Erectile Dysfunction

What is erectile dysfunction?

Erectile dysfunction, otherwise known as ED or impotence, is the condition of being unable to get or maintain an erection. It is a common condition that most males will experience at some stage in their life, though it is most prevalent in older men. Erectile dysfunction is usually temporary, though it can also be recurring.

The potential causes of this condition are numerous, including both physical and psychological factors. In most cases, erectile dysfunction can be successfully managed, with treatment options depending on the root cause of the disorder.[1]

Erectile dysfunction symptoms

The symptoms of erectile dysfunction are:

  • An inability to get an erection
  • An inability to maintain an erection during sexual activity

These symptoms may come and go over time or be situational, for example, not present during masturbation but present with a partner. If symptoms occur regularly or semi-regularly, visiting a doctor is advised.[2]

Erectile dysfunction causes

Erectile dysfunction can be caused by a variety of physical and psychological factors.[3]

Physical causes

Most cases of erectile dysfunction are caused by physical factors, which include:

  • The most common cause for erectile dysfunction is reduced blood flow to the penis. This happens as a result of a narrowing of the arteries in the penis, with ageing, high blood pressure, high cholesterol and smoking making this more likely.
  • Excessive intake of alcohol or drugs can impair the ability to get or maintain an erection.
  • Diabetes, which can affect blood vessels and nerves, is another common cause of erectile dysfunction.
  • Conditions, such as Parkinson’s disease, multiple sclerosis and stroke, can make erectile dysfunction more likely.
  • In some cases, erectile dysfunction can occur as a side-effect of medications, such as antidepressants, beta blockers and some diuretics.
  • A lack of certain hormones, particularly testosterone, can lead to erectile dysfunction, though this is uncommon.
  • Injury to the nerves in the penis as a result of surgery to nearby areas or spinal injury, for example, can lead to erectile dysfunction.

If the causes of erectile dysfunction are physical in origin, the condition is more likely to appear gradually, with the problem occurring intermittently before getting more frequent. An individual’s sex drive is unlikely to be affected, unless the root cause is hormonal in nature.

Psychological causes

A range of mental health issues can lead to the development of erectile dysfunction, including:

  • Depression
  • Stress/Pressure
  • Anxiety
  • Relationship issues

Purely psychological causes for erectile dysfunction are rare, limited to approximately 10 percent of cases.[4]

Psychological causes typically result in the sudden onset of the condition, as opposed to the gradual development caused by physical factors. When an individual is able to sometimes get and maintain a healthy erection (for example, when masturbating or in the morning) it may be a sign that their erectile dysfunction is psychological in origin.

Diagnosing erectile dysfunction

The first stage in diagnosing erectile dysfunction is visiting a doctor, who will typically begin with questions regarding:[5]

  • The symptoms experienced
  • The length of time symptoms have been present
  • General physical and mental health
  • Levels of alcohol and drug intake
  • Whether any other medication is also being taken

It may also be necessary for an individual to answer questions about their sex life. These may include:

  • Details of current and past sexual relationships
  • Information about sexual orientation
  • Whether the dysfunction occurs all the time, intermittently or only in certain situations
  • Whether ejaculation is possible
  • Libido (levels of sexual desire)

As narrowed blood vessels are the most common cause of erectile dysfunction, a doctor will usually examine an individual’s cardiovascular condition as part of the diagnosis. This may involve testing for high blood pressure, checking for heart irregularities, as well as evaluating an individual’s weight or overall level of health.

Blood tests may also be ordered to check for underlying medical conditions that may be causing the condition.

  1. Patient. “Erectile Dysfunction (Impotence).” April 1, 2016. Accessed August 25, 2017.

  2. Healthline. “Everything You Need to Know About Erectile Dysfunction.” May 17, 2017. Accessed August 25, 2017.

  3. Patient. “Erectile Dysfunction (Impotence).” April 1, 2016. Accessed August 25, 2017.

  4. The British Association of Urological Surgeons. “Erectile dysfunction (impotence).” Accessed August 25, 2017.

  5. NHS Choices. “Erectile dysfunction (impotence) - Diagnosis.” September 23, 2014. Accessed August 23, 2017.