Erectile dysfunction can be caused by many factors. These are the most common ones.

While no one wants to experience erectile dysfunction, commonly referred to as ED, many men - and their partners - are often relieved to learn that the condition is far more common than many people realize. 

Various forms of it occur in a significant number of men, says Dr. Paul Turek, a men’s fertility physician and the director of the Turek Clinic in San Francisco. He provides the following formula to his patients on just how often it happens: "ED occurs with a frequency of about one's age minus 10%," he explains. In other words, around 60% of 70-year-olds experience some form of ED and so on.

"The rates are also not insignificant for younger age groups as well, including just under 20% of those who are 18-24-years old experiencing it," adds Dr. Nahid Punjani, a physician and urologist at Mayo Clinic in Arizona.

Is ED the same as erectile dysfunction? 

While ED and erectile dysfunction are the same thing, the condition is also commonly referred to as impotence or sexual dysfunction. No matter what you call it, ED is defined as "the inability to either obtain or maintain an erection sufficient for sexual activity," says Punjani. Indeed, there are three different ways one can experience the condition: not being able to get an erection, not being able to keep one, or both. 

One area of confusion for many people is that various degrees of ED can occur either situationally as a result of any number of factors or chronically as an ongoing issue. "Those who cannot reliably get an erection are more likely to have a chronic problem while those who only occasionally have a problem maintaining an erection are more likely to be dealing with a shorter-term issue such as stress," says Turek. 

What causes erectile dysfunction?

In fact, psychological issues such as poorly managed stress or anxiety are among the most common causes of situational or occasional ED. "Anxiety and stress certainly can contribute to ED by affecting emotional health and causing changes in blood flow and nerve function, which are critical for achieving an erection," says Dr. John Whyte, a practicing physician in Washington D.C. and the chief medical officer at WebMD. He says the two can even create a cycle, "where fear of sexual failure causes ED, which in turn increases anxiety and stress - further exacerbating the problem." 

Adrenaline is also released when one experiences anxiety, "which can block the blood flow to the penis and will also make it leave the penis more quickly, mimicking a physical problem though it is more a situational problem," explains Dr. Stanton Honig, a urologist and chief of the reproductive and sexual medicine department of urology at Yale University School of Medicine. 

Other factors that can contribute to situational ED include fatigue, diet, fighting or disconnection between partners, excessive alcohol consumption, being distracted, or as a result of an injury to the area.

The causes of chronic or persistent ED also vary but are usually "due to underlying pathophysiology such as worsening nerve or blood vessel function," says Dr. Matt Armstrong, a physician and urologist at Revere Health in Utah. As examples, he says that diabetes can cause impaired nerve sensation and function while cardiovascular disease including high blood pressure and high cholesterol levels can also lead to worsened erectile dysfunction over time. Whyte says that hormonal imbalances and advanced age can play a part in similar fashion.

Other less commonly known causes of longer-term ED include "obesity, sleep disorders such as sleep apnea, as a side effect of certain medications, and even cigarette smoking," says Punjani. More rarely, Honig says that even cyclists who ride often and for long distances can develop issues as the repeated impact or pressure on the area from the bike seat can damage arteries and nerves needed for obtaining or maintaining an erection. 

Can erectile dysfunction be cured? 

Situational ED is often resolved as easily as dealing with whatever is causing the temporary issue. For instance, if stress or fatigue are causing problems in the bedroom, getting more sleep or doing more to manage or minimize stress levels will usually lead to favorable outcomes sexually and otherwise. "Sex therapy can have a very beneficial impact on individuals and couples as well," says Armstrong.

But if one is dealing with chronic ED, "seeking out a healthcare provider - initially a primary care doctor for standard treatment, is the best way to go," says Honig. Common treatments include oral medication prescriptions such as sildenafil (Viagra) and tadalafil (Cialis), topical gels, vacuum erection devices or shockwave therapy. 

No matter how you choose to deal with erectile dysfunction, "it's important to remember that it's a common and treatable condition," says Whyte. "Open communication with partners and seeking help when needed can demystify the issue and reduce stigma."