Blog What causes erectile dysfunction?
a man looking worried while his partner sleeps in the background

Erectile dysfunction (ED) is the most common sex-related issue men report to their doctor, affecting as many as one in five men in the UK. Although most of the time the cause of ED is nothing to worry about and is usually easily treatable, the condition can also be linked with increased risks of other underlying conditions such as cardiovascular disease and dementia. For this reason, it is essential you understand the potential causes of ED and always seek professional medical attention if you are concerned about this area of men’s health

In this blog, we explain exactly what ED is before focusing on a range of the most common causes, from stress and overtiredness to medical side effects and psychological causes. Read on to find out more. 

What is erectile dysfunction?

Erectile dysfunction, also referred to as impotence, is characterised by the inability to achieve and/or sustain an erection sufficient for full sexual intercourse. A very common condition and one usually linked with age, ED is thought to occur at least occasionally in around half of all men between the ages of 40 and 70. This is typically nothing to worry about. However, ED can also become a regular occurrence in men of all ages and, when this is the case, it can be very distressing for sufferers. Away from the physical symptoms of ED, this condition can impact men pyschologically, affecting confidence and self-esteem, preventing them from enjoying a full sex life, and potentially even damaging relationships.
Fortunately there are plenty of treatments to fight the symptoms of ED. However, before a medical solution is sought, it is important that the potential causes of ED are addressed. Below we look in detail at some of the most common causes.

What are the physical causes of erectile dysfunction?

Fundamentally speaking, ED is caused by restricted blood flow to the penis. As mentioned above, this can be caused by a number of medical issues including:

  • – Hormonal imbalances such as underactive or overactive thyroid glands and Cushing’s syndrome. These conditions can impact the production of testosterone which can trigger erectile problems.
  • – Anatomical illnesses such as Peyronie’s disease, which can impact the tissue of the penis, can also contribute to bouts of ED.
  • – Disorders of the nervous system and/or congenital problems with the structure or development of the penis through childhood. 
  • – Cardiovascular conditions, including heart disease, diabetes and high blood pressure
  • – Chronic neurological conditions such as Parkinson’s disease and multiple sclerosis. 
  • – Trauma, injury or as a result of surgical treatments. This is most common in procedures that impact the penis, pelvic area, or spine.

Can exercise cause erectile dysfunction?

This is a bit of a paradox. Although exercise is generally good for your health, and can indeed help to reduce the risk of ED if done in moderation, excessive exercise can actually cause problems with your sexual potency. This is a fine line, but the key is to remember to always exercise within your healthy limits and to be careful when it comes to sports that require concerted effort, such as weight lifting. 

It’s also important to note that excessive cycling can cause impotence. This is because bike saddles put constant pressure on the perineum – the area between the genitals and the anus – while cycling. This can damage nerves and temporarily slow blood flow in this area. To avoid this, consider wearing padded bike shorts, taking regular breaks during long rides and exchanging your standard bike saddle for a wider, more comfortable seat.

What drugs cause erectile dysfunction?

There are a number of commonly prescribed medications that have been linked to ED. These include certain antihistamines, antidepressants, beta blockers, anti-androgens, anti-ulcer drugs, diuretics, certain drugs used as part of chemotherapy, and more. If you are concerned that any medication you are taking may be causing issues when it comes to achieving or maintaining an erection, speak to your GP. There may be alternative treatments available to you.

Can heart medication cause erectile dysfunction?

As touched upon above, some heart medication can contribute to ED. For example, diuretics and beta blockers, commonly prescribed to treat a range of heart-related conditions such as heart failure and high blood pressure, have been linked to ED. This includes common drugs such as atenolol (Tenormin), metoprolol (Lopressor), bisoprolol (Zebeta) and propranolol (Inderal). Once again, if you take any of these medications and are concerned they are causing ED, speak to your GP.

Does alcohol cause erectile dysfunction?

Drinking a large volume of alcohol can cause temporary erectile dysfunction. This is because, when you are drunk, the alcohol in your body can interfere with the messengers in your brain that tell the penis to fill with blood. Interestingly, extreme fatigue and the consumption of recreational drugs can result in impotence in this way too.

Alcohol can also reduce the amount of testosterone produced in your body. This means that, over a long enough period, alcohol abuse can contribute to ED too.

How to know if erectile dysfunction is psychological

Aside from physical and medical reasons, ED can also be caused by psychological conditions such as stress, anxiety and depression. Common emotional issues such as sexual inexperience, past sexual problems and/or relationship issues have all been linked to ED. Interestingly however, psychological causes of ED can also be linked to physical causes. For example, if you suffer from heart disease or high blood pressure which is impacting your ability to get an erection, you may start to feel self-conscious about this issue, which in turn can contribute to the problem.  

One rudimentary method of determining whether or not your ED is psychological is to perform the ‘tissue paper test’. To do this, simply wrap a very thin and narrow piece of tissue paper around your flaccid penis, securing it with a small piece of tape, before going to bed. If you wake up in the morning to find the paper torn, it is likely an erection was achieved while sleeping, meaning the cause of ED is not physical but rather psychological. On the other hand, if the paper remains intact, the reason is more likely to be physical. However, it is important to remember that this is a very basic test with a large margin for error. For this reason, whatever you believe is the cause of your ED, it is important to speak to your doctor if the issue becomes a regular occurrence. 

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