Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience ED.
Lifestyle choices that contribute to heart disease and vascular problems also raise the risk of erectile dysfunction. Smoking, being overweight, and avoiding exercise are possible causes of ED.
Also, surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.
In addition, many common medicines blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug) can produce ED as a side effect.
Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression). Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.
Source: National Kidney and Urologic Diseases Information Clearinghouse
I’m a thirty four year old guy. I have never had erectile issues before. In fact, I usually stay hard after I am done and can go again. Lately, I have had issues. I do have diabetes where I take insulin, or type 1, but it is tightly controlled. I have looked online and it says that erectile issues are uncommon in people under age of 40.
Also, I have noticed in the last year that I do not have the urge to have sex as much. I used to want it at least once a day, now I am fine with 3-4 times a week. Any thoughts? Are sex drive and erectile dysfunction attached? I want to see my doctor, but am afraid he will try to prescribe Cialis or something, and I have a feeling that’s a temporary solution and not getting to the root problem.
What are the biggest causes in guys in their thirties that experience this, diabetic or otherwise? Is stress a big factor?