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Your sexuality is a vital part of your overall health and quality of life, so it can be troubling if you’re unable to get or keep an erection.

The causes of erectile dysfunction vary greatly. Erectile Dysfunction (ED) often results from an underlying health problem related to the blood vessels or nerves that supply the penis. However, certain medicines and lifestyle factors can also make it difficult for you to maintain an erection.

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ED Risk Factors

The most common risk factors for ED affect your body’s endocrine, nervous, or cardiovascular system:

  • Atherosclerosis: This narrowing of the blood vessels due to plaque buildup is a common cause of ED. This is because narrowed blood vessels reduce blood flow to the penis, which is necessary for getting and keeping an erection.
  • Diabetes: More than half of men with diabetes get ED, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes can cause nerve damage and circulation problems that affect the health of your penis.
  • Endocrine disorders: These include thyroid issues and testosterone deficiency.
  • Heart disease risk factors: High blood pressure, high cholesterol, obesity, and metabolic syndrome — all risk factors for heart disease — are also linked to ED, according to a study in the American Heart Association’s journal, Circulation.
  • Medical procedures: Procedures that can cause ED include pelvic radiation, treatment for prostate cancer, or an enlarged prostate.
  • Multiple sclerosis (MS): MS can damage the nerve pathway along your spinal cord that carries signals of sexual arousal from your brain to your penis. Up to 91 percent of men with MS may have sexual problems, according to the National Multiple Sclerosis Society. Spinal cord injuries unrelated to MS can also contribute to ED.
  • Parkinson’s disease: ED is the most common sexual problem in men with Parkinson’s disease, according to the Michael J. Fox Foundation for Parkinson’s Research. This can be due to the disease itself, medicines used to treat the disease, and related body image or psychological issues.
  • Peyronie’s disease: This rare disease causes scar tissue to form inside your penis, causing your penis to curve. You may still be able to get an erection but having sex might be painful.
  • Psychological issues: Some ED cases can have a psychological component. These include depression, stress, anxiety, fatigue, and past sexual trauma or abuse.

Lifestyle factors, including smoking and alcohol and substance use — especially the use of cocaine — can also contribute to ED.

Medicines That May Cause ED

Some medicines can cause ED. Talk to your doctor to learn if stopping your current medication(s) or switching to another medicine might improve your symptoms. Medicines known to contribute to ED include:

  • Amphetamines
  • Anticholinergics
  • Antidepressants and anti-anxiety drugs, including monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants
  • Cancer chemotherapy drugs
  • Cimetidine, which is used to treat peptic ulcers
  • Drugs to treat high blood pressure, such as beta-blockers, clonidine, spironolactone, thiazide diuretics, and possibly loop diuretics
  • Hormonal therapy, including estrogens, antiandrogens, and luteinizing hormone-releasing hormone agonists and antagonists
  • Opioids
  • Prostate treatment drugs
  • Some types of sleeping pills

Treatment for ED

Treatment for ED can include lifestyle changes, medicine, penile injections, and penile implants. Discuss with your doctor the best treatment options for you based on your overall health, the underlying cause of your ED, and your preferences.

For more information about ED, visit the UPMC Men’s Health Center or call 1-877-641-4636(4MEN) to make an appointment with an expert.

Editor's Note: This article was originally published on , and was last reviewed on .

About Urology

The UPMC Department of Urology offers a wide variety of specialized care for diseases of the male and female urinary tract and the male reproductive organs, including erectile dysfunction, kidney stones, urinary incontinence, prostate cancer, and more. We have a multifaceted team of physicians and researchers working together to provide the best care to both children and adults. Our team is nationally renowned for expertise in highly specialized technologies and minimally invasive surgical techniques. To find a provider near you, visit our website.