Erectile dysfunction can be a sign of an underlying medical condition. In fact, a physical cause can be identified in about 80% of cases. These causes fall into four main categories:
- Vasculogenic conditions like cardiovascular disease, diabetes and high blood pressure affect how blood flows to your penis.
- Neurogenic conditions like spinal injury, Parkinson’s disease and multiple sclerosis impact your nervous system, which can lead to ED.
- Hormonal conditions like hyperthyroidism, hypothyroidism, low testosterone levels or Cushing’s syndrome can make it more difficult to get and maintain an erection.
- Anatomical conditions like Peyronie’s disease, which happens when scar tissue forms over the penis, can cause ED.
Especially when erection issues appear suddenly or for the first time, it’s best to get them checked out in person by a doctor in case there’s an underlying illness that needs treatment.
Does diabetes cause ED?
Does diabetes cause ED? Yes, diabetes often causes erectile dysfunction. In fact, studies have shown that 35-75% of men with diabetes experience erectile dysfunction, versus only 26% of men in the general population. Additionally, erectile dysfunction tends to appear 10-15 years earlier in men with diabetes. This is because diabetes can damage your nerves and blood vessels, making it difficult to get and maintain an erection.
For men with diabetes, ED medications like Viagra can be a good solution. But because diabetes often comes hand-in-hand with other health conditions like high cholesterol or high blood pressure, it’s important to make sure that the erectile dysfunction treatment doesn’t interfere with any other prescribed medication.
But having both diabetes and ED isn’t a done deal. Lifestyle changes that help manage conditions like diabetes, high blood pressure and high cholesterol can also help improve erectile function. Quitting smoking, exercising more and eating a healthy and varied diet have all been found to lower the chance of ED.
Enlarged prostate and ED
Can prostate problems cause ED? Prostate health and erectile function are linked, but it’s complicated. Benign prostatic hyperplasia (BPH) is a condition in which the prostate becomes enlarged and presses on the urethra in the penis. Prostate enlargement and ED are both more common in older men than younger men and while one doesn’t cause the other, some medications that treat BPH can have sexual side effects.
Generally, alpha blockers like tamsulosin have a lower chance of contributing to erectile dysfunction than 5-alpha reductase inhibitors like finasteride. A 2015 study of 407 men treated with finasteride and 230 men treated with tamsulosin found that the finasteride led to erectile dysfunction that didn’t improve when treatment was stopped. Tamsulosin, on the other hand, did not negatively impact erectile function or testosterone levels.
Some prescriptions can be used to treat both ED and BPH at the same time. The erectile dysfunction medication tadalafil (sold under the brand-name Cialis) was approved as a treatment for benign prostatic hyperplasia in 2012. That’s because PDE5 inhibitors like tadalafil relax the bladder and prostate, which helps alleviate lower urinary tract symptoms (LUTS) attributed to BPH in much the same way as relaxing the blood vessels in the penis helps a man get an erection.
Can ED be a sign of prostate cancer?
No, ED is not a sign of prostate cancer. But while the condition itself doesn’t cause ED, its treatment can. Some of the specific procedures that can lead to erectile dysfunction include hormone and radiation therapy as well as prostate surgery, where the prostate gland is removed. Sometimes, erectile function can be regained a few years after surgery.
High cholesterol and erectile dysfunction
Can high cholesterol cause ED? Yes. There are actually a few different ways in which high cholesterol can contribute to erectile dysfunction. High cholesterol makes it more difficult to produce certain chemicals and hormones in the body, like nitric oxide (necessary for erections) and testosterone (which impacts sex drive). Additionally, too much cholesterol creates plaque in your blood vessels, limiting blood flow to the penis.
STDs and erections: is ED a sign?
A sexually transmitted disease, or STD, is what happens when a sexually transmitted infection (STI) goes untreated. Although the two terms are often used interchangeably, they’re not quite the same. But in any case, erectile dysfunction is not usually a sign of an STI or STD.
That’s not to say they’re completely unrelated. Can an STI cause a man not to get hard? Possibly. STIs can affect self esteem and cause psychological erectile dysfunction. Additionally, a painful STI can make it uncomfortable to have sex.
Can chlamydia cause ED? Yes, but this usually happens when untreated chlamydia causes prostatitis (an infection of the prostate) or epididymitis (swelling of the back of the testicles). Chlamydia can also make sex painful, so it’s important to get tested for STIs regularly.
Heart problems and ED: what’s the link?
Erectile dysfunction can be a warning sign of heart disease, and treating diagnosed heart disease can also help treat ED. But how exactly are these two conditions connected?
One heart problem that often appears alongside ED is coronary heart disease, which can cause a painful feeling of pressure in your chest called angina. Coronary heart disease happens when plaque builds up in the arteries and blocks blood flow to your heart and the rest of your body. Because the blood vessels in the penis are so small, ED can be a clue that something is also going on in the heart. Chronic heart failure and ED can also occur together. Erectile dysfunction and libido issues (low sex drive) were reported by up to 75% of patients with heart failure.
If you’re experiencing erectile dysfunction, it’s important to rule out heart problems before beginning treatment. Medications like nitrates, which are used to treat some heart problems, aren’t safe to use with ED pills like Viagra. It’s also possible that if you have an unstable heart condition, you’ll be advised against having sex at all as elevating your heart rate can be dangerous.