Physical causes
- Heart and blood-vessel disease
- Diabetes
- High blood pressure
- Obesity
- Kidney disease
- Neurologic conditions or nerve injury
- Low testosterone or thyroid disorders
- Peyronie’s disease or pelvic injury/surgery
Medication-related causes
Some antidepressants, blood-pressure medicines, antihistamines and other medications can contribute. Never stop a prescribed medicine on your own; ask the prescriber whether an alternative is appropriate.
Psychological and relationship factors
Stress, depression, anxiety and performance anxiety can all affect erections, even when physical health is otherwise good.
Lifestyle contributors
Smoking, heavy alcohol use, recreational drugs, inactivity and poor cardiometabolic health can worsen erectile function.