Erectile Dysfunction Causes

Erectile Dysfunction Causes

Erectile Dysfunction (ED) occurs when there isn’t enough blood flow into the penis. To help you understand what causes ED, it will probably help to first understand how an erection works.

How An Erection Works: 

1. When you’re aroused, nerve messages stimulate the penis.

2. Brain and nerve impulses cause the muscles of the penis to relax, letting more blood flow in. 

3. The increased blood flow creates a pressure in the penis, expanding the penis to create an erection.

4. The membrane of the muscles in the penis help to trap blood in the erectile tissue, maintaining the erection.

5. When the muscles of the penis contract, blood flow into the penis is stopped and flows out instead. That’s when the erection is reversed. 

The cause of impotence can be due to physiological or psychological reasons. In most cases, it can be a combination of both.

Physiological Causes of ED

Physiological causes are commonly the cause of ED in older patients especially. For example, ED can occur as a result of underlying health issues such as heart disease, diabetes, high blood pressure and high cholesterol, which make it more difficult to get an erection. 

Here are some common physiological causes of ED:

Insufficient blood flow into the penis  

Health issues such as diabetes, heart disease, high blood pressure or hardened arteries reduce blood flow into the penis 

Damage to the spongy muscle tissue in the penis

When a man has gone through radiation treatment or surgery near the pelvis or lower abdomen (i.e prostate, bladder or colorectal cancer)

The brain not sending the correct signals to the penis or the signals are not reaching the penis

This can happen due to neurological diseases, injury or surgery in the pelvic area where the nerves to the penis are harmed


➡ Can cause small vessel disease or even nerve damage to the penis which affects your ability to achieve an erection

Smoking and Alcohol

According to a study by Wu et al. (2012) of 2686 men aged 20-79 years in the Chinese city of Fanchenggang: 

➡ Out of which half (49.5%) had ED, 

➡ Those who smoked more than one pack of cigarettes in a day had a significantly higher risk of ED than those who didn’t smoke.

➡ These results show that the habit of heavy smoking might contribute to ED, and that this risk increases with continued smoking, especially in Chinese men.

As for alcohol, it has been long thought of as a cause of ED. However, more research needs to be done to prove a definitive connection between alcohol and ED. 

➡ Based on the study by Arackal and Benegal (2007), it is the persistent use of alcohol that is most likely to cause sexual dysfunction. 

➡ If you have a few drinks once in a while it’s unlikely to damage your ability to get an erection permanently— although you might experience something called “whiskey dick” occasionally when you drink too much—but like with everything else in life—moderation is key. 

Apart from improving health in general, it may help you to perform better if you reduce your alcohol intake. 

The first step to understanding and diagnosing your ED cause is to consult with a doctor. There is medication available at digital men’s health clinic Noah, such as Sildenafil Citrate or Tadalafil, which is prescribed for effective ED treatment in Singapore. A medical professional will be best equipped with the knowledge to help you ascertain the root cause of your ED, if it is physiological or psychological. This way, they will also be able to advise you on the right treatment for you.

Get ED Treatment 

Psychological Causes of ED

Psychological causes, on the other hand, are less common—only 1 in 10 cases of persistent ED are psychologically connected. Psychological causes are mental issues that affect your ability to achieve an erection. These psychological causes of ED are more commonly the reason for ED in young men too.

As we just covered the importance of our brain in sending signals to help us get an erection, any disruption to this process can cause ED. Common psychological issues include depression, stress, anxiety or even feeling nervous to perform.

Mental Health 

Mental health is a big contributor to your overall wellbeing and your sexual health. Mental health disorders can affect your mood, the way you think and behave. Some examples of mental health disorders are depression and anxiety. These disorders can impair the brain’s ability to send signals responsible for erection. 


Depression causes feelings of sadness and/or a decreased interest in activities you used to enjoy. It can impact all aspects of your life, weighing on your body and mind. According to the American Psychiatric Association, the symptoms of depression can differ from mild to severe, some examples include:

· Feelings of sadness or hopelessness

· Loss of interest in normal activities

· Irritability, frustration or angry outbursts

· Feelings of worthlessness or guilt

· Difficulty concentrating, making decisions or thinking

· Fatigue or lack of energy 

· Appetite changes 

The loss of interest in normal activities that comes with depression can cause men to lose interest in sex too. Based on the Massachusetts Male Aging Study, researchers concluded that depressive symptoms and ED are related, outside of age and demographics as well.


Anxiety can affect how well the brain is able to send the signals necessary to trigger erection. According to a study by Rajkumar and Kumanran (2015), men that had pre-existing anxiety conditions had a higher chance of experiencing performance anxiety. 

Some symptoms of anxiety disorder include:

· Difficult concentrating

· Excessive worrying

· Feelings of agitation

· Feeling restless

· Fatigue

· Tense muscles

· Trouble sleeping

If you’re feeling nervous about your ability to satisfy your partner—it’s most likely performance anxietywhich is a big contributor to ED and even premature ejaculation. When those nervous feelings are allowed to fester, it may become serious enough to cause sexual dysfunction. Performance anxiety often stems from negative self-talk, whether it’s about achieving an erection or ejaculating too early.

If you think about it, it makes sense if you find yourself worrying more about doing the act than being in the moment enjoying it, that your experience and ability to perform will be altered as a result.

Apart from mental health disorders, stress can also take a toll on your ability to perform in the bedroom.


Stress can arise for a number of reasons whether it’s at home or in the workplace, and can also impair sexual function. Similar to anxiety, stress can also affect your brain’s ability to send signals to the penis to allow increased blood flow. Stress can also cause you to feel more anxious and that leads to even more stress, turning this into a vicious cycle, and the combination of the two can result in a cycle of ongoing ED. 

Relationship Issues

If you and your partner are having problems in the relationship, it is very possible that your sex life may be affected as a result. It takes time, trust and dedication to build a healthy relationship after all. On the other hand, ED may be the cause of relationship issues, and that can contribute to the cycle of ED that permeates throughout your life.

In this case, the first step to resolving these issues would be to communicate with your partner, and if that is too difficult, you may want to consider couples counselling.

Pornography Addiction

Pornography addiction is a serious potential cause of ED. Watching too much porn can lead to unrealistic expectations about sexual partners and sex. This cause of ED has risen in concern so much so that researchers have studied it and termed the condition pornography-induced erectile dysfunction (PIED). 

Physiologically, if you watch and masturbate to porn extremely regularly, you may experience “hyperstimulation”. Hyperstimulation refers to the instance when men get greater pleasure from masturbation than with sex, caused by frequent masturbation (Jenkins & Mulhall, 2015).  

Is Your ED Cause Physiological or Psychological?

If you are struggling with ED and are unsure of what is causing it, it is an important part of recovery to speak to someone about your experience, whether it is with your partner or a healthcare professional. 

Physical causes of ED usually occur over a span of time (months or years), and it is often a gradual loss in function. If you are getting random hard-ons in the morning (morning wood), or overnight, then the cause of your ED could be psychological. In most cases, it is a mix of both so the best way to find out is by consulting a doctor.

Get ED Medication

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