Is a physical condition causing my ED?

It’s a good question. When you see (or feel, smell, hear, etc) something sexually stimulating, your brain sends a message to your body. The blood vessels in your penis relax and blood rushes in to fill them, creating an erection as your penis expands.

The part of your penis containing all the blood vessels (aka the corpora cavernosa) is surrounded by a membrane which helps keep the blood in place so you stay hard long enough for sex.

Erectile dysfunction can be a sign of an underlying medical condition. In fact, a physical cause can be identified in about 80% of cases. These causes fall into four main categories:

Vasculogenic conditions like cardiovascular disease, diabetes and high blood pressure affect how blood flows to your penis.
Neurogenic conditions like spinal injury, Parkinson’s disease and multiple sclerosis impact your nervous system, which can lead to ED.
Hormonal conditions like hyperthyroidism, hypothyroidism, low testosterone levels or Cushing’s syndrome can make it more difficult to get and maintain an erection.
Anatomical conditions like Peyronie’s disease, which happens when scar tissue forms over the penis, can cause ED.

Especially when erection issues appear suddenly or for the first time, it’s best to get them checked out in person by a doctor in case there’s an underlying illness that needs treatment.

Does diabetes cause ED?

Does diabetes cause ED? Yes, diabetes often causes erectile dysfunction. In fact, studies have shown that 35-75% of men with diabetes experience erectile dysfunction, versus only 26% of men in the general population. Additionally, erectile dysfunction tends to appear 10-15 years earlier in men with diabetes. This is because diabetes can damage your nerves and blood vessels, making it difficult to get and maintain an erection.

For men with diabetes, recognized options include oral prescription medications, non-drug clinical interventions (for example, vacuum constriction devices), and psychological support. But because diabetes often comes hand-in-hand with other health conditions like high cholesterol or high blood pressure, it’s important to make sure that the erectile dysfunction treatment doesn’t interfere with any other prescribed medication.

But having both diabetes and ED isn’t a done deal. Lifestyle changes that help manage conditions like diabetes, high blood pressure and high cholesterol can also help improve erectile function. Quitting smoking, exercising more and eating a healthy and varied diet have all been found to lower the chance of ED.

Enlarged prostate and ED

Prostate health and erectile function are linked, but it’s complicated. Benign prostatic hyperplasia (BPH) is a condition in which the prostate becomes enlarged and presses on the urethra in the penis. Prostate enlargement and ED are both more common in older men than younger men and while one doesn’t cause the other, some medications that treat BPH can have sexual side effects.

Different classes of prostate medications have potential risks for erectile function. For example, some hormone-blocking prostate therapies have a risk of contributing to long-term erectile difficulties, while other muscle-relaxing prostate medications generally show a lower incidence of sexual side effects.

Some prescription medications can be used to treat both ED and BPH at the same time. They work by relaxing the smooth muscle tissues in both the bladder neck and the blood vessels of the penis. You need a consultation with a doctor or urologist to safely evaluate your prostate symptoms and determine the most suitable treatment plan for you.

Can ED be a sign of prostate cancer?

No, ED is not typically a sign of prostate cancer. But while the condition itself doesn’t cause ED, various treatments for prostate cancer can. Some of the specific procedures that can lead to erectile dysfunction include hormone and radiation therapy as well as prostate surgery, where the prostate gland is removed. Sometimes, erectile function can be regained a few years after surgery.

High cholesterol and erectile dysfunction

Can high cholesterol cause ED? Yes. There are actually a few different ways in which high cholesterol can contribute to erectile dysfunction. High cholesterol makes it more difficult to produce certain chemicals and hormones in the body, like nitric oxide (necessary for erections) and testosterone (which impacts sex drive). Additionally, too much cholesterol creates plaque in your blood vessels, limiting blood flow to the penis.

STDs and erections: is ED a sign?

