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What causes E.D. (erectile dysfunction)?

The term ED refers to the inability of men to sustain an erection.

It can happen in all age groups and could sometimes be multifactorial.

This article will attempt to answer any questions that might arise and is by no means a complete list.

By far, the most common cause of ED is smoking.

Recreational issues

If you smoke at age 17, enough changes occur in the circulatory system to cause noticeable erectile dysfunction by the age of 35. It is the single most preventable cause of ED.

Marijuana has been linked not only to erectile dysfunction, but also on decreased sperm volume and quality of sperm.

Any hallucinatory, mind altering or hypnotic drugs can cause difficulty, also pain medications which act as a suppressant of sensory input have been cited.

Mental issues such as depression, anxiety and stress in itself can cause problems, but also the treatment of it can lead to ED. In Younger men, problems with body image or perceived expectations can cause what is referred to as performance anxiety, which can be during the first date. Questions as how one measures up in relation to girlfriend’s previous encounters, premature ejaculation can lead to difficulty with erections.

Medical conditions such as diabetes in particular can cause damage to the nerves, and blood supply to the genital organs called peripheral neuropathy, microangiopathy which causes decreased sensations, macroangiopathy causing the inability to pump enough blood to attain and maintain erections.

Obesity which may or may not be related to diabetes is also a significant factor. Heart conditions, history of heart attacks are inextricably linked to erectile function, that ED can be used as a predictor of future heart disease.

Certain Blood pressure medications in some patients can cause ED while no effect in others.

A decrease in the male hormone testosterone will cause a drop in libido and sexual function and can be due to several reasons. Although a slow drop in testosterone with aging is normal, a significant decrease can be due to poor liver function, loss of testicular tissue, suppression due to certain medications , alcoholism etc.

Cirrhosis can be caused by viral infections (hepatitis), liver damage due to excessive alcohol intake, or biliary problems

Infections such as prostate infection, which make ejaculation uncomfortable and hard to achieve, groin and back pain and burning/ pain during ejaculation. Venereal diseases such as gonorrhea and chlamydia can cause these symptoms, although prostatitis most often is nonbacterial and more inflammatory in nature.

Surgery such as abdominal aneurysm repair, radical prostate removal, spinal cord operations, or injury can have the unfortunate side effect of either decreased blood supply or innervation to the penis.

Contact The Writers

Dr Paul M.

Senior Medical Staff Columnist


Dr Paul M. is a board certified surgeon with over 35 years of experience. He has held the title Chief of Staff at several hospitals and maintained a private practice for many years.