• are never able to erect;
• have an brief erection but only for a short time;
• have an effective erection but in a instable way.

ED is primary if the man has never been able to achieve or maintain an erection.

ED is secondary if it develops later in the life of a man who previously achieved normal erections.

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Secondary ED is more common than primary.

A healthy penis requires adequate blood supply, slowed flow, proper nerve function, adequate testosterone levels, sufficient sexual desire (libido) for erection to take place.

A majority of cases of ED are caused by abnormalities in blood vessels or nerves within the penis. There are also hormonal disorders, structural problems of the penis and use of certain medications. Psychological disorders can also be a cause. These are the most common causes:

• Atherosclerosis is a condition that causes hardening of the arteries. It affects the penis arteries.
• Diabetes mellitus
• Prostate surgery complications
• Some medications are used to treat high blood pressure, an enlarged prostate or other conditions. Others, like those that treat depression, act on the central nervous systems.

Vascular disease

The peripheral vascular disease, which is partially caused by atherosclerosis, can cause blood obstructiveness to the legs. ED is often caused by blockage of the penis arteries. Atherosclerosis is caused by high cholesterol, high blood pressure, smoking, and high blood pressure.

Sometimes, blood can flow out of the penis veins too fast. This lowers blood pressure and interferes with the ability for erection to occur (veno-occlusive dysfunction).

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Neurological disorders

ED can happen if the nerves that transmit messages to the penis become damaged. Diabetes can cause atherosclerosis and have a negative impact on nerves serving the penis. Prostate surgery, such as for cancer or hypertrophy, can often result in ED.

Multiple sclerosis, spinal cord injury and stroke are all less common causes of ED. Temporary ED can also be caused by prolonged strain on the nerves in the buttocks or genital area (known collectively as the saddle), which is similar to what can happen during a long bicycle ride.

Additional conditions:

Hormonal disorders, such as low testosterone levels, can cause ED.

Peyronie’s disease is characterized by scar tissue in the penis. This causes painful and curved erections, and can also lead to ED.

ED can also be caused by certain substances, such as alcohol, illicit substances like cocaine, and amphetamines.

Sometimes, ED can be caused by psychological issues (such performance anxiety or depression), or factors that reduce men’s vitality (such illness, fatigue, stress) Erectile dysfunction may be caused by certain circumstances, such as those involving a specific place, time, or partner.

Prapism, a prolonged and painful erection, can cause damage to the erectile tissues of the penis. This can lead to ED.

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Evaluation of Erectile Dysfunction

While occasional episodes of erectile disorder (ED) are not uncommon, men who experience persistent difficulty in erecting should consult their doctor. This could be a sign that there is a more serious condition, such as atherosclerosis, or a neurological disorder. Most cases of erectile dysfunction can be treated. This information will help men decide when they should seek medical attention.

Warn Signs:

Men with ED have certain characteristics and symptoms that are troubling. Find out more:

• Absence of erections upon waking or at night
• Numbness in the area around and between the buttocks, and the genital area (called “the saddle”)
• Painful cramps in the legs that are caused by physical activity, but can be quickly relieved with rest (claudication).

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