A sexually transmitted disease, or STD, is what happens when a sexually transmitted infection (STI) goes untreated. Although the two terms are often used interchangeably, they’re not quite the same. But in any case, erectile dysfunction is not usually a sign of an STI or STD.

That’s not to say they’re completely unrelated. Can an STD cause a man not to get hard? Possibly. STIs and STDs can both affect self esteem and cause psychological erectile dysfunction. Additionally, a painful STI can make it uncomfortable to have sex.

Can chlamydia cause ED? Yes, but this usually happens when untreated chlamydia causes prostatitis (an infection of the prostate) or epididymitis (swelling of the back of the testicles). Chlamydia can also make sex painful, so it’s important to get tested for STIs and STDs regularly.

Heart problems and ED: what’s the link?

Erectile dysfunction can be a warning sign of heart disease. The two conditions share a fundamental link: the health of the vascular system.

One heart problem that often appears alongside ED is coronary heart disease, which can cause a painful feeling of pressure in your chest called angina. Coronary heart disease happens when plaque builds up in the arteries and blocks blood flow to your heart and the rest of your body. Because the blood vessels in the penis are so small, ED can be a clue that something is also going on in the heart. Chronic heart failure and ED can also occur together. Erectile dysfunction and libido issues (low sex drive) were reported by up to 75% of patients with heart failure.

If you’re experiencing erectile dysfunction, it’s important to rule out heart problems before beginning treatment. Some medications which are used to treat some heart problems, aren’t safe to use with ED prescription treatments. Your doctor will ensure during your consultation that you are prescribed only medications that are safe for your specific needs.

Around 25% of all erectile dysfunction is caused by medication according to one Harvard report. However, some medications list erectile dysfunction as a possible side effect even though it’s actually caused by the underlying issue the medication is addressing. Always read the patient info that comes with any prescription, and talk to your doctor about side effects and contraindications (reasons why you shouldn’t take a specific medication).

Types of medication that can cause erectile dysfunction include:

• Antidepressants and anti-anxiety medication
• Medication for Parkinson’s disease
• Non-steroidal anti-inflammatory drugs
• Antihistamines
• Antiarrhythmics
• Medication for prostate cancer
• Muscle relaxants
• Diuretics
• Medication for high blood pressure
• Chemotherapy drugs

Can recreational drugs cause ED?

Recreational drug use changes how your body works and can cause lasting damage, including erectile dysfunction. By “recreational drug,” we mean illegal drugs, misused prescription drugs and legal drugs like tobacco products.

It’s important to let your doctor know about drug use when you’re getting help for ED. Without knowing the full picture, medical professionals can’t help you as effectively.

There are many lifestyle factors that can cause erectile dysfunction. Because many of these factors relate to daily habits, addressing them can be a positive step toward improving vascular health and supporting the recovery of erectile function.

The main lifestyle factors that can cause ED include:

• Smoking
• Lack of exercise
• A diet lacking in essential nutrients
• Overweight or obesity
• Metabolic syndrome
• Alcohol and recreational drugs

Smoking and erectile dysfunction

Smoking can cause ED. Research has continually shown that men who smoke have a higher risk of developing erectile dysfunction. And in 2014, ED was added to the list of conditions caused by smoking.

But how does smoking affect you sexually? Well, to get an erection, you need to be able to have proper blood flow to your penis. Cigarettes contain thousands of chemicals, which can have a negative effect on the health of your blood vessels and your ability to become erect.

Does chewing tobacco cause ED?

Some people mistakenly chew tobacco thinking that it is less harmful than smoking. However, there aren’t really any harmless tobacco products and chewing tobacco has many of the same risks as well as some additional ones.

Nicotine, the ingredient in both chewing and smoked tobacco, has been linked to decreased libido, infertility and, yes, erectile dysfunction. This is because it can affect (and in some cases damage) your blood vessels, which can make getting and keeping an erection difficult. For healthy erections, it’s best to stay away from all types of tobacco, including chewing tobacco and vaping.

