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Causes

Many different factors affecting your vascular system NIH external link, nervous system NIH external link, and endocrine system can cause or contribute to ED.

Although you are more likely to develop ED as you age, aging does not cause ED. ED can be treated at any age.

Certain diseases and conditions

The following diseases and conditions can lead to ED:

  • type 2 diabetes
  • heart and blood vessel disease NIH external link
  • atherosclerosis
  • high blood pressure
  • chronic kidney disease
  • multiple sclerosis NIH external link
  • Peyronie’s disease
  • injury from treatments for prostate cancer NIH external link, including radiation therapy and prostate surgery
  • injury to the penis, spinal cord, prostate, bladder, or pelvis
  • surgery for bladder cancer NIH external link

Men who have diabetes are two to three times more likely to develop ED than men who do not have diabetes. Read more about diabetes and sexual and urologic problems.

Taking certain medicines

ED can be a side effect of many common medicines, such as

  • blood pressure medicines NIH external link
  • antiandrogens—medicines used for prostate cancer therapy NIH external link
  • antidepressants NIH external link
  • tranquilizers, or prescription sedatives—medicines that make you calmer or sleepy
  • appetite suppressants, or medicines that make you less hungry
  • ulcer medicines

View a list of specific medicines that may cause ED NIH external link.

Certain psychological or emotional issues

Psychological or emotional factors may make ED worse. You may develop ED if you have one or more of the following:

  • fear of sexual failure
  • anxiety NIH external link
  • depression NIH external link
  • guilt about sexual performance or certain sexual activities
  • low self-esteem
  • stress—about sexual performance, or stress in your life in general

Certain health-related factors and behaviors

The following health-related factors and behaviors may contribute to ED:

  • smoking
  • drinking too much alcohol
  • using illegal drugs
  • being overweight
  • not being physically active

Source: “Symptoms & Causes of Erectile Dysfunction - NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes.

ED can be caused by a number of factors, including:

  • Vascular disease: Blood supply to the penis can become blocked or narrowed as a result of vascular disease such as atherosclerosis (hardening of the arteries).
  • Neurological disorders (such as multiple sclerosis): Nerves that send impulses to the penis can become damaged from stroke, diabetes, or other causes.
  • Psychological states: These include stress, depression, lack of stimulus from the brain and performance anxiety.
  • Trauma: An injury could contribute to symptoms of ED.

Chronic illness, certain medications, and a condition called Peyronie's disease can also cause ED. Operations for the prostate, bladder, and colon cancer may also be contributing factors.

Source: “Erectile Dysfunction (Ed): Causes, Diagnosis & Treatment.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction.