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  • Writer's pictureFabio Castiglione

Causes of Erectile Dysfunction

We have dealt with the topic of erectile dysfunction many times, in this article the topic will be: causes of erectile dysfunction. In this article we will check the main causes that lead to this dysfunction.

Causes of erectile dysfunction, we talk about it with Dr. Fabio Castiglione Andrologist.

Dr. Fabio Castiglione Urologist London and Director HolisticAndrology Clinic and Diga33. The center uses a therapeutic approach based on the most recent clinical studies, on the guidelines of the international scientific societies of sexual medicine of which Dr. Castiglione, andrologist London, is a member of the commission.

Erectile dysfunction as we know is the inability to achieve or maintain an erection sufficient to conduct sexual intercourse. It is a fairly common disorder among men over the age of 40, which can have different causes. Unfortunately, there are many possible causes of erectile dysfunction and they can include both emotional and physical conditions.

The most common causes include:

  • Cardiovascular disease.

  • Diabetes.

  • Hypertension or arterial hypertension.

  • High cholesterol.

  • Obesity.

  • Low testosterone levels or other hormone imbalances.

  • Kidney disease.

  • Age.

  • Fatigue.

  • Anxiety.

  • Depression.

  • Relationship problems.

  • Certain prescription drugs, such as those used to treat high blood pressure or depression.

  • Disorders of sleep.

  • Drug use.

  • Consuming too much alcohol.

  • Use tobacco products.

  • Certain health conditions, such as Parkinson's disease or multiple sclerosis (MS).

  • Damage to the pelvic area following injury or surgery.

  • Peyronie's disease, which causes scar tissue to develop in the penis.

Erectile dysfunction, as seen, can be caused by just one of these factors or a combination of some of them. That is why it is important to work with a specialist (Andrologist), so that he can rule out or treat any medical conditions.

The most common causes in detail

Causes erectile dysfunction

From the long list that we have made, we will now go on to analyze the most frequent causes individually, taking into consideration that erectile dysfunction can also be caused by a combination of several factors.

Heart conditions

Conditions that affect the heart and its ability to pump blood well can cause impotence. Without enough blood flow to the penis, you cannot achieve an erection. Atherosclerosis, a condition that causes blood vessels to clog, can cause impotence. High cholesterol and hypertension are also associated with an increased risk of impotence.

High cholesterol and Erectile dysfunction

Diabetes, endocrine diseases

The body's endocrine system produces hormones that regulate metabolism, sexual function, reproduction, mood and much more. Diabetes is an example of an endocrine disease that can cause impotence. Diabetes affects the body's ability to use the hormone insulin. One of the complications associated with chronic diabetes is nerve damage. This affects the sensations of the penis. Other complications associated with diabetes include alterations in blood flow and hormone levels. Both of these factors can contribute to impotence.

Lifestyle factors and emotional disturbances

To achieve an erection, you must first go through what is known as an arousal phase. This stage can be an emotional response. If you have an emotional disorder, this will affect your ability to become sexually aroused. Depression and anxiety are associated with an increased risk of impotence. Depression is a feeling of sadness, loss of hope, or helplessness. Fatigue related to depression can also cause impotence.

Performance anxiety can also cause impotence. If you have not been able to achieve an erection in the past, you may fear that you will not be able to achieve an erection in the future. You may also find that you cannot achieve an erection with a particular partner. If you have been diagnosed with ED related to performance anxiety, you may be able to have full erections when you masturbate or sleep, but you cannot maintain an erection during intercourse.

The abuse of drugs such as cocaine and amphetamines can also cause impotence. Alcohol abuse and alcoholism can also affect the ability to achieve or maintain an erection. See your doctor if you suspect you have a substance abuse problem.

Taking medications

Taking certain medications can affect blood flow, which can lead to erectile dysfunction. N.B. You should never stop taking a drug without your doctor's permission, even if it is known to cause impotence.

Examples of medications known to cause impotence include:

Alpha-adrenergic blockers, including tamsulosin (Flomax).

Beta blockers, such as carvedilol (Coreg) and metoprolol (Lopressor).

Cancer chemotherapy drugs, such as cimetidine (Tagamet).

