Erectile dysfunction (ED) can frustrate your relationship with your partner, leading to feelings of depression, anxiety, or low self-esteem. It might feel embarrassing to have ED, especially if you think you’re the only one experiencing it. ED is a fairly common medical condition, affecting about 30 million men in the United States, according to the National Institutes of Health.
ED isn’t always caused by psychological problems, as people used to think. Dr. Justin Houman, a board-certified urologist and fellowship-trained Men’s Sexual and Reproductive Health specialist, tells Health Digest that ED could be a symptom of underlying cardiovascular issues. “The blood vessels in the penis are small, so a lack of blood flow due to plaque buildup or vascular disease can be an early warning sign for heart problems or other circulation issues,” he said.
Houman adds that men with ED also tend to have conditions such as high blood pressure, coronary artery disease, and type 2 diabetes. It’s important to discuss ED with your doctor because untreated ED might also point to other health conditions.
Health conditions that can cause ED
In addition to cardiovascular issues and type 2 diabetes, ED might also be a symptom of chronic kidney disease, multiple sclerosis, or Peyronie’s disease, which is a buildup of scar tissue in the penis. A physical injury to the penis, spinal cord, or pelvis might also trigger ED. You might experience ED after being treated for prostate or bladder cancer. Houman says that treatments for benign prostatic hyperplasia (BPH) could worsen ED.
Medications for blood pressure and prostate cancer might have ED as a side effect. ED might also result if you’re taking antidepressants, sedatives, or appetite suppressants, so check your list of medications to see if ED is a possible side effect. Your behaviors might also factor into ED, such as smoking, heavy drinking, and using illegal drugs. Being overweight or sedentary could also cause ED. Older men are more likely to experience ED, even though ED is not necessarily part of normal aging. However, low testosterone levels, either due to aging or issues with your endocrine system, could cause ED.
ED can affect your mental and emotional health
Your mental and emotional health can also factor into your risk of ED or make ED worse. One problematic night of getting an erection could make you more anxious during your next sexual encounter. “Performance anxiety, in particular, can create a vicious cycle where stress about ED makes it even more difficult to achieve an erection,” Houman said. “Men often associate erections with masculinity, confidence, and sexual identity, so experiencing ED can lead to feelings of embarrassment, frustration, or inadequacy.”
(Read: Is there a cure for erectile dysfunction?)
ED might also affect the mental and emotional health of your partner. According to a 2021 study in Trends in Urology and Men’s Health, your partner might feel unloved or unattractive if you have difficulty getting or maintaining an erection. Your partner might also suspect infidelity or have doubts about the integrity of your relationship. ED could also cause your partner to withdraw intimacy out of a sense of shame. “Seeking support — whether through counseling or open conversations with a partner — can be key to managing these emotional challenges,” Houman said.