Erectile difficulty is the frequent or consistent inability to get or sustain an erection of the penis sufficient to engage in sexual intercourse. While most men occasionally fail to get an erection, or lose one prematurely during sexual activity, some men suffer from these problems regularly.
Accurate statistics are lacking on how many men are affected by the condition, but some doctors estimate that about half of men aged 40 to 70 have frequent problems achieving or maintaining an erection. The number of men with erectile difficulties is low for those under the age of 40, but it increases with age.
A wide range of diseases, medications, injuries, and psychological problems can cause erectile difficulties. Here are some of the most common causes:
Circulatory problems: An erection occurs when the penis fills with blood and a valve at the base of the penis traps it. Diabetes, high blood pressure, cholesterol, clots, and atherosclerosis (hardening of the arteries) can all interfere with this process. Such circulatory problems are the number one cause of erectile difficulties.
Peyronie's disease: This disease causes fibers and plaques to appear in the genitals, interrupting blood flow.
Cancer: Cancer can interfere with nerves or arteries that are vital to erection.
Surgery: Surgery to the pelvis, and especially prostate surgery for prostate cancer, can damage the nerves and arteries that are required to gain and maintain an erection.
Spinal cord or pelvic injury: The nerves that stimulate erection can be cut by injury to them.
Hormonal disorders: A lack of testosterone (male hormone or androgen) can result from testicular failure, pituitary gland problems, or certain medications.
Depression: This condition is a common cause of erectile difficulties. Depression is a physical disorder as well as a psychiatric one, and it can have physical effects. This may be true even if you feel comfortable in a sexual situation.
Alcoholism: Chronic alcoholism can produce erectile difficulties, even if there is no alcohol in the blood at the time of sex.
Smoking: Smoking cigarettes causes constriction of blood vessels. This may decrease blood flow to the penis, causing erectile difficulties.
Performance anxiety: Most men have had erection problems at some point due to worrying about performing well during sexual intercourse. If this happens often, the anticipation of sex can trigger nervous reactions that prevent erection, setting up a vicious cycle.
Situational psychological problems: Some men have problems only in certain situations or with certain people. In troubled relationships, men may be unable to achieve erection with their partner but have no problem away from home.
Sexual aversion: Being repelled by sex is rare. It is most common in people who suffered child abuse and those who have been brought up in strict religious surroundings. Aversion can also exist in homosexuals or bisexuals who attempt to lead a heterosexual life against their basic inclinations.
Drugs: The following can cause erectile difficulties:
- anti-anxiety medications
- anticancer medications
- ganglionic and adrenergic (beta) blockers
- MAOI and tricyclic antidepressants
- narcotic pain relievers
- medicines prescribed to control high blood