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Dr. David Shusterman Content Administrator Updated on: 21/02/2024 Next review: 21/08/2024

If a man suffers from erectile dysfunction, women often blame themselves. But in most cases, erectile dysfunction has purely physical causes.

Causes of erectile dysfunction in men

1. Medicines can cause impotence

If erectile dysfunction suddenly occurs, medication may be the cause. Numerous medications prescribed for high blood pressure or hormonal imbalances affect blood flow in the body and therefore also on the penis. Psychotropic drugs used to treat depression can suppress nerve impulses (from the head through the spinal cord to the penis), which can lead to erectile dysfunction.

Medications for diabetics, tranquilizers and so-called cytostatics (for treating tumors) can also lead to erectile dysfunction. In addition, according to a study by Northwestern University in Chicago, hair loss medications often contain active ingredients such as finasteride or dutasteride, which can reduce potency.

If the drug is taken for a limited period of time, potency-related problems disappear when treatment is stopped. However, if taken over a long period of time or for a lifetime (such as beta blockers for cardiovascular disease), they can cause permanent erection problems. If doctors find that "organic transformation processes" are taking place in the body, special therapy will be prescribed.

2. Cigarettes and alcohol as a cause of potency problems

Smoking and alcohol consumption interfere with blood circulation. Blood vessels wear out faster and lose their elasticity. The blood circulation of the arteries is disturbed by the calcification of the vessels - there are constant problems with erection.

In this context, erectile dysfunction may also indicate vascular disease. It can be a harbinger of heart attacks and strokes, and seeing a doctor early can be life-saving.

Doctors recommend that patients quit smoking and minimize alcohol consumption. A healthy diet and physical activity help blood circulate and flow to the genitals.

3. Diabetes

If a man suffers from diabetes, then sooner or later he will develop erectile dysfunction. This is caused by the deposition of sugar in the blood vessels, which constrict as a result. As a result, the penis can no longer be supplied with enough blood for swelling.

Also, persistently high blood sugar can damage the nerves and thus cause sexual dysfunction. Diabetes is the cause of impotence in about a quarter of all men over 50 with erectile dysfunction.

In addition to diabetes, other diseases can also lead to erectile dysfunction, such as metabolic disease, damage to certain nerve pathways (such as herniated discs), cancer, severe kidney and liver damage, or prostate surgery.

By the way, women who have diabetes often suffer from vaginal dryness because the mucous membranes no longer receive enough blood, so they can neither swell nor become moist.

4. Sleep disturbances can contribute to impotence

An Australian study found that in addition to a healthy lifestyle, restful, quality sleep can increase potency. Men who suffer from sleep disorders and breathing problems will sooner or later face erectile dysfunction.

According to the latest research, millions of people around the world suffer from sleep disorders. Poor sleep and lack of sleep should not be underestimated: those who cannot sleep well for long periods of time are at increased risk of developing depression and cardiovascular disease. Impotence is just one of the possible consequences of persistent sleep disturbances.

Experts advise, instead of resorting to sleeping pills, to undergo behavioral therapy. Sleep disturbances are often caused by stress or inappropriate activities before bed, such as using gadgets and watching TV.

5. Cardiovascular disease

Atherosclerosis (deposits on the walls of the arteries) is a common cause of erectile dysfunction. In men aged 50 and over, about 33 percent of all erectile dysfunctions are associated with atherosclerosis.

Coronary artery disease and high blood pressure can also lead to impotence. An erection can no longer be achieved or is insufficient if little blood enters the penis or if blood flows out of the penis too quickly.

If one of these reasons is suspected, doctors examine the blood flow in the vessels (using a Doppler ultrasound scan). If a circulatory disorder is identified, the condition and function of the heart is checked.

6. Testosterone deficiency (hypogonadism)

The male hormone testosterone is essential for an erection. With age, the body's own hormone production naturally decreases. As a result, erectile dysfunction can occur.

If the problem is caused by low testosterone levels, the doctor may prescribe testosterone, which is given to the patient in the form of an injection into the muscle or a skin gel. This is substitution therapy. As a side effect of testosterone administration, hair loss and increased muscle growth can occur.

Can also be used drugs for the treatment of erectile dysfunction - the so-called PDE-5 inhibitors. However, they often cause heartburn and headaches.

Men whose body produces too many female hormones (estrogens), which is caused, for example, by an unhealthy lifestyle and a large amount of belly fat, may also experience problems with potency.

7. Psychological reasons

From stress at work to relationship problems, anxiety disorders and depression, these can all cause erection problems, especially when you're young. When erectile dysfunction occurs for the first time in men (before the age of 40), it can trigger a fear of failure. A vicious circle is created: fears lead to erectile dysfunction.

Causes of erectile dysfunction in men

8. Neurological diseases

For the full functioning of the male genital organs, normal hormonal balance, healthy blood vessels and a healthy nervous system are necessary. Neurological conditions such as multiple sclerosis, Parkinson's or Alzheimer's disease can cause erectile dysfunction. The reason for this is diseased nerves that can no longer transmit the necessary signals to the genitals. Some nerves can also be damaged after a stroke.

9. Obesity and lack of exercise

Improper diet and lack of exercise raise blood sugar, blood pressure, and lipid levels. As a result, damaged blood vessels impede blood circulation, which prevents an erection from occurring.

Doctors advise to monitor weight, eat right, exercise regularly, and also refrain from smoking and alcohol. Several studies have shown that a healthy lifestyle is the key to male health.

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