What Really Causes Erectile Dysfunction? 5 Common Causes of ED

Dr. Niket Sonpal
March 8, 2018

What Really Causes Erectile Dysfunction? 5 Common Causes of ED

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Getting (and maintaining) an erection requires a surprising amount of things to go right. You have to get aroused, then pass that signal from your brain, through your nerves and hormones, to your blood vessels and muscles before an erection can even happen. If one thing goes wrong in that complicated exchange between your cardiovascular, and nerve system, and your hormone levels, blood vessels, and even your mood the result is usually erectile dysfunction. In other words, getting an erection is hard.

But don’t panic. ED can be caused by a number of factors, from depression and medication side effects to high blood pressure, high cholesterol, low testosterone levels, Peyronie’s disease, nerve damage, performance anxiety, heart disease, diabetes, and more. Even better, many of these ED causes are treatable with medication and simple lifestyle changes. It’s important to know the root cause of your erectile dysfunction in order to treat it in the fastest, most effective way possible. Here are the 5 most common causes of erectile dysfunction.

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Table of Contents

ED & Cardiovascular Health

Erectile dysfunction is often an early warning sign of more serious problems like hypertension, diabetes, obesity, and cholesterol. That’s why we call ED your body’s “check engine light”. The blood vessels in the penis are smaller than the rest of the body, especially the blood vessels that lead to the heart and brain. So ED is usually the first sign of high cholesterol or high blood pressure before a blockage causes more serious problems, like a heart attack or stroke.

If you have existing risk factors for heart disease (diabetes, obesity, family history of heart problems, high cholesterol)–it may be time for a checkup of the old ticker. Improving blood flow and heart health can result in better, more frequent erections.

Medically Induced ED

ED medication

Many commonly used drugs can cause erectile dysfunction. Prescription medication and over-the-counter drugs can decrease libido, interfere with normal blood flow, or even cause absent seminal emission or retrograde ejaculation. In fact, 8 of the 12 most commonly prescribed medications list ED as a side effect. Medications that commonly cause ED include:

  • SSRIs
  • Beta Blockers
  • Anti-hypertensives
  • Diuretics
  • Antifungals such as Ketoconazole
  • Histamine H2-receptor antagonists used in the treatment of GERD
  • Non-steroidal anti-inflammatory drugs
  • Muscle relaxants
  • Antihistamines

If you’re experiencing ED, tell your physician the medications you’re taking.  A frank discussion can lead to alternative medications or treatments, and a better discussion about ED. Just remember that you should never stop taking a prescription medication without the supervision of a doctor.

Recreational Drugs & Erectile Dysfunction

Now moving away from legal drugs and onto recreational drugs. Research and reports have shown that almost all recreational drugs have been implicated in ED. This includes:

  • Alcohol
  • Amphetamines
  • Barbiturates
  • Cocaine
  • Marijuana
  • Methadone
  • Nicotine
  • Opiates

Illegal drugs don’t just affect and suppress the central nervous system. They cause serious damage to blood vessels. And any damage to blood vessels or normal blood flow will eventually cause erectile dysfunction. Some experts even argue that a single use of any of these chemicals can lead to subsequent ED. Chronic use raises the risk even more. If you have a substance addiction speak to your physician. There’s always help available.

Diabetes Mellitus and ED

A study of 7,689 participants found that 61% of men with diabetes aged 55 to 59 years had ED. And it makes sense that poor blood sugar control leads to erectile dysfunction.

Diabetes leads to vascular complications throughout the body and the penis is no exception. A large survey reported that the majority of men with diabetes and ED had never even been asked about their sexual function. That means they never received treatment for ED. If you think you might have diabetes or even prediabetes, talk to your doctor about ED.

Cycling and ED

erectile dysfunction causes

What’s good for the soul (cycle) may not be good for your member. The research is somewhat controversial, but the link between cycling and ED is getting stronger. In fact, anything that places pressure on the pudendal artery can result in penile numbness and impotence. For those of you who don’t remember these from anatomy class, this is the area commonly referred to as the “undercarriage.”

The pudendal arteries supply blood to the sex organs and the perineum and all structures in that area. This doesn’t mean to stop cycling cold turkey. But if you are experiencing ED, and you cycle (a lot), it might be time to make a stop on the Tour De Doctor’s Office to see if pressure on your pudendal artery is to blame.

5 Common Causes of Erectile Dysfunction

Not enough info for you? No problem. Nerd out on all the causes of erectile dysfunction with research from the most trusted sources on the interwebs. If you have any questions or you think we missed something important, leave a comment or book a consultation with one of these trained professionals and we’ll get you on the way to a healthier manhood.

This information isn’t a substitute for professional medical advice, diagnosis, or treatment. You should never rely upon this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He’s a practicing Gastroenterologist and Hepatologist with a focus on Men’s and Women’s Health, and a regular contributor to Women’s health, Shape and Prevention Magazine.

Dr. Niket Sonpal

Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.

All stories by:Dr. Niket Sonpal
5 comments
  • Claudio Rohrsetzer March 25, 2018 at 3:21 pm

    Excellent and important information, thanks Dr. Niket.

  • Phil Castellano May 10, 2018 at 9:54 am

    You might not feel it in everyday lives of men but we must not neglect every symptom that you feel that is stated above to avoid some serious diseases that might happen.

  • George V Yiannakopoulos October 24, 2019 at 7:41 pm

    I have diabetes. Viagra and penile injections used to work but now they dont.
    I tried the vacum pump but that never worked. Before I install the penis implant is there a way to clear or unplug the blood vessels that lead to my penis?

  • Wow, it’s interesting that around 61 percent of men with diabetes from 55 to 59 had ED. My dad told me last week he noticed how things weren’t working there properly and he will be tested soon. I appreciate the information and I’ll be sure to pass this along to him and keep it in mind to avoid it myself.

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Dr. Niket Sonpal

Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.

All stories by:Dr. Niket Sonpal