Erectile dysfunction (ED) is caused by a variety of physical, psychological, and lifestyle factors that interfere with the ability to achieve or maintain an erection. The main causes include:

Physical Causes

• Blood vessel disorders: Conditions like atherosclerosis (hardening of the arteries), high cholesterol, high blood pressure, diabetes, and smoking can reduce blood flow to the penis, which is essential for an erection

• Nerve damage: Damage to the nerves controlling erections can result from diabetes, spinal cord injuries, multiple sclerosis, stroke, prostate surgery, or prolonged pressure on nerves (e.g., from cycling)

• Hormonal imbalances: Low testosterone, thyroid disorders, increased prolactin, or hormone treatments for prostate cancer can contribute to ED

• Structural problems: Peyronie’s disease causes scar tissue in the penis, leading to curved, painful erections and ED

• Medications: Many drugs, including those for high blood pressure, depression, anxiety, prostate conditions, and chemotherapy, can cause ED as a side effect

• Chronic illnesses: Heart disease, kidney disease, obesity, and chronic obstructive pulmonary disease are linked to ED

• Injuries or surgeries: Pelvic or spinal injuries and surgeries, especially prostate surgery, can damage nerves or blood vessels involved in erections

Psychological Causes

• Mental health conditions such as depression, anxiety, stress, and relationship issues can reduce sexual desire and interfere with the brain's signals needed to trigger an erection

Lifestyle Factors

• Smoking, excessive alcohol consumption, illicit drug use, lack of physical activity, and obesity increase the risk of ED by affecting blood flow, nerve function, and hormone levels

In many cases, ED results from a combination of these factors rather than a single cause

. This comprehensive understanding highlights that erectile dysfunction can be a symptom of underlying health problems, and addressing these can improve erectile function.