What Increases Your Risk

Your risk of developing an erection problem (erectile dysfunction) increases with age.^{1, 2}

• About half of the men between ages 40 and 70 report erection problems.
• More than 15 out of 100 men in their 40s report having a moderate erection problem. But twice as many (about 30 out of 100) men in their 70s say they have a moderate erection problem.
• While only about 5 out of 100 men in their 40s say their erection problems are severe, three times as many (15 out of 100) men in their 70s report severe problems.

Diseases, physical or psychological problems, and certain activities also may increase your risk.

Diseases that affect blood vessels include:

• Diabetes. About half of men with diabetes develop erection problems.²
• High blood pressure or other blood vessel diseases.
• High cholesterol or low HDL (high-density lipoprotein) cholesterol.

Diseases or procedures that affect nerves include:

• Diabetes.
• Multiple sclerosis.
• Stroke.
• Parkinson's disease.
• Having had surgery involving the prostate, bladder, rectum, or urethra. These procedures may cause injury to nerves involved in achieving and maintaining an erection.

Other conditions include:

• Thyroid problems.
• Low levels of the hormones needed for the normal development and function of the sex organs (hypogonadism), leading to low testosterone levels.

Injuries or treatment include:

• Injury to the penis or pelvic region.
• Injury to the spinal cord or nerves to the penis.
• Pelvic surgery.
• Radiation in the pelvic area.

Medicines and other substances that increase your risk include:

• Some medicines to treat high blood pressure or depression.
• Long-term (chronic) alcohol abuse.
• Drug abuse.
• Tobacco use.

Psychological risk factors include:

• Depression.
• Anxiety or stress.
• Relationship problems.
• A recent major life change (birth of a child, retirement, job change, loss or death of a partner, divorce, or marriage).

Activities that constrict blood flow to the penis—such as frequent long-distance bicycle riding on a hard, narrow saddle—may increase a man's risk of developing an erection problem. But experts continue to debate this issue.

A vasectomy usually does not cause erection problems. But pain after the operation may affect sexual performance for a time, and if a man was not comfortable with his decision to have a vasectomy, or is having second thoughts, it could affect him psychologically.