Causes of Erectile Dysfunction (Impotence)

Causes of Erectile Dysfunction (Impotence)


Definition of Erectile Dysfunction = Is the Inability to achieve or maintain an erection  enough for a satisfactory sexual encounter.

How an erection occurs:

Un-aroused penis is soft and limp, during sexual arousal, nerve messages release chemicals that increase blood flow into the penis. The blood flows into 2 erection chambers made of spongy tissue (the corpus cavernosum) in the penis.The "smooth muscle" in the erection chambers relaxes, which lets blood enter and stay in the chambers. The pressure of the blood in the chambers makes the penis firm, giving you an erection. After orgasm, the blood flows out of the chambers and the erection goes away.

Any disruption of the process outlined above can cause erectile dysfunction.

There are may causes and contributing factors that lead to the development of erectile dysfunction.

The main ones are:

  1. Vascular problems
  2. Hormonal imbalance
  3. Trauma
  4. Nerve Damage
  5. Alcohol, Smoking, Drug use
  6. Psychogenic
  7. Medications


  1. Vascular causes  can  be : Arterial



- Arterial causes stem from some type of vascular blockage, in most cases due to atherosclerosis.

Most patients with significant Cardiovascular Disease, Diabetes Mellitus, Hypertension tend to develop Erectile Dysfunction. In fact Erectile Dysfunction is seen as the first sign of Cardiovascular disease.


- Venous cause otherwise called venous leak is when during erection the veins are supposed to close, instead they stay open causing all the blood to egress out of the penis.


  1. Hormone imbalance : Three hormones that can cause erectile dysfunction are :


     Low Testosterone - The main male hormone which is very important for  libido and ability to achieve erection and maintain one.

     High Estradiol levels- Female hormone that men have in small quantities can increase by a process called aromatization which means in certain conditions like obesity, testosterone is converted into estradiol in fat cells when estradiol  levels are high it can cause impotence.

     High Prolactin Levels - Hormone of lactation in women is also produced in men and when levels are high in cases of certain brain tumors like a prolactinoma in men it can cause impotence.


  1. Trauma- direct trauma to erectile tissue like bike accidents can cause impotence
  2. Nerve damage - I cases like post prostate surgery nerve damage can cause impotence
  3. Alcohol consumption of alcohol and drugs and especially cigarettes can cause vascular damage that leads to impotence
  4. Psychogenic causes especially in younger men can cause impotence. some causes are depression, performance anxiety
  5. Medications like certain blood pressure medications and medications for depression can cause impotence

In conclusion, Erectile Dysfunction can strike at any age but it usually affects men that are older and with the advances in technology there are more ways to  treat erectile dysfunction something we will talk about in our next blog.


Dr. Anteneh Roba

You Might Also Enjoy...