Erection Problems (Erectile Dysfunction) - What Increases Your Risk

What Increases Your Risk

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

• About 40% of men in their 40s report at least occasional problems getting and maintaining erections.
• 52% of men between ages 40 and 70 report erection problems.
• About 70% of men in their 70s report erection 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.

Medications and other substances that increase your risk include:

• Medications 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. However, experts continue to debate this issue.

A vasectomy usually does not cause erection problems. However, 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.