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Erectile dysfunction (impotence) - Causes

Medical expert of the article

Dr. Leon Agulianski

Urologist

Alexey Kryvenko, medical expert
Last reviewed: 04.07.2025

The reasons for the development of erectile dysfunction (impotence) are the following:

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Psychogenic causes of erectile dysfunction (impotence)

Situational features.
- Neuroses.
- Addiction to psychotropic substances.

Organic causes of erectile dysfunction (impotence)

Vasculogenic.
- Cardiovascular diseases:
- Arterial hypertension.
- Atherosclerosis.
- Diabetes mellitus.
- Hyperlipidemia.
- Tobacco smoking (penile angiospasm).
- Leriche syndrome.
- Veno-occlusive disorders.
- Surgical interventions or radiation exposure in the pelvic area and retroperitoneal space.
Neurogenic.
- Diseases of the brain and spinal cord (Parkinson's disease, stroke, neoplasms, multiple sclerosis, trauma, intervertebral disc lesions).
- Peripheral neuropathies (diabetes mellitus, alcoholism, chronic renal failure, polyneuropathy, surgical interventions in the pelvic area and retroperitoneal space).
Hormonal.
- Hypogonadism (congenital, acquired, age-related).
- Hyperprolactinemia.
- Hyperthyroidism.
- Hypothyroidism.
- Itsenko-Cushing's disease.
Structural (diseases of the penis).
- Peyronie's disease.
- Trauma, congenital curvature.
- Sclerotic changes due to cavernitis or priapism. Small penis.
- Hypospadias, epispadias.

Medicinal Causes of Erectile Dysfunction (Impotence)

Antihypertensive drugs (diuretics, beta-blockers)
Antidepressants
Antiandrogens.
Psychotropic and narcotic drugs.

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Classification of erectile dysfunction (impotence)

Erectile dysfunction (impotence) is classified by severity: mild, moderate, severe; and by the causes of its occurrence: organic, psychogenic and combined, i.e. combining mental and organic factors. It should be taken into account that psychogenic influences are present in all types of erectile dysfunction (impotence).

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