Causes of Erectile Dysfunction
The causes of erectile dysfunction are usually either physical, psychological, or a combination of both. Erectile dysfunction can be a short-term problem caused by stress or fatigue, or a long-term issue linked to chronic illness or medication.
Physical Causes
Most cases of ED have a physical origin. Common medical causes include:
Cardiovascular disease – Narrowed or blocked blood vessels reduce blood flow to the penis
Diabetes – Damages nerves and blood vessels, making it harder to achieve an erection
High blood pressure – Affects circulation and may damage penile tissue over time
High cholesterol – Contributes to atherosclerosis, which restricts blood flow
Obesity – Impacts hormone levels and blood circulation
Hormonal disorders, such as low testosterone or thyroid imbalances
Neurological conditions – Multiple sclerosis, Parkinson’s disease, and stroke can interfere with nerve signals
Pelvic surgery or injury – Can damage nerves or arteries needed for erections
Medication Side Effects
Several prescription drugs can lead to ED, including:
Antidepressants
Blood pressure medications (e.g., beta-blockers)
Sedatives
Cancer treatments
Hormone-blocking therapies
Psychological Causes of Erectile Dysfunction
Mental health plays a major role in erectile function. Common psychological causes include:
Stress – Related to work, finances, or daily life
Performance anxiety – Fear of failure during sex
Depression – Can affect libido and physical response
Relationship problems – Poor communication or emotional disconnect
Lifestyle Factors
Unhealthy habits that contribute to ED:
Smoking, which narrows blood vessels
Excessive alcohol use, which impairs hormone levels and nerve function
Drug abuse, particularly stimulants or depressants
Lack of physical activity, which contributes to obesity and poor circulation
In South Africa
In South Africa, ED may go untreated due to cultural attitudes, traditional beliefs, or lack of healthcare access. Chronic illnesses like diabetes and hypertension—both major risk factors—are also on the rise, especially in urban and peri-urban areas. Addressing these underlying causes is key.
Recognising the causes of erectile dysfunction can lead to earlier intervention, better health, and a more satisfying sex life.
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