5 causes of erectile dysfunction (and how we can help)

By Mosh

25 January 2021

minute read

Man sitting on couch looking contemplative

Erectile dysfunction is more common than you think, even in younger guys. Treating it successfully involves understanding the cause. Here are five reasons you could be suffering.

Problems getting it up can be a serious downer, and more guys have it going than you think, including younger blokes. While erectile dysfunction becomes more common with age, complaints of the condition in younger men is on the rise, with one in four new erectile dysfunction patients now under 40.

But before we delve into why it happens, it helps to understand what erectile dysfunction is. It’s a man’s inability to get or keep an erection firm enough for sexual activity with penetration. Some men are completely unable to get an erection and others may get one that doesn’t remain rigid enough for intercourse. If it only happens occasionally (up to 20 per cent of the time), it’s not considered a dysfunction by medical standards. It’s when it happens frequently (more than 50 per cent of the time) over a significant period (several weeks to months) that you may want to talk to a Mosh doctor and consider your treatment options.

In most cases, once you understand what’s causing your erectile dysfunction symptoms, there’s something you can do about it. Here are five common causes and potential treatments.

1. Physical causes

Doctors once thought that erectile dysfunction was primarily in a man’s head, but we now know that physical illness is actually behind most cases. It may, however, be combined with psychological causes.

Given that erections happen when blood collects in the shaft of the penis, any kind of vascular (blood vessel) disease or heart condition, can limit the amount of blood flowing to or staying in the penis. Such conditions include atherosclerosis (plaque build-up inside the arteries), high blood pressure and high cholesterol. Diabetes and smoking also affect the cardiovascular system, which means they’re linked to erectile dysfunction too. Other less common physical causes of erectile dysfunction include nerve damage from conditions such as spinal cord injuries and multiple sclerosis, as well as hormonal imbalances, sometimes caused by steroid use in bodybuilders, having too little or too much thyroid hormone, or taking hormones used to manage prostate cancer.

Obesity, while not directly linked to erectile dysfunction, is also thought to be a major risk factor for the condition via its link to diabetes, heart disease and cholesterol.

If you lead an unhealthy lifestyle, cleaning up your diet and making some lifestyle changes to help you lose weight could help in the hard-on department. It’ll also give you an added self-esteem boost, which is always welcome! If your erectile problems are still persisting, arrange a discreet online consultation with a Mosh doctor to help determine the real cause of your issue and possible treatment options.

2. Psychological causes

Mental health conditions like stress and anxiety can affect how your brain signals your body’s physical response. In the case of an erection, these conditions can interrupt how your brain sends messages to the penis to allow extra blood flow. The stress hormone, cortisol, is a key player, as it supresses production of the sex hormones, making it more difficult to get or sustain an erection.

Psychological causes of erectile dysfunction are pretty common, with 90% of teenagers and young men experiencing it at some point, usually due to nervousness and anxiety. Older men can experience this too, but as men age, it’s less likely to be from nervousness and more likely to be from professional or relationship stress, loneliness, or loss of a loved one.

Once you’ve failed to get it up a few times, it can lead to the vicious cycle of performance anxiety. That is, one bad sexual experience leads to negative thinking, which leads to more anxiety, which leads to further bad sexual experiences.

So how can you break the cycle?

Getting stress levels under control and ensuring you get enough sleep is the first step. Mindfulness-based meditation has been shown to be effective as it helps to focus your thoughts intently on the present moment. Just 10 minutes a day can make a difference.

Talking to your partner about your stresses can also help take a load off your mind.

If you find you need additional support, consider talking to a Mosh psychologist, who can help you discreetly from the comfort of your own home.

3. Medications

If you’re taking medications for high blood pressure, high cholesterol (statins), heartburn, depression, anxiety, prostate cancer, heart failure or pain (opioids), they may be causing you to experience erectile dysfunction or be worsening existing erectile dysfunction. But before you stop taking a medication that may be affecting your sex life, you should always speak to your doctor first. They’ll help you find a balance between treating your symptoms and managing the side effects.

4. Porn

Whilst watching porn might seem harmless, evidence increasingly suggests that watching too much porn can cause problems with sexual performance, such as erectile dysfunction. And the problem is highly prevalent in men under 40.

Too much porn can lead to unrealistic expectations around sex, which increases a person’s tolerance to sex. It’s similar to when you drink too often and you find you need more and more alcohol to experience the same effect. Chronic porn consumption can mean sex in real life is unable to arouse you.

On a neurological level, porn addiction causes a decrease in your sensitivity to the pleasure-seeking chemical, dopamine, which not only desensitises you to real sexual encounters, but fuels your addiction and makes it difficult to quit porn.

The good news is that porn addiction is reversible with proper assistance. If you’re finding it too hard to stop watching porn or reduce your porn consumption, an online consultation with a Mosh doctor or psychologist can help you find a solution.

5. Recreational drug use

Using recreational drugs such as alcohol, cocaine, speed, MDMA (ecstasy), GHB and marijuana can actually be causing your erectile difficulties. Recreational drugs not only include illegal substances, but prescription drugs that are misused, for example, Dextroamphetamine, commonly called ‘dexy’ (used to treat symptoms of ADHD). The stimulant drugs such as cocaine, speed and MDMA impact blood flow to the penis, making it hard to get an erection. In the case of alcohol, it’s lowers testosterone levels, making it hard to get in the mood for sex. It’s also a nervous system depressant, which means circulation and nerve ending sensitivity are reduced, affecting your ability to get a hard on.

Then there’s marijuana. While it gives you that ‘chilled’ feeling and even increases sexual desire, it interferes with erections by preventing the smooth muscle in your penis from relaxing to let enough blood flow in.

If your alcohol and drug intake is too high and it’s starting to affect your sexual performance, it’s time to cut back. If you’re struggling to do this on your own, there is help and support available. A discreet consultation with a Mosh doctor will set you on the right track.

Want to know more about erectile dysfunction? Read Erectile Dysfunction: The Definitive Guide.

Tags: ed sex