There are various forms of erectile dysfunction. Someone who has ED may have just one of these problems or he may experience all of these at different times.

  • Inability to develop an erection: Despite sexual desire and stimulation, one is unable to obtain an erection.
  • Obtaining erections which are neither rigid nor full: It is possible to obtain an erection but cannot become hard and/or full enough for sexual intercourse.
  • Inability to maintain an erection: One can develop a complete erection but cannot maintain it long enough to complete intercourse.

Common Causes of ED may include:

High Cholesterol

Cholesterol can accumulate in the blood vessels of the penis just like it can accumulate in the blood vessels of the brain, heart, and other areas. This leads to decreased blood flow to the penis and can cause the inability to get and maintain an erection. According to a study conducted by the Japanese Urological Association, 26% of men with ED have high cholesterol.

High Blood Pressure

According to the Massachusetts Male Aging Study, 15% of men on treatment for high blood pressure have complete ED. High blood pressure can cause your blood vessels to become stiff and narrow throughout the body, including the penis. It can also decrease the response your blood vessels have to signals your body produces telling them to open wider or dilate. This ultimately causes decreased blood flow to the penis which can lead to erectile dysfunction. Medications commonly used to treat high blood pressure can also lead to erectile dysfunction.


Diabetes and poor control of blood sugar levels can eventually lead to nerve damage and thickening and hardening of the blood vessels. Nerve damage can decrease your ability to develop an erection and thickening and hardening of arteries can decrease the necessary blood flow. Both of these effects can negatively affect your ability to get and maintain an erection.

  • The New England Journal of Medicine reported in a recent study that the prevalence of ED is 3 to 4 times higher in men with diabetes
  • In a recent study, approximately 64.4% of men with diabetes had ED versus the general population in which only 10.73% have ED prevalent in their lives.
  • Of this 64.4%, 40% of them will fail on treatment pills (PDE5 inhibitors such as Viagra)
  • Of this 40% that fail, 85% of them will achieve success with an intracavernosal injection
Prostate Cancer

There are many different treatments that men who have prostate cancer may undergo which can lead to ED

  • Radical prostatectomy (removal of the prostate)? Nerve bundles that are located on the sides of the prostate are essential for the initiation of an erection. Having a prostatectomy can damage these nerves.
  • Radiation ? ED caused by radiation takes time to develop. Radiation can damage the blood vessels that carry blood to the nerves that are needed to initiate an erection
  • Hormone therapy? The hormone therapy used to treat prostate cancer centers around stopping testosterone production because testosterone usually makes the tumor grow. Unfortunately, testosterone is responsible for sex drive and is needed to obtain and maintain an erection.

Both the psychological factors and medications associated with depression may cause ED. Although psychological reasons only account for approximately 10% of all ED cases, behaviors associated with depression such as inactivity, lack of exercise, and poor eating habits may contribute to ED issues.

Antidepressants and anti-anxiety drugs have been known to cause ED because of how they affect nerves and blood circulation. Examples of some medications are Prozac, Zoloft, Sinequan, Ativan, Serax, and Dilantin.

It is important to check with your doctor to find a balance between treating your depression issues and ED.


Emotional stress caused by anything from financial problems, to relationship issues and anything in between can lead to erectile dysfunction. When you’re under stress, your body undergoes physiological changes that can hinder the ability to get an erection and may make it hard to keep an erection.

Urinary Tract Symptoms

Do your hormones decline because you age or do you age because your hormones decline? Hormone deficiencies currently affect over 55 million men and women in the United States. As we age, hormone levels decline affecting our social functioning, productivity, sexual desires, and overall health. Andropause is the result of low testosterone and decreasing DHEA throughout the male body. In a study done by the World Health Organization, men have only 10 percent of the androgen levels at age 70 than what they had at age 25. The changes in your hormonal levels are very gradual with age, however are more likely to develop earlier in conjunction with diabetes, hypertension, and various other genetic disorders.

Andropause is commonly misdiagnosed as ED, therefore men are put on treatments that will not solve their sexual dysfunction. It is important to take our self-assessment to uncover the cause of your ED which will allow us to apply the most appropriate method of treatment for your situation.

Just like women go through menopause, men can experience andropause. Andropause is when the body’s level of testosterone decreases. This change is gradual and can occur over the course of many years. As all men age testosterone levels decrease, but not all men experience symptoms of andropause. The decrease in testosterone can lead to decreased libido as well as erectile dysfunction.


Diabetes, high blood pressure, high cholesterol, and lifestyle habits can all contribute to erectile dysfunction. The chance of developing ED is 60% greater if one is overweight. Obesity increases the risk of developing type II diabetes and high blood pressure. It also increases the aromatization of testosterone in men to estradiol and causes a decrease in the sex hormone binding globulin. Having a healthy diet can help keep cholesterol levels under control and losing weight can lower blood pressure and the risk of diabetes.

Lifestyle habits such as alcohol consumption, smoking, and lack of exercise will also increase the risk of ED. Attempt to limit these activities and see if your ED cases begin to decrease. If not, it is important to see a doctor and review your available treatment options. Studies have shown that the correcting lifestyle risk factors will improve the overall success rate of ED treatment methods to 82%. Click on the link below to get started and find out more information about making an appointment with a doctor today!

Drug Side Effects

There are many medications that can have ED as a side effect

  1. Antihypertensives
    • Beta-blockers: atenolol, metoprolol, propranolol
    • Calcium channel blockers: verapamil, nifedipine
    • Diuretics: furosemide, spironolactone, hydrochlorothiazide
    • ACE inhibitors: enalapril, captopril
  2. NSAIDS ? examples: naproxen, indomethacin, ibuprofen
  3. H2-blockers(medications to treat heartburn/GERD) ? examples: cimetidine ranitidine
  4. Anti-Parkinson medications ? examples: levodopa, benxtropine, bromocriptine
  5. Antihistimines ? examples: diphenhydramine, meclizine
  6. Antidepressants ? examples: fluoexitine, sertraline, nortriptyline, desipramine, amitriptyline
  7. Anti-anxiety medications ? examples: diazepam, lorazepam

Other medications and substances that can cause ED are:

  1. Alcohol
  2. Nicotine
  3. Marijuana
  4. Cocaine
  5. Barbiturates
  6. Methadone
  7. Amphetamines

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