress, and
  • unresolved relationship problems with your partner.

ED can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of ED.

Other causes of erectile dysfunction

Other possible causes of ED include:

  • obesity,
  • smoking,
  • alcohol,
  • tiredness, and
  • using illegal drugs, such as cannabis, or cocaine.

Sometimes, cycling can also be a cause of ED. People who spend more than three hours a week cycling may experience ED due to the saddle placing pressure on the nerves in their penis.

view information about Erectile Dysfunction on www.nhs.co.uk »

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The information provided on this website (including any NHS Choices medical information) is for use as information or for educational purposes only and is not a substitute for professional medical care by a qualified doctor or other qualified healthcare professional. We do not warrant that any information included within this site will meet your health or medical requirements. This Embarrassing Bodies site does not provide any medical or diagnostic services so you should always check with a health professional if you have any concerns about your health.


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