There are five major reasons for erectile dysfunction in men.

1. Psychological / Mental -- The causes of psychological sexual dysfunction and loss of libido are numerous, and it is difficult to list them all, but most often low libido is related to stress, lack of adequate sleep, depression, anxiety, marital or relationship problems, life crisis, financial difficulties, problems at work, religious repression, or some forms of mental illness. Getting a deep sleep at night can do wonders for a healthy libido.

2. Hormonal -- Androgens, such as testosterone, are a major component of libido, and they certainly can be considered libido enhancers. Testosterone levels decline about 1 percent each year in men, which may contribute to lower male libido with aging. Testosterone also declines with age in women leading to a decrease in female libido with menopause. Women who have had surgical removal of the ovaries notice a drop in sexual interest. Replacement of androgens can be helpful in those with age related sexual dysfunction. Testosterone is available by prescription only. An over the counter hormones, such as DHEA, converts into testosterone and thus has a positive influence on libido. Pregnenolone is another over the counter hormone that may increase testosterone levels and thus enhance libido. I personally prefer the safer approach of libido enhancement with natural herbs rather than hormones since hormones can have many side effects. Testosterone levels and high or low libido are not always directly linked.

3. Vascular -- Alterations in the flow of blood to and from the penis are thought to be a common cause of male erectile dysfunction. For instance, medical conditions such as atherosclerosis (hardening of the arteries), high cholesterol, hypertension, or diabetes reduce blood flow to the penis and genital organs thus leading to difficulty with erection or genital swelling. Additional factors that can impede blood flow include penile injury, surgery in the pelvic or abdominal area, and sitting on a bicycle too long. Men who log several thousand miles a year on their mountain bikes suffer scrotal damage that could reduce their fertility.

4. Neural -- Nerve damage from disorders such as diabetes, multiple sclerosis, Parkinson's disease, and stroke affect the brain's ability to respond to sexual stimulation. In women, abdominal or pelvic operations can occasionally lead to nerve damage. Sexual dysfunction is common in men undergoing surgical treatment for prostate enlargement or cancer.

5. Chemical -- Some chemicals involved in the human sexual response and libido include dopamine, acetylcholine, and nitric oxide. Excess serotonin can lower libido in men and women. The chemicals we call prescription drugs are often responsible for reduced libido or dysfunction. These include antidepressants (such as Prozac or Zoloft). The primary side effect of these antidepressants is to decrease libido and make the achievement of an orgasm very difficult. Antihistamines, anxiolytics, drugs for Parkinson's disease, and particularly drugs that lower blood pressure can also cause ED. Note that alpha blockers such as Hytrin or Cardura, which are often prescribed for urinary problems following prostate-cancer procedures, lower blood pressure. Proscar (finasteride) and Propecia (a hair-growth drug) also lower libido, as do the medications used in hormone blockade or thyroid treatments. Dopamine antagonists like haloperidol appear to diminish sexual arousal. Tranquilizers, can lower libido and delay or prevent orgasm. Diet aids, sleep aids, and other over-the-counter drugs, which can cause drowsiness, reduce sexual desire, and impair function. Side effects of chemotherapy, can lower libido.

Several antipsychotic agents, including:

• haloperidol (Haldol),
• thioridazine (Mellaril) and
• risperidone (Risperdal)
• can decrease libido.

Erectile dysfunction is not a disease in itself but a symptom or side effect of other problems. Approximately 65 percent of diabetic men over the age of 50 have some degree of erectile dysfunction. Ten to 20 percent of erectile dysfunction cases are reversible. The remaining 80 to 90 percent of cases are not reversible but still treatable. If you have diabetes and it has caused erectile dysfunction (ED), you still have every reason to be optimistic about the future and a healthy sex life. Confidence Rx is a proven treatment for this.

Diabetic erectile dysfunction necessitates adequate long-term glucose control. Doing so can mitigate the disorder may be less severe or avoided completely. Excess sugar (glucose) in your blood can damage the nerves and blood vessels responsible for erections. Your brain might be ready to have sex, but that information isn't relayed to your penis - so it doesn't respond.Conditions that often accompany diabetes, such as cardiovascular disease, can narrow or harden your blood vessels. This may reduce blood flow to your penis, which makes it tough to achieve or maintain an erection. Poor blood sugar control can inhibit the release of a chemical known as nitric oxide. Too little nitric oxide may hamper blood flow to your penis, which - again - makes it tough to achieve or maintain an erection.

If you are experiencing diabetic ED you should;

• Control your blood sugar level. Good blood sugar control can prevent the nerve and blood vessel damage that leads to erectile dysfunction. If you're having trouble controlling your blood sugar level or following your diabetes treatment plan, talk to your doctor.

• Manage your medications. If you're taking any medications that may be contributing to erectile dysfunction - such as certain drugs used to treat depression or high blood pressure - ask your doctor about changing your treatment plan.

• Stop smoking. Smoking and using other types of tobacco narrows your blood vessels. This contributes to blockages that can lead to erectile dysfunction. Smoking can also decrease nitric oxide levels, which may hamper blood flow to your penis.

• Limit how much alcohol you drink. Drinking too much alcohol - more than two drinks a day - can damage your blood vessels and make erectile dysfunction more likely.

• Reduce stress. Stress can hamper your erections. To keep stress under control, evaluate and prioritize your tasks. Set realistic expectations, deadlines and limits - and ask for help when you need it.

• Get physical. Regular exercise can keep your arteries clear, boost your stamina and more. If you're not motivated to exercise on your own, team up with a buddy or join a sports league.

• Fight fatigue. If you're well rested, you're less likely to struggle with erectile dysfunction.

• Deal with anxiety and depression. Anxiety and depression can cause erectile dysfunction. Even the fear of having erectile problems can make erectile dysfunction worse. If you're struggling with anxiety or depression, talk to your doctor or a mental health professional. Treatment is available.

• Consider erectile dysfunction drugs. Your doctor may recommend oral medication to treat erectile dysfunction. Choices may include sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra). These drugs aren't safe for all men, however, especially those who take nitrates to treat heart disease or alpha blockers to treat prostate enlargement or high blood pressure.

• Ask about other treatment options. Pills aren't the only way to treat erectile dysfunction. You may insert a tiny suppository into the tip of your penis to help relax smooth muscle tissue and increase blood flow to your penis. You may inject medication directly into the base of your penis to increase blood flow and cause an erection. Or you may use a vacuum device to draw blood into your penis and create an erection. In some cases, a surgical implant inside your penis may be recommended.

And, don't let embarrassment keep you from enjoying a healthy sexual relationship with your partner. Work closely with your diabetes treatment team to prevent erectile dysfunction or keep it from interfering with your sex life. Erectile dysfunction is a couples problem. What you do about it becomes much easier to accomplish if you and your partner have common goals. Seek qualified medical advice. The doctor's role is to determine the type and cause of the dysfunction and to help you and your partner select an appropriate and effective treatment. If your physician does not normally treat erectile dysfunction, ask him or her to refer you to a specialist, usually a urologist or endocrinologist. But act on the problem and be assured that erectile dysfunction can be successfully treated.

A healthy strong erection requires a precise sequence of many events and ED can occur when any of them is disrupted. Damaged or atrophied muscles, damaged fibrous tissues; veins, arteries, damaged to nerves all contribute to ED. Diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease—account for about 70 percent of ED cases. Lifestyle choices that contribute to heart disease, smoking, obesty and a life devoid of exercise are all possible causes of ED.

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.

Depression & Erectile Dysfunction

Clinical tests used to diagnose ED

Smoking & ED

Alcohol & ED

ED & Race

Blood Pressure Medications and ED