Erectile dysfunction (ED), sometimes called impotence, is the inability to get or keep an erection firm enough for sexual intercourse. The condition has become highly visible in recent years, but that doesn’t make it any more welcome for the 5 to 15 percent of American men whose sex lives are affected.
The disorder can occur at any age, but is more common in men over age 75, according to the American Academy of Family Physicians (AAFP).

Causes of Erectile Dysfunction

Since sexual arousal is a complex process involving hormones, emotions, nerves, muscles, blood vessels and the brain, a malfunction in any of these can lead to ED. Stress, exhaustion and psychological issues can also contribute, and anxiety over maintaining an erection can actually make it harder to attain. In short, any condition that inhibits blood flow to the penis can lead to ED.

Aging is a large part of ED, but according to the AAFP and the Mayo Clinic, ED can also be caused by:

  • Heart disease or clogged blood vessels
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome, a grouping of conditions that include high blood pressure, cholesterol and insulin levels and excess fat around the waist
  • Multiple sclerosis
  • Parkinson’s disease
  • Low testosterone
  • Peyronie’s disease, which is scar tissue inside the penis
  • Certain prescription drugs, such as antidepressants and high blood pressure medication
  • Smoking
  • Alcoholism or drug addiction
  • Prostate treatments
  • Brain or spinal cord injuries
  • Stroke
  • Radiation therapy to the testicles
  • Certain types of surgery on the prostate or bladder

Certain types of surgery on the prostate or bladder

The vast majority of ED cases are caused by disease, according to the National Institutes of Health (NIH), while drug side effects account for 25 percent.

Low libido, which is a low interest in having sex, should not be confused with ED. People often have drops in testosterone levels as they age, often called male menopause or “manopause.”

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