For years, it was believed that erectile dysfunction (ED), the inability to achieve or maintain an erection during sexual intercourse, was the result of a psychological problem or simply an unfortunate part of the aging process. Men were reluctant to discuss the problem, despite the fact that it affects up to 30 million of them in the United States each year, according to the National Institutes of Health (NIH).

Recently, though, many misconceptions concerning the condition have been redressed, and experts now know that ED is often the result of a physical malady. An erection relies on an intricate web of nerves, hormones, blood vessels, tissue, and muscle. If any one of those mechanisms is injured or diseased, then the penis will likely fail to perform normally. Here, some of the factors that can contribute to ED.

Disease and Injuries

Those with illnesses such as hormonal disorders, multiple sclerosis, artherosclerosis, vascular diseases, and diseases of the lung, liver, and kidneys account for approximately 70 percent of ED cases, according to the NIH. Injuries to the spinal cord and pelvic area, as well as surgery for bladder, rectal, or prostate cancer, can also play a role.


Selective serotonin reuptake inhibitors (SSRIs), which alleviate anxiety and depression, and beta blockers, which help control high blood pressure, are among the chief medications that can trigger ED. Antihistamines and sedatives have also been linked to the disorder.

An Unhealthy Lifestyle

Heavy drinking, smoking, and obesity can lead to vascular and heart trouble and, in turn, erectile dysfunction. However, some studies suggest that moderate alcohol consumption (no more than two drinks a day) decreases the likelihood of ED because of its ability to thin the blood, thus benefiting the cardiovascular system, although more research is needed.

Diagnosing ED

When diagnosing ED, a doctor will keep an eye out for a few things: If the penis fails to respond to touch, then the nervous system is suggested as the source of the problem. If gynecomastia (swelling of breast tissues in men) is concurrent, then a hormonal imbalance may be the cause. If the pulse is weak at the ankles or the wrists, a circulatory disruption is indicated. A health-care professional will also screen for diabetes and other diseases while taking into account possible psychological components (although emotional disorders are no longer seen as the source of most ED cases, they are still a contributing factor in 10 to 20 percent of diagnoses).

Treating ED

Since the late 1990s, treating ED has become much more successful, primarily because of medical innovations and the resultant media saturation surrounding these breakthroughs. Oftentimes, a man suffering from ED simply needs to eat better, exercise, and quit smoking in order to reap results. Other individuals are prescribed medications such as Viagra, Levitra, or Cialis. In other cases, penile implants or surgery, both of which have benefited greatly from technological advances, may be indicated. But one of the important ED developments in the past decade is the increasingly open dialogue that has allowed men to more comfortably discuss their condition, ultimately leading to more effective treatments.