Health Conditions and Treatments Affecting Male Impotence: A Comprehensive Guide

Male impotence
A heart-healthy diet is also a diet that supports optimal erectile function.


Rare indeed is the man who has not experienced occasional difficulty in getting an erection. This sort of problem is usually fleeting and may recur every once in a great while but isn’t part of a persistent pattern of impotence. However, once erection problems recur on a regular basis, there may be good reason to seek medical counsel to determine the cause.

Although the definitions of erectile dysfunction may differ slightly from one authoritative medical reference to another, most agree that ED is a persistent inability to get and keep an erection firm and long-lasting enough for intercourse. If this describes your personal situation, you need to seek professional help to address the problem before it gets worse and even more difficult to treat.

The vast majority of ED can be traced to physiological causes, some of which are symptomatic of common diseases and disorders, as you will learn. The most common physiological cause of male impotence is insufficient blood flow to the penis. Because the signals needed to initiate the erection process are transmitted through the nervous system, damage to nerves can also make it difficult, if not impossible, to achieve and sustain erection.

It is estimated that 10 to 20 percent of all ED can be attributed to psychological issues, such as depression, anxiety, and the inability to cope with the stress in one’s life. ED also occurs in men who suffer from congenital or traumatic damage to the genitals, blood vessels, and nerves. Generally speaking, surgical repair of such damage is necessary to regain normal erectile function.

Unhealthy lifestyle choices often lead to erection problems and can also morph into serious medical conditions if no action is taken to reverse the damage they cause.

Lifestyle-Related Conditions

Unhealthy lifestyle choices often lead to erection problems and can also morph into serious medical conditions if no action is taken to reverse the damage they cause. From comes this list of unhealthy behaviors that can lead eventually to ED and even worse consequences:

  • Heavy alcohol consumption dulls the senses and can make it difficult for a man to get and keep an erection. If you must drink, do so in moderation, which means a drink or two at most.
  • Smoking interferes with the endothelial function of your blood vessels and can lead in time to atherosclerosis, a buildup of fatty plaques on the inner walls of arteries, sharply restricting blood flow.
  • Carrying around excess weight, whether you’re obese or simply overweight, puts an extra strain on your heart and circulatory system and may compromise blood flow to the penis.
  • Eating a diet that is high in calories and fat but low in nutrients can lead to vascular compromise that causes not only ED but cardiovascular disease as well.
  • A sedentary lifestyle is an invitation for a host of health problems, not the least of which might be ED. Even 30 minutes of brisk walking each day can help to undo the damage caused by years of inactivity.
  • Substance abuse is antithetical to healthy erectile function and, depending on the drug of choice, can dull the senses to the physical pleasures of sex.
Male impotence
Chronic high blood pressure can lead to erectile dysfunction.

Cardiovascular Disease

Atherosclerosis, often referred to simply as clogged arteries, is the primary cause of cardiovascular disease. It occurs when the arteries that supply the heart — and also the brain — become clogged with fatty plaques that adhere to artery walls and eventually harden. This process makes the heart work harder to pump oxygen-rich blood to all the systems of the body that depend on it. That includes the penis, which requires a robust flow of blood to facilitate erection.

While men with advanced cardiovascular disease are more likely to suffer from ED than those whose cardiovascular systems are uncompromised, in this particular area, ED symptoms can serve as an early warning system of more serious health consequences. Men who begin to experience erection problems can often head off a future heart attack or stroke by working with their doctors to combat the advance of cardiovascular disease.

As in many diseases that are more common in men with ED, cardiovascular disease often results because of unwise lifestyle choices. Eating a healthy diet, exercising regularly, and kicking the smoking habit are all steps that may preserve — or restore — erectile function while also slowing or halting the advance of cardiovascular disease.

What’s Blood Flow Got to Do with It?

For most healthy men, it’s enough to know that they can get an erection when they need it — and sometimes even when they don’t. It’s only when the plumbing begins to break down that they begin to question how things work. It’s estimated that insufficient blood flow to the penis accounts for roughly 80 percent of all erectile dysfunction. And many of the medical conditions associated with a higher risk of ED arise because of vascular problems or eventually lead to blood flow problems.

Erectile function begins when the brain detects physical stimuli to male erogenous zones or generates feelings of sexual desire. The brain then sends nitric oxide, a vasodilating neurotransmitter, coursing toward the pelvic region. On its way, nitric oxide sets off other chemical reactions, one of which triggers the production of a substance known as cyclic guanosine monophosphate, or cGMP. 

