The 15 most common causes of erectile dysfunction/Impotence
Why am I experiencing erectile dysfunction and impotence?
There are many causes of erectile dysfunction. You will often find that it starts small. That one night when your body doesn’t want the same thing as your head. That morning when the lack of morning erection scares you.
Most men experience periods of erectile dysfunction and impotence in their lives, but when it persists, it’s natural to ask: Why can’t I get an erection? What is the cause of erectile dysfunction?
Erectile dysfunction, also known as erectile dysfunction, affects around one in three men during their lifetime. For most, it is associated with great shame, loss of masculinity and identity.
But lack of erection is not just a question of masculinity, it’s an expression of bodily health. When something in the system is not working, be it physical, hormonal or psychological, it’s often on the verge of an erection that it is first felt.
In this article, I will go through the 15 most common causes of erectile dysfunction. The aim is not to diagnose you, but to understand. But I’m happy to help you with that part in the clinic too.
Read about Martin's experience with erectile dysfunction impotence and shockwave
A personal account of erectile dysfunction
“Although I’ve always been physically active, eaten healthily and had a good sex life, during my 50s I noticed a slow decline in my ability to get and maintain a good erection. The truth is that the change started earlier, but only became apparent with age.
I’ve never been a big fan of potency medication – although it works quickly and effectively, it didn’t feel like the right solution for me. When I read about Michael and MS Insight, my curiosity was piqued. I took the test and decided to give myself a birthday present: a course of treatment for erectile dysfunction with the 6 treatments recommended for erectile impotence.
The shockwave treatment itself – targeting the perineum and penis – is completely painless and actually surprisingly pleasant. It feels like light tingles and waves and you quickly get used to it.
If you can put aside the mental barrier and accept that taking your pants off is no more uncomfortable than opening your mouth at the dentist, the treatment becomes almost routine. Michael is very professional and makes the whole situation feel comfortable and relaxed around erectile dysfunction impotence. I have felt comfortable with every single treatment.
After the 6 sessions, I noticed a clear improvement – both in the ability to get an erection and in how often it happened spontaneously. It’s a pleasure to wake up in the morning and feel natural again – and even better to share it with my boyfriend.
For me, it’s been worth every penny. And if one day I feel that the effect is wearing off, I could easily come back in a few years for a refresher.”
Understand what a good potency and erection requires
What actually happens in the body during an erection?
An erection is the result of a complex interaction between the brain, nerves, hormones, blood vessels and pelvic floor muscles. An erection starts with desire and stimulation, which sends signals from the brain, out through the spinal cord and to the nerves in the penis.
This triggers a number of different neurotransmitters and NO, which causes the blood vessels in the penis to dilate. The blood then flows into the cavernous bodies, which fill up, and the pelvic floor muscles ensure that the blood does not flow back.
If just one of these elements is not working, it could be the cause of erectile dysfunction. This applies to physical illnesses, psychological stresses and lifestyle factors as a whole.
The 15 most common causes of erectile dysfunction and impotence
1. impotence due to stress and exhaustion
Chronic stress has a well-documented negative effect on male sexual function. When the body finds itself in a state of constant alert, functions such as sex and erectile function are de-prioritized.
High levels of the stress hormone cortisol inhibits male sex hormone T production and affects the nerves’ ability to respond. Many men will frequently describe it as mental fatigue and a lack of desire that has gradually increased. It’s natural, the brain is working overtime and the body is slowly shutting down.
It will also reduce your sleep quality and you may become more irritable, and ultimately, the erection will disappear as your energy levels drop.
2. High blood pressure and circulatory problems cause ED Impotence
For a good erection, it’s important that the blood vessels are elastic and can expand up to 25 times, allowing the blood to fill the penile erectile tissue completely.
With high blood pressure, the vessel walls become less elastic and more resistant, which also reduces blood flow. This results in erectile dysfunction/ ED. This is probably one of the most common causes of erectile dysfunction in general. But it can be effectively treated with shockwave, which creates new blood vessels
High blood pressure also increases the risk of atherosclerosis, especially in the tiny blood vessels that supply the penis. They are no more than 1mm in diameter and are therefore really vulnerable to calcium deposits.
The special thing about erectile dysfunction as a symptom is that it often occurs earlier than, for example, heart cramps. It is therefore an early sign that there may be problems in the cardiovascular system. Recent studies have shown that ED can occur up to 5 to 10 years before a serious heart problem.
