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Erectile Dysfunction

Causes of Erectile Dysfunction

According to the NIH, ED also is a symptom in many disorders and diseases. Causes of ED include the following:

  • Premature ejaculation (PE). Premature ejaculation is the inability to maintain an erection long enough for mutual satisfaction. Premature ejaculation is divided into primary and secondary forms. Primary premature ejaculation is a learned behavior that begins when a male first becomes sexually active (as opposed to organic or physical) impotence. Secondary premature ejaculation occurs when, after years of normal ejaculation, the duration of intercourse grows progressively shorter. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both.
  • Performance anxiety. Performance anxiety is a form of psychological impotence, usually caused by stress or anxiety.
  • Depression. Depression is another cause of psychological impotence. Some antidepressant medications cause erectile failure.
  • Organic impotence. Organic impotence involves the penile arteries, veins, or both, and is the most common cause of impotence, especially in older men. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. The controllable risk factors for arteriosclerosis--being overweight, lack of exercise, high cholesterol, high blood pressure, and cigarette smoking--can cause erectile failure often before progressing to affect the heart. Many experts believe that when veins are the cause, a venous leak or "cavernosal failure" is the most common vascular problem.
  • Venous leak. Venous leak may be caused when the veins in the penis cannot prevent blood from leaving the penis during erection. This may be congenital or result from damage to the veins of the penis.
  • Diabetes. Impotence is common in persons with diabetes. The process involves premature and unusually severe hardening of the arteries. Peripheral neuropathy, with involvement of the nerves controlling erections, is commonly seen in persons with diabetes.
  • Neurologic causes. There are many neurological (nerve problems) causes of impotence. Diabetes, chronic alcoholism, multiple sclerosis, heavy metal poisoning, spinal cord and nerve injuries, and nerve damage from pelvic operations can cause ED.
  • Drug-induced impotence. A great variety of prescription drugs, such as blood pressure medications, anti-anxiety and antidepressant medications, glaucoma eye drops, and cancer chemotherapy agents are just some of the many medications associated with impotence.
  • Hormone-induced impotence. Hormonal abnormalities such as increased prolactin (a hormone produced by the anterior pituitary gland), steroid abuse by body-builders, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause impotence. Rarely is low testosterone responsible for impotence.
  • Peyronie's disease. Peyronie's disease is a rare inflammatory condition that causes scarring of erectile tissue that may result in curvature of the penis. This condition can impair sexual function.

Locations for Erectile Dysfunction