Erectile dysfunction (ED) is a common condition. Sometimes called impotence, ED is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse.
Erectile dysfunction may affect as many as one-third of all people with penises. That means around 30 million people in the United States alone experience ED. Its frequency increases with age—but ED is not considered an expected part of the aging process. Instead, the condition has a wide range of possible causes.
There’s no one cause of erectile dysfunction. Sexual arousal is a highly complex process. It relies on hormones, muscles, emotions and brain activity to work together.
Here’s how erections happen:
ED can occur suddenly or over time when something interrupts even one of these steps. That's why it can be challenging to determine the root cause—or causes.
In one study, scientists discovered a genetic risk factor in the human genome associated with erectile dysfunction. This suggests a genetic component. But various acute and chronic health conditions can come with ED as a side effect.
Medical factors linked to ED include:
Trouble with erections is also common after a vasectomy—the surgery that prevents sperm from mixing with semen. But there’s no evidence that the procedure causes impotence.
Because sexual stimulation starts in the brain, some psychological conditions can trigger ED. These include:
Some lifestyle factors can lead to health conditions that trigger or worsen ED.
Lifestyle causes of ED can include:
Older people are more often affected by ED. As they age, people often need more stimulation to achieve an erection. And their erections may not become fully firm. But ED isn’t an assumed part of the aging process.
And young men aren’t immune to ED. A 2013 study found that 1 in 4 new cases of erectile dysfunction occur in those under 40. The causes of erectile dysfunction in your 20s and 30s are thought to be more often psychological than physiological. So if you’re dealing with a lack of erections or lost sensitivity, erectile dysfunction may be at play.
In most cases, it’s possible to reverse ED by addressing lifestyle factors and finding the right prescription medication. Even when the condition isn’t completely curable, lessening symptoms is possible. So if you’ve wondered, “If I stop drinking, will my ED go away?” you’re headed in the right direction.
Changes to lifestyle factors that can reverse ED include:
Prescription erectile dysfunction treatments can increase blood flow in the penis to help maintain an erection. In most cases, health experts recommended using erectile dysfunction medicine in addition to addressing any medical or psychological root causes.
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Capogrosso, P., et al. (2013). One patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice. The Journal of Sexual Medicine.
Chu, N. V., et al. (2002). Erectile dysfunction and diabetes. Current Diabetes Reports.
Gerbild, H., et al. (2018). Physical activity to improve erectile dysfunction: A systematic review of intervention studies. Sexual Medicine.
Gu, Y., et al. (2022). Erectile dysfunction and obstructive sleep apnea: A review. Frontiers in Psychiatry.
Jorgenson, E., et al. (2018). Genetic variation in the SIM1 locus is associated with erectile dysfunction. Proceedings of the National Academy of Sciences of the United States of America.
Mahmoud, M., et al. (2022). The impact of smoking on sexual function. BJU International.
Nunes, K. P., et al. (2012). New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension.
Sansone, A., et al. (2021). Addressing male sexual and reproductive health in the wake of Covid-19 outbreak. Journal of Endocrinological Investigation.