Read more about it here:
3. Why does impotence occur in type 1 and type 2 diabetes?
Diabetes is one of the most common causes of impotence anderectile dysfunction. This is due to several physiological mechanisms. High blood sugar levels over a long period of time damage both the small blood vessels and the peripheral nerves. Both in the penis, but also in the hands and feet.
The penis generally becomes less sensitive and the signals weaken. This means that it takes significantly more stimuli to get and maintain a good erection. In addition, diabetes affects the body’s hormone balance and often leads to imbalances in the body.
The combination of reduced sensitivity, poor blood flow and hormonal imbalance creates a difficult starting point for a healthy erection. Diabetes is also often linked to neuropathy and Peyronie’s disease, which can create further erection problems.
4. Overweight and inactivity for erectile dysfunction
Being overweight, especially where there is a lot of fat around the abdomen, has a direct impact on a man’s hormonal balance and erectile function.
Adipose tissue converts the male sex hormone T into estrogen and increases the body’s level of inflammatory substances. This creates a hormonal state where desire and erectile function slowly declines over time.
At the same time, physical inactivity reduces blood circulation and weakens the pelvic floor muscles that help maintain erection. In addition, there is the “bonus” that the penis may appear smaller as the amount of fat around the pelvic floor and abdomen increases.
5. Hypogonadism (Low t level) and impotence
Male sex hormone T is essential for desire, energy and the ability to respond to sexual stimulation and maintain physical strength. When levels drop, which can happen as a result of age, illness, obesity or stress, many men find that their erection gradually becomes weaker. And this can become even more frustrating, even when desire is still present.
Symptoms are often diffuse and insidious: They can be symptoms such as
- Fatigue and poor sleep quality
- Irritation and less joy in everyday life
- Low motivation level for normal activities
- Decreased libido and lack of morning erections
- Loss of height and physical strength/endurance.
What’s really important with hypogonadism is to find the cause of it. It’s not enough to just get a shot, gel or pill. This will be a symptom treatment only. Often, hormone levels can be raised by changing lifestyle. And if it hasn’t had an effect within 3 months, it can then consider whether T-supplements are the solution for you. But again, this is one of the most common causes of erectile dysfunction
6. Performance anxiety and lack of erection
Erection starts in the head and requires contact with the pelvic floor and penis. If a man feels pressured, anxious or insecure in a sexual situation, the sympathetic nervous system is activated. It’s the same system as the flight and fight response. It causes the blood to be drawn away from the abdomen and out to the large muscles, where the erection then disappears.
Performance anxiety can occur suddenly or over time. And it knows no age. It can be a man of 20 or 83. A single bad experience is often enough to trigger a self-perpetuating spiral that can be difficult to get out of.
Read more about it here:
7. Trouble sleeping and not getting up in the morning
Many men discover their first signs of ED through lack of morning erections. Morning erection is an indicator of hormonal and neurological health. It’s the body’s way of testing yourself.
Most morning and nighttime awakenings occur during REM sleep, and if sleep is disturbed, both hormone production and nervous system function will be negatively affected.
The causes of erectile dysfunction and sleep problems can be many, but some of the more well-known ones include
- Sleep apnea
- Stress-related anxiety
- Irregular circadian rhythms
- High alcohol intake
- High-intensity training shortly before bedtime (adrenaline pumping)
8. Smoking, e-cigarettes and vaping cause erectile dysfunction
Nicotine affects both blood vessel function and the production of nitric oxide (NO). NO is the neurotransmitter that allows blood vessels in the cavernous bodies of the penis to dilate properly.
Smokers have a significantly higher risk of ED than non-smokers. The more cigarettes, the greater the risk of developing erectile dysfunction. And the longer you smoke, the more tissue damage you do.
Today, there are many different types of nicotine products, and today it’s not just about whether it’s harmful to the lungs. It’s also that all the ways in which nicotine can be ingested destroys the fine tissue in the cavernous bodies of the penis. This decreases elasticity and reduces the ability to get blood to the penis. The effect is often underestimated because it creeps in gradually. Get help to quit smoking.
9. Alcohol and drugs – why is it a cause of erectile dysfunction
Although a single glass of wine can be relaxing, alcohol reduces nervous system function and can weaken the response of the penis to stimuli. With higher consumption, both sensitivity and hormone production are reduced over time.
Long-term use of different types of drugs, especially cannabis, can dull the nervous system so much that morning arousal and general erection are completely absent. This is because it affects the secretion of various neurotransmitters in the brain that contribute to arousal and erection.
