Health advice

What causes erectile dysfunction?

Man in blue shirt sitting on a sofa is holding papers and smiling
There are many reasons why you might experience erectile dysfunction. Whether you have a physical, mental health or neurological condition, understanding the underlying causes will help you find a treatment that works for you.
Causes of erectile dysfunction

Erectile dysfunction can affect your life regardless of age or lifestyle, it is normal to experience symptoms from time to time. But if you struggle to get or maintain an erection regularly, you may want to understand the causes.

Your GP can assess and diagnose you with erectile dysfunction. During your appointment, they’ll ask you about your medical history, lifestyle and examine you to see if you have any physical differences that may contribute to your erectile dysfunction.

It’s important to remember that there are many reasons why you might have erectile dysfunction. Your GP will help you to understand how they might impact your life.

Some common triggers for erectile dysfunction include:

  • Age
  • Feeling tired
  • Anxiety or depression
  • Drinking alcohol
  • Being overweight
  • Some cancer treatments
  • Other health conditions like heart problems.

Getting older can impact your health in a variety of ways.

Erectile dysfunction affects more than 50% of men between the ages of 40 and 70. So, it’s not uncommon for older men to have experienced erection problems at some point in their lives. However, it is increasingly affecting younger men too.1

Although your age can directly impact the likelihood of you developing erectile dysfunction, there are other conditions that can increase your risk for erectile dysfunction. Type 2 diabetes2 and being overweight3 also become more likely as you age. These are two conditions that can trigger erectile dysfunction.4

Even if you think your age might be the cause of your erectile dysfunction. It’s important to talk to your GP or pharmacist about your condition. They’ll discuss your lifestyle and medical history with you to understand the reasons for your ED.

You can also get support from your local sexual health clinic.

Being tired

Being tired or fatigued (extreme tiredness) may cause erection problems.1

Whether you’re finding it difficult to get to sleep at night, feel stress, or have a hormonal condition, your GP will be able to help you understand the reasons why you might feel tiredness or fatigue.

There may be ways you can boost your energy levels and improve your sleep quality that could help you tackle your erectile dysfunction.

If you want to try to improve your energy levels on your own, you could try:

  • Eating a balanced diet
  • Developing positive habits around sleep – relaxing for a few hours before you go to bed and creating a consistent nighttime routine could help
  • Quitting smoking
  • Reducing the amount of alcohol you drink – you should have no more than 14 units per week
  • Avoiding caffeine before going to bed.

Eating a well-balanced diet and exercising regularly can also help if you’re feeling very tired.3

Anxiety and depression

Your mental health can impact your life in a variety of ways.

For some people, erectile dysfunction can be a symptom of anxiety or depression. These conditions can affect the way your brain works and make it more difficult to get an erection.

Alongside your erectile dysfunction, you might notice that you have a reduced sex drive.

It’s always important to seek support for mental health conditions. Your GP can provide guidance and refer you to specialists who can treat you. They will also be able to diagnose you with erectile dysfunction.

Erection problems in men are a reported side effect of taking some types of antidepressants. These types of antidepressants are serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs).4 It’s important to speak to your GP before deciding to stop taking these medicines.

Some people also find that talking to a professional about how you feel can be helpful. Ask your GP if they can refer you to a psychologist or counsellor. Or you can refer yourself for counselling through the NHS. Psychologists and counsellors are professionals who are trained to listen.

Read more about anxiety and depression here.

Alcohol and substance misuse

Alcohol can make you more likely to have erection problems.1,5 Try to reduce the amount of alcohol you drink. National guidelines say not to drink more than 14 units of alcohol a week, which is about six pints of beer a week.6 If you’re finding it difficult to cut down on the amount of alcohol you drink, there are services that can help.

Substances such as MDMA, amphetamines and cocaine have also been shown to increase the risk of erectile dysfunction.7 If you’re struggling with your use of substances, there is help available for you.

Taking prescribed medicines

Taking certain medicines can also cause erectile dysfunction.

Some medications that are more likely to cause erectile dysfunction include:

  • Finasteride
  • Dutasteride
  • Citalopram
  • Sertraline
  • Gabapentin
  • Risperidone
  • Pregabalin
  • Oxycodone.8

Do not stop taking any prescribed medicines without talking to your doctor. They may be able to find an alternative treatment that works better for you, or recommend an erectile dysfunction medication.

Being overweight

You may be more likely to have erection problems if you’re overweight.1 Try to eat a well balanced diet and do regular exercise. Always talk to your GP before you start a new diet or exercise routine. You can read more about maintaining a healthy weight here.

