Erectile Dysfunction is a condition that affects millions of men around the world. This article discusses some of the most common causes, both psychological and physiological, of Erectile Dysfunction.

Erectile Process Understanding how an erection occurs is the first step in understanding the causes of ED. In order to achieve an erection, a number of factors are involved, and certain complex processes have to occur.

An erection depends on psychological factors, such as the level of stress and anxiety, physical factors such as the blood vessels and muscles in the penis itself, the level of sex hormones, and the central nervous system.

The process begins with a signal to the brain, in response to one or more sexual stimuli, which can include touch, smell, auditory and visual signals. When the brain interprets these stimuli, it sends signals to the nerve centres at the base of the spine. The spinal cord nerve fibres connect to the penis through nerves in the pelvic region, and instruct the blood vessels in the penis to relax, and to engorge with blood. The shaft of the penis consists of two erectile bodies, each called the corpus cavernosum. It is the smooth muscles in these two bodies that control the flow of blood into the penis. When the smooth muscle relaxes, the penis becomes engorged with blood, resulting in an erection. At the same time, the veins that drain blood away from the penis are closed off as the erectile bodies enlarge.

Anything that disrupts this chain of events, thereby causing less blood to flow into the penis, or more blood to flow out of it, can cause erectile failure. A number of different factors can be responsible for this, including stress and anxiety, physical condition or illness such as obesity and diabetes, nerve damage as result of certain types of surgery, and certain medications.

Erectile dysfunction can generally be divided into two types, psychological and physiological.

Psychological causes Anxiety, stress and depression are all psychological causes of erectile dysfunction. And when erection problems occur, this in itself produces a significant emotional reaction, known as "performance anxiety", which can further interfere with normal sexual function. Other psychological causes include feeling nervous about sex, work or financial stress, and problems in your relationship.

It should be noted that the issue of psychological causes is quite complex. Some men may lose interest in sex because of stress, or relationship issues, or any other reason, and simply may not be aroused enough to get an erection, or to keep the erection until ejaculation. This in itself does not mean that your sexual function is impaired, or that you have erectile dysfunction. However one episode of failure, regardless of cause, may result in further stress that results in further erectile failure.

Physiological causes There are certain conditions, such as cardiovascular disease, high blood pressure, diabetes, high cholesterol, and low hormone levels, which are all associated with erectile dysfunction. Tests by your doctor can determine whether any of these conditions are present. Often, the effects of these conditions on erectile function can be reversed, through diet and exercise. Other diseases known to cause erectile dysfunction include kidney failure, cirrhosis of the liver (usually the result of too much alcohol), chronic obstructive pulmonary disease (COPD), epilepsy, stroke, multiple sclerosis, Alzheimer's disease, and Parkinson's disease.

Nerve damage as the result of certain types of surgery can cause erectile dysfunction. Specifically, surgery in the pelvic area, such as abdominal or prostate surgery, may affect the nerves and arteries near the penis, resulting in erectile dysfunction.

Certain medications used for treating other conditions are known to cause erectile dysfunction. These include antidepressants, antipsychotic drugs, antihypertensives (for high blood pressure), antiulcer drugs, medications used for prostate cancer, and drugs for lowering cholesterol. If you are using any of these drugs, do not stop taking them without consulting your doctor. If you think they may be causing erectile dysfunction, you should talk to your doctor about possible alternatives.