Erectile dysfunction can originate from either psychological or physical factors, although it is not uncommon for a patient to experience a combination of both. In fact, psychological erectile dysfunction may eventually lead to physical erectile dysfunction and vice versa.

	Learn About The Psychological Causes Of ED
	Learn About Physical Causes Of ED
	Learn About The Mechanism Of An Erection
	Learn About ED And The Process Of Aging

	The Mechanism of a better erection: FLACCID STATE Smooth muscle cells keep a tight grip on the incoming arteries and blood-filled spaces to prevent blood from filling the penis when it is flaccid. Dorsal Vein Cavernosal Artery Erectile Chamber Smooth Muscle Cell Membrane
	The Mechanism of a better erection: ERECT STATE Sexual excitement triggers the release of chemicals that relax smooth muscle cells. Arteries widen and spaces fill with blood. The expanding tissue occludes the venous return trapping the increasing volume of blood. The increased pressure subsequently causes an erection. Blood Filled Space Pinched Veins

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Psychological Impotence Causes

Psychological factors account for about 10% of erection problems and often result from nervousness, performance anxiety or fear of failure during lovemaking. These factors result in physical manifestation of a surge of adrenaline, which in turn causes a reduction of blood flow to the penile area, hence causes erectile difficulty. Psychological ED may become self-perpetuating. After several episodes of repeated failure, the body becomes accustomed to releasing adrenaline at the very thought of a sexual relation. This can become a vicious cycle difficult to break out of without help.

Other less common causes include stress, low sexual drive, guilt, anxiety, sexual boredom or depression.

The characteristics of psychological erectile dysfunction include:

• Being able to achieve or maintain an erection with one partner but not with another
• Having strong and lasting erections in the mornings and during masturbation but not during lovemaking.
• Tendency to affect younger men with unstable relationships or unsettling past experiences.

At Boston Medical Group, we usually treat psychological ED with a type of medication that assures that you will likely obtain a full and lasting erection every time you wish to make love, regardless of your state of mind. Once your confidence is fully restored and you’ve completely overcome the anxiety customarily associated with love making, you would then be able to fully restore your sexual function on your own. Such healing process may take longer in some individuals than others depending on various underlying factors, your personality traits as well as the nature of the interpersonal relationships cultivated.

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Physical Impotence Causes

About 90% of cases of ED are caused by physical factors, classified as vascular (related to blood flow) and non-vascular diseases. It is estimated that 70%₁ of cases of ED may be attributable to vascular diseases alone.

The penis requires a healthy blood flow to become completely erect. Even a marginal reduction in blood flow can cause problems. This condition is referred to as “vascular insufficiency” and is known to be caused by or associated with the following risk factors:

• Diabetes
• Hypertension
• High Blood Cholesterol
• Cardiac diseases
• Smoking
• Poor Overall Circulation

Research indicates that more than 200 prescription medications₂ can cause, contribute to or aggravate ED. However, it is imperative that you must not discontinue your medications unless otherwise instructed by your physician.

Other associated physical conditions or causes are less common. These include:

• Hormonal deficiencies caused by testicular disease, liver disease or thyroid problems.
• Neurological problems such as Multiple Sclerosis, Stroke or Parkinson’s disease.
• Trauma to the pelvic area as experienced in certain types of surgery, radiation therapy or automobile accidents resulting in damaged pelvic nerves or arteries.
• Chronic illnesses such as chronic liver disease, chronic renal disease etc.
• Peyronie’s plaque or disease, a peculiar condition of excessive fibrosis in the penile tissue

It is however, not uncommon to see ED in an otherwise completely healthy person, both physically and psychologically. It is postulated that the penile circulation is intrinsically precarious, being an end-artery. It may not take much over the years to cause a partial obstruction to blood flow to the penis, which, under normal condition may be inconsequential but may be enough to cause insufficiency of blood flow to the penis when sexually aroused, hence erectile difficulty.

Note that the risk factors for most cases of Erectile Dysfunction, namely being older than 50 years of age, diabetes, hypertension, high blood pressure, high blood cholesterol, cardiac disease and smoking are also the same risk factors for rare cases of sudden blindness which is linked, but not conclusively proven, to the use of Viagra^®, Levitra^® Cialis^®.

1) Source: The National Institute of Diabetes and Digestive Kidney
2) Source: WebMD
3) Source: The US FDA

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Penile Erection and the Aging Process During the process of aging, factors such as diabetes, high cholesterol, high blood pressure or simple wear and tear cause arteries to narrow. To achieve an erection, a healthy blood flow is required and even minimal narrowing of the penile arteries can upset blood flow, hence the ability to achieve and maintain a full erection. 14 - 20 Years 20 - 30 Years 30 - 40 Years 40+ Years

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