Central nervous system (CNS) depressants, such as alprazolam (Xanax), diazepam (Valium) and codeine.

CNS stimulants, such as cocaine and amphetamines.

Diuretics, such as furosemide (Lasix) and spironolactone (Aldactone).

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and . In the Massachusetts Male Aging Study, eating a diet rich in natural foods such as fruits, vegetables, whole grains and fish (with less red and processed meat and refined grains) decreased the likelihood of ED.

Pay attention to your vascular health. Hypertension, high blood sugar, high cholesterol, and high triglycerides can damage arteries in the heart (causing heart attack), brain (causing stroke), and penis (causing ED). A voluminous waistline also contributes to this. Simply by going to your doctor for a check up on your vascular system, you will have confirmation if it is in good shape or in need of a tune-up; through lifestyle changes and, if necessary, medication.

Size matters in the sense that if you are overweight you need to lose weight and stay slim! Losing weight can help fight erectile dysfunction, thus achieving optimal weight and maintaining it; is another good strategy to avoid or correct ED. Obesity increases the risks of vascular disease and diabetes, two of the main causes of ED. And the excess fat interferes with several hormones that can be part of the problem.

Move the right muscles. We are not talking about your biceps, but the pelvic floor! A trained pelvic floor increases stiffness during erections and helps prevent blood from leaving the penis by pressing on a key vein. Three months of series twice a day with Kegel exercises (which strengthen these muscles); in combination with biofeedback and advice on lifestyle changes (quitting smoking, losing weight, limiting alcohol); they worked much better than just the advice listed above.

How to cure and fight impotence? What medical treatments are provided?

Urologist London | Andrologist London
Holistic Andrology London

In Holistic Andrology, The therapeutic approach is based on the most recent clinical studies, on the guidelines of international scientific societies of sexual medicine and on the extensive clinical experience gained by Dr. Fabio Castiglione.

Furthermore, each patient is treated, following some fundamental points:

The detailed history and physical examination of the patient are always essential elements to identify the real causes of the dysfunction.

A gradual approach is always suggested, starting with less invasive treatments.

If drug treatment fails, more invasive second-line treatments or investigations may be considered.

Surgery should be reserved for men in whom less invasive reversible treatments have failed or are contraindicated.

The treatment must be personalized and the follow-up must be organized to evaluate the effectiveness and satisfaction of the treatment.

In Holistic Andrology , a personalized therapy is set up that allows the patient to obtain more vigorous erections and continue to have satisfying sexual activity. All treatments are chosen to correct the different underlying causes of erectile dysfunction.

Treatments available for erectile dysfunction cure

The following list shows the available treatments, classified according to the desired therapeutic result.

As-needed solutions, i.e. they allow patients to get erections before and during sexual intercourse:

Medicines by mouth (belonging to the PDE-5 inhibitor category) such as Viagra®, Cialis®, Levitra® and Spedra®

Topical drugs such as:

Penile injections

Alprostadil intraurethral pellets (MUSE®)

Alprostadil cream (Vitaros®)

Vacuum device (vacuum pump)

Penile prostheses.

Penile rejuvenation and physiotherapy

These are treatments that allow you to reinvigorate and rejuvenate the tissues, helping to improve the mechanism of erection.

Pelvic floor strengthening exercises.

Vascular surgery to increase blood flow or reduce venous leakage.


As we have seen, the topic of causes of erectile dysfunction is extensive and complex. In many cases the dysfunction can be the result of one or more causes that must be analyzed and identified by an expert. We have seen that the andrologist is the best figure to untie this intricate knot.

The goal of Dr. Fabio Castiglione, Urologist in London, like any good specialist, is to eliminate, if possible, the causes that lead to this disorder, aiming to achieve a significant improvement in the quality of sexual life of patients.

shockwave for erectile dysfunction
shockwave for erectile dysfunction

HolisticAndrology, urology clinic in London, has always been at the forefront to improve the quality of life for all people suffering from Impotence. If you are interested and want more information, do not hesitate to contact us.

Contact HolisticAndrology, andrology clinic in London (tel. +44 (0) 7830398165) to book an andrological consultation with dr. Fabio Castiglione, Urologist London.

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