Erectile dysfunction can be caused by any number of physical and psychological factors. In general, ED is divided into organic (having to do with a bodily organ or organ system) and psychogenic (mental) impotence, but most men with organic causes have a mental or psychological component as well.
Erection problems will usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety and stress that can further interfere with normal sexual function. This "performance anxiety" needs to be recognized and addressed by your doctor.
If you are troubled by occasional erectile dysfunction, remember that arousal takes longer as you get older and that satisfaction should not be equated with performance. If dysfunction is severe and persistent, you should seek medical help. The number of treatment options has increased in recent years.
Many doctors will recommend changes in lifestyle as a first step in treatment. Suggestions may include the following:
Cut back on alcohol.
Stop any tobacco or illegal drug use.
Almost any disease can affect erectile function by altering the nervous, vascular, or hormonal systems. Various diseases may produce changes in the smooth muscle tissue of the penis or influence mood and behavior.
Vascular diseases account for nearly half of all cases of ED in men older than 50 years. Vascular disease includes atherosclerosis (fatty deposits on the walls of arteries, also called hardening of the arteries), a history of heart attacks, peripheral vascular disease (problems with blood circulation), and high blood pressure. Prolonged tobacco use (smoking) is considered an important risk factor for ED because it is associated with poor circulation and reduced blood flow in the penis.
Trauma to the pelvic blood vessels and nerves is another potential factor in the development of ED. Bicycle riding for long periods has been implicated, so some of the newer bicycle seats have been designed to soften pressure on the perineum (the soft area between the anus and the scrotum).
Medications used to treat other medical disorders may cause ED.
Systemic diseases associated with ED
High blood pressure
Renal (kidney) failure
Hemochromatosis (too much iron in the blood)
Cancer and cancer treatment
Diseases of the nervous system associated with ED
Trauma (including spinal trauma)
Respiratory disease associated with ED: Chronic obstructive pulmonary disease