What Causes Erectile Dysfunction (ED) & Impotence in Men?
Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. It can be devastating to the self-esteem of a man and of his partner. As many as 30 million American men are afflicted on a continuing basis, and transient episodes affect nearly all adult males. But nearly all men who seek treatment find some measure of relief.
There are many potential causes of ED, and sometimes, more than one cause is involved. In general, ED is divided into organic, psychogenic, or mixed etiologies.
The most common organic causes of ED are vasculogenic, neurogenic, endocrinologic, and anatomic.
- Vasculogenic—arterial insufficiency
- Neurogenic—cavernosal nerve injury
- Endocrinologic—testosterone deficiency, pituitary adenoma
- Anatomic—pelvic surgery, pelvic radiation
Psychogenic ED, which is far less common than organic ED, is caused by psychological factors.
- Performance anxiety
- Relationship problems
Mixed organic and psychogenic ED is not uncommon. In these cases, the organic component is often mild and may be difficult to diagnose.
The following are risk factors for developing ED:
- Age. The risk of ED increases with age. Men younger than 40 are more likely to experience psychogenic ED, whereas older men are more likely to have organic ED.
- Lifestyle choices. Smoking, excess alcohol consumption, illegal drug use, and being overweight can all contribute to ED.
- Medical conditions. Conditions such as diabetes, hypertension, heart disease, and neurologic disorders can all lead to ED.
- Medications. Many medications, both prescription and over-the-counter, can cause ED.
- Pelvic surgery. Surgery in the pelvic area, such as prostate surgery, can damage the nerves and blood vessels responsible for erections.
- Radiation therapy. Radiation therapy to the pelvis can damage the erectile tissue.
The good news is that ED is often treatable, regardless of the underlying cause. In many cases, simple lifestyle changes can improve ED. If more aggressive treatment is needed, there are a variety of effective options available.