Some cancer treatments

If you’ve been diagnosed with cancer including prostate, bladder or testicular cancer, your cancer treatment may cause erection problems. Read more about cancer treatment and erectile dysfunction here.

Other conditions

If you’ve had heart problems, there is some evidence to show that you’re at an increased risk of having ED.9,10 There is also research to show that if you have ED, you’re at an increased risk of having heart problems.11

People who have been diagnosed with diabetes are also more likely to experience erection problems than people who don’t have diabetes.12

Other health conditions that may cause erection problems include:

  • Multiple sclerosis (MS)13
  • High blood pressure or medicine for high blood pressure14
  • High cholesterol1
  • Low testosterone1
  • Parkinson’s disease.15

Talk to your GP if you have any of these conditions and you’re experiencing ED. If you have ED, there is treatment and support available that can help.

Where can I get further support and information?

As well as talking to your GP for information and support, there are also a number of organisations and charities offering support and information.

British Association for Counselling and Psychotherapy
01455 883 300
Find a registered counsellor or psychologist near you.

British Association of Urological Surgeons
Information for people with erectile dysfunction.

NHS website
Information about erectile dysfunction, treatment options and support.

Sexual Advice Association
Information for men about erectile dysfunction.

  1. Erectile dysfunction (impotence). | Published November 13, 2017 | Accessed September 4, 2020.
  2. Mulhall JP, Luo X, Zou KH, Stecher V, Galaznik A | Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the United States | Int J Clin Pract | 2016;70(12):1012-1018 | doi:10.1111/ijcp.12908.
  3. Sleep and tiredness. | Published April 26, 2018 | Accessed September 4, 2020.
  4. Overview - Antidepressants. Published February 5, 2021. Accessed March 24, 2021.
  5. Dachille G, Lamuraglia M, Leone M, et al | Erectile dysfunction and alcohol intake | Urol J. Published online January 22, 2018 | doi:10.1177/039156030807500305.
  6. Drinkaware Home | Accessed September 4, 2020.
  7. Bang-Ping, J. (2009) ‘Sexual dysfunction in men who abuse illicit drugs: A preliminary report’, The Journal of Sexual Medicine, 6(4), pp. 1072–1080. doi:10.1111/j.17436109.2007.00707.x.
  8. Kaplan-Marans, E. et al. (2022) ‘Medications most commonly associated with erectile dysfunction: Evaluation of the Food and Drug Administration National Pharmacovigilance Database’, Sexual Medicine, 10(5), pp. 100543–100543.doi:10.1016/j.esxm.2022.100543.
  9. Raheem OA, Su JJ, Wilson JR, Hsieh T-C | The Association of Erectile Dysfunction and Cardiovascular Disease: A Systematic Critical Review | Am J Mens Health | 2017;11(3):552-563 | doi:10.1177/1557988316630305.
  10. Hackett G, Kirby M, Wylie K, et al | British Society for Sexual Medicine Guidelines on the Management of Erectile Dysfunction in Men—2017 | J Sex Med | 2018;15(4):430-457 | doi:10.1016/j.jsxm.2018.01.023.
  11. Dong J-Y, Zhang Y-H, Qin L-Q | Erectile Dysfunction and Risk of Cardiovascular Disease | J Am Coll Cardiol | 2011;58(13):1378-1385 | doi:10.1016/j.jacc.2011.06.024.
  12. Diabetes and sexual problems – in men | Diabetes UK | Accessed September 4, 2020.
  13. Erectile dysfunction | MS Trust | Accessed September 4, 2020.
  14. Wang X, Huang W, Zhang Y | Relation between hypertension and erectile dysfunction: a meta-analysis of cross-section studies | Int J Impot Res | 2018;30(3):141-146 | doi:10.1038/s41443-018-0020-z.
  15. Zhao S, Wang J, Xie Q, et al | Parkinson’s Disease Is Associated with Risk of Sexual Dysfunction in Men but Not in Women: A Systematic Review and Meta-Analysis. J Sex Med | 2019;16(3):434-446 | doi:10.1016/j.jsxm.2018.12.017
  16. Sooriyamoorthy T, Leslie SW. Erectile Dysfunction. In: StatPearls. StatPearls Publishing; 2022. Accessed September 16, 2022.

ED treatments are available in our online clinic

A private and secure way to get prescription treatments delivered to you without the need for a GP appointment.

Find out more

Smiling man in burgundy shirt is holding a phone and leaning against a the table

Published: October 2022
Next review: October 2024
Reviewed by: Mital Thakrar, Pharmacist

Help us improve our health information

If you have the lived experience of a health condition and want to help shape the direction of our future content, get in touch. Help us create meaningful and accurate health-related articles and informative content by joining our community.

Learn more