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The Most Common Causes of Impotence and Erectile Dysfunction
Statistics regarding impotence and erectile dysfunction are sketchy. As cited by Merck in the Merck Manual for Health Care Professionals, at le...

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Statistics regarding impotence and erectile dysfunction are sketchy. As cited by Merck in the Merck Manual for Health Care Professionals, at least 10 to 20 million men in the United States alone suffer from erectile dysfunction. Experts believe that the number may actually be higher because men aren’t comfortable speaking to their doctors about their sexual problems. What many men don’t realize is that most men at some point in their life will experience some form of erectile dysfunction.

What Is Impotence and Erectile Dysfunction?

Impotence refers to a man’s inability to get or maintain an erection long enough to have sexual intercourse. Having trouble getting or keeping an erection on occasion is quite common and not generally a cause for concern, but if it happens more than just on occasion, then it needs to be addressed with your doctor. Erectile dysfunction can be a sign of an underlying health condition like diabetes or heart disease. Regardless of the cause of impotence, left untreated it can take a toll on your relationship and your self-confidence.


Again, experiencing problems with erections once in a while is something that happens to most men at some point over the course of their lives. It is when the following symptoms are persistent or become a problem for you and your partner that you need to be concerned:

  • difficulty getting erect
  • difficulty keeping a strong erection
  • reduced sex drive

Causes of Erectile Dysfunction

There are several factors that play a role in a man’s sexual arousal, both physical and emotional in nature. The causes of erectile dysfunction can be as simple as a side effect from a medication, the result of an illness, or from stress and relationship issues. Here, we break down the physical and psychological causes of erectile dysfunction.

Common physical causes:

  • certain prescription medications
  • heart disease
  • diabetes
  • high blood pressure
  • high cholesterol
  • low testosterone levels
  • metabolic syndrome
  • obesity
  • multiple sclerosis
  • Parkinson’s disease
  • cancer treatments
  • Peyronie’s disease
  • certain surgeries
  • drug and tobacco use
  • excessive alcohol consumption

Common psychological causes of erectile dysfunction:

  • depression
  • anxiety
  • stress
  • various mental health issues
  • relationship issues stemming from resentment, anger, lack of trust, etc.

Risk Factors

As you can see, there are many things that can cause erectile dysfunction. Along with all of the causes already listed, you should know what other factors could be putting you at risk for developing an ongoing problem getting or maintaining an erection or getting aroused at all. The most common one is aging. As men get older, it becomes more difficult for them to get an erection.  In some cases, a little bit of extra touching and stimulation is all they need, while others may require treatment. A rarely discussed risk factor is prolonged cycling, which affects the flow of blood to the penis and can compress nerves, leading to temporary erectile dysfunction.


The first step in treating erectile dysfunction is an examination by a doctor. Your doctor will want a full rundown of your symptoms and will also want to talk to you about any stressors in your life that may be contributing to your impotence. He or she will try to figure out based on the information that you provide whether or not depression is a factor. A complete physical examination, including blood and urine tests and possibly an ultrasound, will also be used to determine what could be causing the problem. It’s not easy to talk to someone about your sexual health or your relationship, but the more candid you are about what’s going on, the easier it will be for your doctor to help you.

Your treatment will depend on what is found during your examination. If a medical condition such as high blood pressure or heart disease is deemed to be the cause, then treating that underlying condition is likely to improve the erectile dysfunction. If the cause is psychological, then counseling will likely be a part of your treatment and may include couples counseling if problems in your relationship are the cause of your impotence.

There are several treatment options available for erectile dysfunction that can help you to achieve and maintain an erection, including:

  • oral medications (sildenafil [Viagra], vardenafil [Levitra, Staxyn], tadalafil [Cialis])
  • self-injections of alprostadil (Caverject Impulse, Edex)
  • alprostadil intraurethral penis suppositories (Muse)
  • penis pumps

Other medications may be used, such as testosterone to treat low testosterone levels; anti-anxiety and antidepressants to treat anxiety and depression that could be causing erectile dysfunction; and high blood pressure medication, blood thinners, or insulin if an underlying medical problem is responsible for your symptoms.

Surgical options are also available in rare cases, including blood vessel surgery to repair damaged or blocked blood vessels that may be causing your impotence or penile implant surgery if all other treatment options have been exhausted to no avail.

Lifestyle Changes to Improve Erectile Dysfunction

There are lifestyle changes that you can make to help improve erectile dysfunction. Losing weight if you are obese will greatly improve your overall health, including your sexual health. A healthier diet and regular exercise will not only help you to achieve and maintain a healthy weight, which can impact your sexual health, but it also improves circulation and can help keep heart problems and diabetes under control.

Smoking and alcohol and drug use can all be contributing factors in erectile dysfunction and wreak havoc on your physical and mental health. Cut back on your consumption of these toxins, and seek help for treatment of an addiction.

Relaxation techniques such as yoga, meditation, deep breathing, and massage have been shown to help people deal with stress and anxiety. Exercise also has a relaxing effect, as does engaging in activities that you enjoy, such as walking, painting, or anything else that brings you pleasure and allows you to decompress.

Written by: Adrienne Longhurst
Edited by:
Medically Reviewed by: [Ljava.lang.Object;@287169e
Published: Feb 7, 2013
Published By: Healthline Networks, Inc.
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