The causes of erectile dysfunction, or impotence, are myriad and complex. They range from lifestyle habits, such as cigarette smoking, to psychological issues, such as fear of failure. The most common impotence causes are due to conditions that affect blood flow or nerve signals to the penis. Some causes, such as spinal cord damage, may not be reversible; others, such as prescription medications that prevent erections, can be changed to restore normal penile function.
An erection requires several bodily functions to operate correctly and in conjunction with each other. There must be an adequate blood supply, the proper transmission of nerve signals, and the ability of penile tissues to respond to chemicals released as the result of stimulation. Depending on the impotence causes, some men encounter erectile dysfunction only occasionally or temporarily, while others experience permanent impotence.
Atherosclerosis, a condition where the arteries narrow and harden, is a cardiovascular disease that can result in restricted blood flow to the penis. Diabetes mellitus can also cause impotence as the disease not only increases the risk of developing atherosclerosis, but it can also damage the nerves and muscle tissues of the pelvic area. Cigarette smoking constricts the blood vessels throughout the body and contributes to the risk of cardiovascular disease. High blood pressure, or hypertension, can cause impotence, although it is not known why this occurs.
Impotence causes depression in some men, and ironically, some medicines that treat depression can cause impotence. Medications for high blood pressure, tranquilizers, and anxiety can also interfere with achieving or maintaining an erection. Alcoholism can cause testicles to shrink and lower testosterone, making erections difficult or impossible. Impotence can be the result of psychological problems rather than physical conditions. Feelings such as stress or guilt can cause erectile dysfunction.
A doctor’s examination is necessary to determine the underlying impotence causes and develop a treatment plan. The examination may consist of a visual inspection along with blood, hormone, and urine tests. Patients with structural abnormities or pelvic trauma may need imaging tests. The doctor may also schedule a psychological consultation.
Sometimes, a simple change in existing medications is enough to reverse erectile dysfunction. Lifestyle changes such as quitting smoking or exercising can improve blood flow to the pelvic region. Some medications treat impotence directly by helping the patient to develop and maintain an erection. Other treatments include psychotherapy or inserting or injecting prescribed drugs into the penis.