Sleep hygiene and erections

Sleep hygiene (healthy sleep habits) is an important part of your general health, along with diet and exercise. Skipping sleep can make it hard to focus the next day and like all habits, the effects stack up. Studies have shown a link between poor sleep hygiene and negative health outcomes and, yes, being tired can cause ED.

Alcohol and ED

Can alcohol cause ED? Yes and no.

If you consume an amount of alcohol that’s equivalent to ‘binge ‘drinking’ (5 drinks or more), it’s quite possible you’ll have difficulty getting an erection later that night. However, occasionally being unable to get an erection is generally not a cause for clinical concern — if erectile dysfunction is happening so frequently that it’s affecting your quality of life, you should seek medical attention, though.

Chronic alcohol use can cause long-term nerve damage and hormonal imbalances that contribute to persistent erectile dysfunction. Long-term alcohol use can also cause other health problems as well, so try to drink in moderation.

Diet and ED

There aren’t any specific foods that cause erectile dysfunction, or specific foods that can help manage it. But while obesity doesn’t cause ED, poor diet and being overweight are both risk factors. That’s because being overweight increases the risk of health conditions like diabetes and heart disease — and those conditions can and do cause erectile dysfunction.

But if you’re concerned that being overweight is the cause of your ED, talk to your doctor. They’ll be able to help you create a plan for weight management that includes minor lifestyle changes.

There are a few injuries which can cause temporary or long-term erectile dysfunction, and they tend to fall into several categories.

First, there are injuries to the penis itself which, fortunately, are quite rare. Erectile tissue damage usually consists of acute rupture to the corpora cavernosa, which is the part of your penis containing all of the blood vessels that help it get hard when you’re aroused. If the injury happens over and over, scar tissue can form on your penis and cause a curved, painful erection. This condition is called Peyronie’s disease.

Neuropathy, or nerve damage, also contributes to erectile dysfunction. Penis nerve damage caused by diseases like diabetes and multiple sclerosis can lead to a feeling of numbness.This feeling can also be described as tingling or burning, like the pins and needles you get when an arm or leg falls asleep. Certain medications, like some that are used like selegiline, which is used to treat Parkinson’s disease, can also cause a loss of sensation in the penis.

Some studies have found that head injuries like concussions can cause erectile dysfunction

as can injuries to the spine.

Because structural and nerve injuries require medical evaluation, it’s essential to consult a clinician for a formal diagnosis and a suitable treatment plan.

Can a hernia cause ED?

The short answer is no. A hernia occurs when an internal part of your body, like an organ, pushes through a more external part, like your muscles or tissue walls. There are several different types of hernias depending on where in your body they happen — a hernia next to your groin is called an inguinal hernia.

While the hernia itself won’t cause erectile dysfunction, it might cause some discomfort. Some inguinal hernias present as lumps in your groin area with no other symptoms while others can cause nausea, vomiting or stomach pain. 

Although getting surgery If the hernia is causing significant discomfort or complications, a medical professional might recommend surgery. And because it’s possible that the hernia was causing you discomfort, studies have shown that it’s likely you’ll actually have better sexual function after your operation.

Will I get ED after a vasectomy?

A vasectomy is a common surgical method of permanent male contraception — it's the most effective method after abstinence, with a 99% long-term success rate, is non-hormonal and can sometimes be reversed.

If you’re considering a vasectomy, ED might be on your mind. But no physical link has been found between the vasectomy (a sterilization procedure that blocks sperm from reaching semen) and erectile dysfunction. The procedure does not alter the blood vessels, nerves, or hormones required to achieve or maintain an erection.

Although some men experience vasectomy impotence, it’s likely that this is psychological erectile dysfunction and not a result of the surgery. Psychological erectile dysfunction (also called psychogenic or mental ED) happens when you’re unable to get an erection but there’s nothing physically wrong. It’s commonly caused by things like stress and performance anxiety, and treatment options are available.