Many men believe that erection problems are an unavoidable part of aging. But the reality is that you don’t have to live with erectile dysfunction (ED)—it can be treated. There are many things that can contribute to ED, from physical issues, like another health condition, to possible side effects of medicines that you’re taking. Even emotional or personal issues can play a role (1)

But for most men, ED can be treated, whether the cause is physical or psychological. (2)

If you think you may have ED, see your doctor as soon as possible for a proper medical assessment. Your doctor can help diagnose and treat your ED, as well as any underlying factors that may be at the root of the problem.

CVD can cause ED due to a compromised blood flow in the arteries leading into the penis.(3)

High blood pressure can be associated with damage to blood vessels throughout the body, including those in the penis.(3)

Diabetes (or high blood sugar) can increase the chances of having ED. Over time, high blood sugar can damage blood vessels and nerves in the penis.(3)

A high level of total cholesterol or a low high-density lipoprotein (HDL) level can be risk factors for the development of ED.(3)

Diseases that affect the nerves, such as Parkinson's disease and multiple sclerosis (also known as MS), are associated with ED. The penis may not receive nerve messages from the brain or spinal cord. And without the nerve messages, not enough blood may flow into the penis.(3,4)

Surgery (especially prostate, bladder, or rectal surgery) or injuries to the pelvic area can damage nerves or blood vessels leading to the penis.(3)

Low levels of male hormone (testosterone) may affect a man's ability to get an erection. ED can also happen when a man's thyroid hormone level is too high or too low.(3,5)

Smoking, being overweight, drinking alcohol in excess, not being physically active, or using recreational drugs can cause ED.(3)

ED can be a side effect of some medicines, including high blood pressure medication and antihistamines (medicines that treat allergies).(3,6)

Less often, ED may be caused by emotional or personal issues, from ongoing stress or relationship problems to depression or anxiety about sexual performance.(1)


  1. Lue TF. Erectile dysfunction. N Engl J Med. 2000;342:1802-1813.
  2. Wespes E, Amar E, Hatzichristou D, et al. EAU guidelines on erectile dysfunction: an update. Eur Urol. 2006;49:806-815.
  3. Ghanem H, Porst H. Etiology and risk factors of erectile dysfunction. In: Porst H, Buvat J, eds. Standard Practice in Sexual Medicine. Malden, MA: Blackwell Publishing; 2006:49-58.
  4. Porst H, Sharlip ID. Anatomy and physiology of erection. In: Porst H, Buvat J, eds. Standard Practice in Sexual Medicine. Malden, MA: Blackwell Publishing; 2006:31-42.
  5. Buvat J, Shabsigh R, Guay A, Gooren L, Torres LO, Meuleman E. In: Porst H, Buvat J, eds. Standard Practice in Sexual Medicine. Malden, MA: Blackwell Publishing; 2006:225-286.
  6. Lewis RW, Mills TM. Introduction. In: Carson C, Kirby R, Goldstein I, eds. The Textbook of Erectile Dysfunction. Oxford, United Kingdom: Isis Medical Media Ltd.; 1999.