A key player in erectile function, cGMP signals the smooth muscle tissue that lines the walls of arteries supplying the penis to relax. As the muscle tissue relaxes, arteries expand, and blood flow to the penis increases sharply. This sudden rush of blood into the penis quickly fills up the corpora cavernosa, the twin columns of spongy erectile tissue within the shaft of the penis. And thus an erection is produced.


Although the disease is more complex than this definition would indicate, diabetes is a condition in which the levels of glucose, or sugar, in your blood are too high. Millions of Americans suffer from varying degrees of diabetes — both types 1 and 2 — and it is estimated that many others are living with the disease but have not yet been diagnosed and are unaware of the damage it can cause.

While diabetics face an increased risk of a host of other health problems, diabetic males are far more likely than nondiabetic men to develop ED. The disease causes damage to the body’s vascular and nervous systems, both of which play a key role in the election process.

If you have been diagnosed with diabetes, you can help to delay or even prevent the onset of erection problems by managing your disease to the best of your ability. This means scrupulously monitoring blood glucose levels and taking whatever steps are necessary to lower those readings if they climb too high. If you suspect you might have diabetes or have been told you’re at higher risk of the disease, ask your doctor to order frequent blood tests to determine blood glucose levels.

Elevated Cholesterol Levels

Here, once again, you can see the wisdom of the observation that what’s good for the heart is good for the penis, or vice-versa. Chronically elevated blood levels of cholesterol can lead to atherosclerosis, which is the culprit behind the vast majority of ED diagnoses and also can lead to cardiovascular disease.

It’s important to distinguish between the two main types of cholesterol, because not all cholesterol is hazardous to your health. Low-density lipoprotein (LDL) is the proper name of so-called bad cholesterol, which tends to hasten the buildup of fatty plaques on the inner walls of your arteries. Helping to slow that process is high-density lipoprotein (HDL), which is called good cholesterol because it helps to reduce levels of LDL and in the process slows the advance of atherosclerosis.

Hopefully, your doctor already monitors your cholesterol levels, as reflected in blood tests of lipid levels, for which you are usually required to fast for up to 12 hours in advance of the lab tests. If not, talk to the doctor about having these tests done. And should they reveal cholesterol levels that are unhealthy, certain medications and dietary modifications can help to bring them into a normal range.

High Blood Pressure

Also known as hypertension, high blood pressure is a condition that occurs when “the force of your blood pushing against the walls of your blood vessels is consistently too high,” according to the American Heart Association. To facilitate erection, the brain sends signals to the pelvic region that ultimately trigger a relaxation of the smooth muscle tissue that lines artery walls. As this muscle tissue relaxes, arteries expand so that they can carry the increased flow of blood needed to support the erection process. Consequently, the constriction of arteries that occurs in those with high blood pressure is incompatible with the robust blood flow necessary to achieve and sustain an erection.

Medication-Related Impotence

Male impotence
the constriction of arteries that occurs in those with high blood pressure is incompatible with the robust blood flow necessary to achieve and sustain an erection

A host of medications prescribed to treat serious medical conditions have side effects that are inconsistent with optimal erectile function. They may make it impossible to get and keep an erection. However, if your doctor has prescribed these drugs, don’t stop taking them before consulting with her or him. It’s possible that you can be switched to alternative medications that are more erection-friendly.

Space constraints make it impossible to list all the many drugs, both prescription and over-the-counter, that are known to cause ED., a service of the U.S. National Library of Medicine, lists the categories of medications most often associated with erection problems as follows:

  • Antidepressants, designed to improve the mood of patients being treated for depression and anxiety.
  • Antihistamines, prescribed to reduce the discomfort of allergies and upper respiratory infections.
  • Antihypertensives, including diuretics, that are taken to treat high blood pressure.
  • Chemotherapy drugs.
  • Hormonal medications.
  • Parkinson’s disease drugs.

To see if a drug you are taking is on this list, visit the MedlinePlus website. In addition to medications that can cause ED, others interact adversely with the oral ED drugs most often prescribed to treat impotence. Nitrate-based drugs are one example. Like the ED drugs, nitrates work by lowering blood pressure. Taking them together can cause a life-threatening drop in blood pressure.

