Physical causes: Erectile dysfunction that slowly becomes more noticeable over time usually has a physical cause.
Physical causes can include:
- blockage in the arteries going to the penis
- a disease that affects tissue in the penis
- injury or surgery in the pelvic area (between the hipbones)
- a chronic disease, such as kidney or liver failure
- health conditions that affect the nervous system
- unusual changes in hormones
- side effects of some medications
- alcoholism and/or drug abuse
- heavy smoking
Psychological Causes: Men who notice a sudden change in their ability to have an erection often have a psychological reason for their condition. For example, just as thinking about sex may cause an erection, negative thoughts can stop one from happening. In fact, when erectile dysfunction is caused by psychological reasons only, a man may still have an erection during his sleep or when he wakes up in the morning.
Psychological causes of erectile dysfunction include:
- stress or anxiety at work or at home
- worry or fears about ability to "perform"
- unresolved sexual orientation
- problems in the marriage or relationship
Whether erectile dysfunction is caused by physical factors, psychological factors, or both, the effect it has on a man and his partner can become a significant source of emotional and physical distress for both people.