Erectile dysfunction (ED) is when a man can’t achieve or sustain an erection for sexual intercourse. About 18 million men in the United States suffer from erectile dysfunction -- also known as impotence. There are many causes of erectile dysfunction, both physical and psychological causes. Luckily, there are many medical treatments and home remedies available to treat the condition.

Causes of Erectile Dysfunction

Achieving an erection is a complex process that involves the nervous and cardiovascular systems. When a man gets an erection, it’s because nerves in the brain travel down his spine to his penis. The penis muscles relax and blood flows into the blood vessels which leads to an erection. There are many reasons why a man may experience erectile dysfunction. Hormones, blood vessels, muscles, and emotions all play a part in getting an erection. A problem or combination of problems in any of those areas may cause ED.

Physical Causes

In many cases, ED is physical. Physical conditions that reduce blood flow or cause interruptions in nerve messages going from the brain and spinal cord to the penis can cause ED. There are also a number of diseases that affect a man’s erection. Below are the most common physical causes for ED.

• Blood vessel diseases that block the blood vessels and slow blood flow to the penis. Clogged blood vessels, high blood pressure, and high cholesterol are common causes of ED.
• Diabetes can damage the nerves and blood vessels to the penis.
• Neurological disorders such asMultiple sclerosis, Alzheimer's disease, stroke and Parkinson's disease can cause ED.
• Metabolic syndrome is a condition involving high blood pressure, high cholesterol, high insulin levels, and body fat around the waist that leads to low testosterone levels and decreased blood flow to the penis.
• Durgery for prostate cancer and bladder cancer may cause damage to nerves and tissues necessary for an erection. Injuries to the pelvis, bladder, spinal cord, and penis that require surgery may also cause ED.
• Kidney disease can affect hormones, blood flow, and the nervous system making it difficult for a man to have an erection.
• Peyronie's disease is scar tissue inside the penis. The scar tissue can hinder a man’s ability to maintain an erection.
• Low testosterone can lead to a disinterest in sex. Causes for low testosterone include kidney and liver disease, pituitary gland tumors, depression, and prostate cancer treatments.
• Obesity, prescription medications, tobacco, alcohol, and drug abuse are also causes of ED.

Psychological Causes

An erection begins in the brain. The brain is vital in triggering physical events that cause an erection starting with a man’s sexual desire. Many emotional and psychological factors can interfere with sexual feelings and lead to problems with a man achieving an erection. It’s been estimated psychological problems affect about 10 to 20 percent of the male population with ED.If a man experiences ED, he may become severely anxious that the problem will happen again. This can lead to "performance anxiety," and a vicious cycle of recurring ED. Below are some other common psychological causes for ED.

• Depression and many drugs used to treat it can cause ED.
• Stress – whether it be over money, career, a relationship – or any other personal circumstances are a significant reason why men suffer from ED or a lack of interest in sex.
• Guilt and low self-esteem over not being able to maintain an erection can worsen ED and make it more permanent.
• Relationship problems with a spouse or partner.

Risk Factors of Erectile Dysfunction

Age in men plays an important role in ED. As men age, sometimes their sexual desire lowers and it they may need more stimulation in achieving and maintaining an erection.

There are a large number of risk factors involved with ED. Diabetes and heart problems are significant risk factors for ED. Medications that treat depression, high blood pressure, prostate cancer, and antihistamines also increase the risk for ED. Being overweight, smoking, and drug/alcohol abuse increase the chances for ED.

Symptoms and Complications of Erectile Dysfunction

Erectile Dysfunction can lead to more problems in men than just an unsatisfactory sex life. Because of its sensitive nature, ED may cause men to have feelings of inadequacy leading to depression, anxiety, and low self-esteem issues. Relationship problems – including the ability to get your spouse or partner pregnant – can heighten because of ED.

Treatments for Erectile Dysfunction

There are a number of successful methods used to treat erectile dysfunction including medical and lifestyle treatments. 

Medical Treatments

• Sildenafil ; Tadalafil ; Vardenafil . These three oral medications stimulate nitric oxide which relaxes the penis and increases blood flow to it. Possible side effects include headache, nasal congestion, vision changes, and nausea.
• Other medications include Testosterone replacement and Alprostadil. Alprostadil causes blood vessels to expand and can be injected with a syringe or placed as a suppository in the tip of penis.
• Surgical procedures such as repairing leaking blood vessels and penile implants have proven successful in curing ED. However, both of these methods are rare and usually only used as a last option.
• Psychological counseling is used to treat ED problems associated with mental health issues or relationship problems.

Home Remedies

• Lose weight and exercise regularly to increase blood flow.
• Stop smoking by using over-the-counter or prescribed nicotine replacements and smoke cessation programs.
• Seek treatment and counseling for alcohol, drug, and marital problems if needed.

Alternative Medicine

More studies need to be done to validate the effectiveness and safeness of the following alternative medicines but the flowing alternative therapies are used to treat ED.

• Supplements such as Korean red ginseng, the hormone Dehydroepiandrosterone which builds testosterone, and the vitamin L-arginine seem to be safe and effective. However, always check with a physician before taking a supplement.
• The practice of acupuncture is used to treat ED.

When to See a Doctor

Experiencing ED occasionally is not a cause for concern. However, if the problem persists you should make an appointment your doctor. Is your ED is accompanied by other symptoms or if you have heart disease or diabetes, you should consult your doctor.