Metabolic Syndrome

In a posting at, internist Michael Roizen, M.D., says metabolic syndrome “is a rather clunky term for a really common condition that can shorten your life. Before it does that, it can shorten your sex life by causing erectile dysfunction.” He says this condition occurs most often in men who have three or more of the following conditions:

  • Fasting blood glucose readings of 100 milligrams per deciliter or higher.
  • Blood levels of HDL, the “good cholesterol,” that are less than 40 milligrams per deciliter.
  • Triglycerides (another type of fat in the blood) over 150 milligrams per deciliter.
  • A waist size larger than 40 inches.
  • A blood pressure reading over 130/87.

As previously stated, diabetes or even pre-diabetes, elevated cholesterol levels, obesity, and high blood pressure can each increase a man’s risk of ED. It’s hardly surprising that the risk is even higher in men who suffer from several conditions that can compromise blood flow to the penis and, in the case of diabetes, damage nerves as well.

Prostate Disorders

The prostate gland is a walnut-sized male reproductive organ located between the bladder and the penis. While not directly involved in erectile function, the prostate gland can suffer from disorders that lead to treatments that contribute to ED. Both prostate cancer and benign prostatic hyperplasia (BPH), a noncancerous condition, cause an enlargement of the gland, which can interfere with normal urinary and ejaculatory function.

In the case of prostate cancer, surgeries to remove the malignant tissue, even those said to minimize nerve damage, can cause temporary or even permanent erectile dysfunction. BPH is usually treated with drugs, some of which can interfere with erectile function. However, some of the active ingredients in ED medications can help treat BPH even as they help overcome the symptoms of impotence.

Psychological Issues

Male impotence
Health Conditions and Treatments Affecting Male Impotence: A Comprehensive Guide
Although mental and emotional problems can cause erection problems at any age, these psychological issues seem to be more prevalent among younger men. Complicating matters, many of the drugs prescribed to treat such problems can interfere with normal erectile function. According to, common psychological issues associated with ED include:

  • Anxiety, particularly anxiety caused by concerns about how well the man is performing sexually. The more he worries about this question, the more poorly he is likely to function.
  • Depression can affect a man both psychologically and physically.
  • Guilt, often caused by concerns about the degree to which a man is satisfying his partner.
  • Indifference is a phenomenon seen more often in older men who have lost their interest in sex or in their partner.
  • Low self-esteem, which is often fueled by earlier episodes of ED and can become a self-fulfilling prophecy.
  • Stress, a preoccupation with external stressors that can be job-, money-, or relationship-related, can sabotage erectile function.

Sleep Disorders

Good health makes for good sexual function, and it’s hard to attain optimal health if you’re not getting enough sleep. Sleep deprivation and sleep apnea, particularly obstructive sleep apnea (OSA), all can lead to erection problems.

According to the International Society for Sexual Medicine, OSA “occurs when tissue at the back of the throat collapses and blocks a person’s airway. This results in a start-stop breathing pattern, making it difficult to sleep soundly.” The society reports that a 2009 German research study found that 69 percent of the male study participants with OSA also suffered from ED.

While the precise cause-and-effect relationship between OSA and erection problems is unknown, scientists suggest that one possible cause is sleep deprivation, which in turn can reduce the body’s production of testosterone. Failure to get a good night’s sleep leads to fatigue and stress, neither of which are conducive to healthy erectile function. Yet another possible link between OSA and erectile dysfunction is a lack of adequate oxygen supply, which is necessary to support erectile function.

Could Viagra Help?

As has been noted, the most common direct cause of ED is insufficient blood flow to the penis. And many of the medical conditions discussed here are the result of compromised blood flow or lead to vascular problems. Viagra, the granddaddy of the oral ED drugs known as PDE5 inhibitors, and those that followed in its wake are designed to temporarily improve blood flow to the penis, thus making it easier to get and keep an erection.

Clinical tests have shown that Viagra and the other PDE5 inhibitors are effective and safe in the majority of men who are healthy enough to engage in sexual activity. If your doctor has cautioned you against the strenuous activity involved in sex, Viagra isn’t going to change that situation.

To buy Viagra and the other PDE5 inhibitors — Cialis, Levitra, Staxyn, and Stendra — in the United States, you will need a prescription, which you can get from your doctor. You can then fill it at your local pharmacy or use it to order the drug from a reliable online supplier, such as For those who’d like to avoid the added cost of a visit to the doctor’s eDrugstore can arrange a complimentary online consultation with one of its team of licensed U.S. doctors. To learn more and/or place an online order, click below to visit eDrugstore’s Male Impotence page.


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