Causes

Erectile dysfunction (ED) is a particularly common condition that affects men’s quality of life. It increases with age, and especially in people over 40. Erectile dysfunction is particularly common in men of all ages. Up to the age of 40, their etiology is usually psychogenic, while after that and as age increases, organic causes prevail.  However, it is not solely a matter of aging.

An erection is a vascular phenomenon, since it is characterized by an increase in blood flow to the corpora cavernosa, the 2 cylinders inside the penis that fill with blood after sexual stimulation to achieve an erection. Psychological causes such as stress, depression and relationship issues can worsen or even initiate erectile dysfunction symptoms.

These findings highlight the importance of holistic approaches to its treatment, considering both physiological and psychosocial factors in prevention and treatment strategies.

Common Causes

Erectile dysfunction (ED) can result from a variety of physical and psychological factors, often interacting in complex ways. The main causes are summarized:

Main causes of erectile dysfunction

Vascular problems: They make up 70% of organic erectile problems. And this is because the blood flow to the penis is affected. Conditions such as atherosclerosis (hardening of the arteries), high blood pressure and diabetes can damage the small blood vessels, preventing adequate and rapid blood flow to the penis.

Neurological disorders: Conditions that affect the nervous system, such as multiple sclerosis, Parkinson’s disease, and spinal cord injuries, can affect the nerve signals necessary to achieve and maintain an erection.

Hormonal conditions: Testosterone deficiency, often associated with aging (hypogonadism), but also affected by conditions such as obesity or certain medical treatments, can contribute to erectile dysfunction.

Medications: Some medications, including those for high blood pressure, depression, anxiety, and prostate conditions, can have side effects that affect erectile function.

Psychological Factors: Psychological problems such as anxiety, depression, low self-esteem and relationship problems can contribute to erectile dysfunction, either as a primary cause or as an aggravation of existing physical conditions.

Lifestyle factors: Unhealthy lifestyle choices such as smoking, excessive alcohol consumption, drug abuse, and lack of regular exercise can increase the risk of erectile dysfunction by affecting blood flow and overall health.

Penile conditions: Certain anatomical issues, such as Peyronie’s disease (the growth of scar tissue inside the penis) or conditions that affect the structure of the penis (eg, phimosis), can lead to difficulties with erection.Surgical procedures: Pelvic surgeries, such as radical cystectomy or prostatectomy, abdominoperineal bowel resection, mainly cause damage to the erectile nerves, but also sometimes to the arteries. Radical prostatectomy for the treatment of localized prostate cancer is the most common surgery associated with erectile dysfunction. The extent of erectile dysfunction after radical prostatectomy can vary depending on factors such as the surgical technique used, the patient’s age, overall health, and pre-existing erectile function.

Psychological trauma or past experiences: Past traumatic sexual experiences or cultural/familial attitudes towards sex can also affect erectile function.  Understanding the underlying causes of erectile dysfunction is critical to effective treatment, which may include lifestyle changes, counseling, medication, or other interventions tailored to address the specific contributing factors.