About Erectile Dysfunction
Erectile dysfunction is characterized by a persistent and recurring inability to achieve or maintain an erection sufficient for sexual intercourse. In the past, doctors used to believe that the causes of erectile dysfunction were purely psychological. In recent years doctors have discovered that there are several physical reasons for erectile dysfunction--it is often the first sign of atherosclerosis and heart disease. Diabetes and hypertension can also contribute to the disorder, as can lifestyle factors like smoking, obesity and alcohol consumption. The disorder most often affects older men, because older men are more likely to have the physical ailments that contribute to erectile dysfunction. However, it is possible for younger men to experience both the physical and psychological issues that cause the disorder.
Physical Causes
While it is unusual for a man in his 20s or 30s to have heart disease, hypertension or type 2 diabetes, it is not impossible. No matter what his age, if a man is obese and sedentary, with poor dietary habits, he is at greater risk of developing those diseases. Additionally, some forms of congenital heart disease may remain hidden and only cause problems as the man ages. Men of any age should contact their physicians if they notice a marked change in sexual function to rule out the possibility of a more serious condition.
Chemical Causes
Young men who have drug and alcohol problems also are more likely to have erectile dysfunction. Overuse and abuse of alcohol and drugs damage the blood vessels, including those that feed the penis, and can also dampen sensation, making it difficult to become aroused. Cigarette smoking also is a factor in erectile dysfunction and, according to Dr. Tony Sliwinski, a urologist at the Virginia Urology Center, smokers are 1 1/2 times more likely to have erectile dysfunction than nonsmokers.
Some prescription drugs, such as selective serotonin reuptake inhibitors, or SSRIs, for depression, have side effects that may affect sexual function.
Psychological Causes
In healthy men under 40--those with no preexisting illness or drug issues--erectile dysfunction is comparatively rare and more likely to have psychological causes. For many young men, performance anxiety plays a large role in erectile dysfunction. Other factors include money and work problems as well as relationship issues and even issues about sexual orientation. On a more serious level, undiagnosed depression and post-traumatic stress disorder can also cause erectile dysfunction--especially if the PTSD is related to a past sexual experience.