In general, long-term alcohol or drug abuse can lead to damage to the liver, brain and nervous system. In many cases, this damage can be permanent and can lead to lasting sexual problems.
If you need help with an addiction, click here.
10. Side effects from medication can cause erectile dysfunction
Many men may experience erectile dysfunction when taking new medications. This can be completely normal, but it’s important to pay attention during the first 3-4 weeks to see if it’s a permanent or temporary side effect.
Blood pressure medications, antidepressants, beta-blockers and certain medications for enlarged prostate are known to be one of the most common causes of erectile dysfunction.
In addition, most anti-cancer drugs and cancer treatments can cause erectile dysfunction.
It is important to understand that the side effect does not necessarily mean that the medication should be discontinued. However, there may be alternatives that can be explored that may have a different side effect profile that may be better suited to your situation. Just talk to your general practitioner.
11. The role of the pelvic floor in impotence
The pelvic floor is often underestimated in men, and as soon as pelvic floor training for men is mentioned, the hairs stand up. The muscles should be seen as a hammock that supports the bladder, bowel and genitals.
During an erection, the muscles of the pelvic floor help to close off for blood to return to the penis. If the muscles are too weak or constantly tense, it has the potential to lead to lack of control and erectile dysfunction.
The pelvic floor is often overlooked in connection with back pain, incontinence and after prostate surgery. Here it is even more important to focus on a good level of function.
Read more about exercises and see how else we can help you.
12. Erectile dysfunction in neurological disorders
Causes of erectile dysfunction related to the nervous system are often related to diseases such as multiple sclerosis, Parkinson’s, diabetic neuropathy or herniated discs. Common to these diseases is that they can damage the nerves that carry signals from the brain to the penis. When the connection becomes weak or a nerve is pinched, erection may not occur, even if you as a man have the desire and stimulation of the penis is there.
Neurological ED is often accompanied by other symptoms: sensory disturbances, weakness or pain.
13. Prostate surgery and other surgical procedures and impotence
Surgery in the abdomen, prostate, pelvis, back or rectum can affect the blood vessels and nerves that give you an erection. This is a common cause of erectile dysfunction, even if the aim is to make it as gentle as possible and even as nerve-sparing as a radical prostatectomy.
All forms of cancer treatment around the genital area can potentially cause erectile dysfunction. Radiation, in particular, can damage nerve tissue, which can be irreversible.
Prostate surgery is one of the most well-documented causes of erectile dysfunction, but with the right rehabilitation and treatment, much of the erection can be regained. It can also lead to Peyronie’s disease
Bowel obstruction and lumbar spine surgery can also cause problems, although this is often not apparent until months or years after surgery.
An enlarged prostate doesn’t necessarily mean that you have erectile dysfunction. I’ve seen clients with prostates up to 120 grams who still have good erectile function and potency. The prostate will normally be around 30 grams, but will grow as men get older.
This is to boost hormone production. We have the possibility to measure the size of the prostate in the clinic via ultrasound scanning.
14. Low sex drive sometimes leads to erectile dysfunction
Decreased libido/sex drive is not the same as erectile dysfunction, but they can be related and reinforce each other.
If desire is lacking, the body’s nervous system will rarely trigger the right neurotransmitters needed to maintain an erection. It is more common for men over the age of 45 to experience a decrease in desire for sex. Women are more likely to have less desire for sex at a younger age.
The causes of erectile dysfunction can be many, but most commonly stress, psychological challenges, relational or hormonal issues are some of the causes of low sex drive and erectile dysfunction. They should always be taken seriously if they persist over time.
15. Age and causes of erectile dysfunction/ lack of potency
Age itself is not a cause, but it causes biological changes in the body’s cells and tissues. Levels of male sex hormones gradually decrease, the nervous system slowly becomes less responsive and blood vessels become less elastic.
This can all contribute to the swallowing organs eventually not functioning optimally. This means that many older men find that erections require more stimulation and more time to achieve a usable erection.
But: Many older men still have a very active sex life, so old age should not mean that sex is impossible.
What do you do now if you experience erectile dysfunction?
This article is not intended to give you a diagnosis, but to raise awareness of what plays a role in erectile dysfunction. If you experience erectile dysfunction for more than 3 months, it’s a sign that should be taken seriously. But contact me and I will help you with guidance on what you can do and how I can help.