Editing Erectile dysfunction (section)

==Causes==
Causes of or contributors to ED include the following:
* Diets high in [[saturated fat]] are linked to [[heart diseases]], and males with heart diseases are more likely to experience ED.<ref name="dietcauseerectiledysfunction">{{cite web |author=<!--Staff writer(s); no by-line.--> |title=Can Your Diet Cause Erectile Dysfunction? |url=https://health.clevelandclinic.org/can-your-diet-cause-erectile-dysfunction/ |date=20 January 2021 |website=www.clevelandclinic.org |location=[[Cleveland, Ohio]] |publisher=[[Cleveland Clinic]] |access-date=4 January 2022 |archive-date=4 January 2022 |archive-url=https://web.archive.org/web/20220104083111/https://health.clevelandclinic.org/can-your-diet-cause-erectile-dysfunction/ |url-status=live }}</ref><ref name="erectandheartdisease">{{cite web |author=<!--Staff writer(s); no by-line.--> |date=17 July 2019 |title=Erectile Dysfunction & Heart Disease |url=https://my.clevelandclinic.org/health/diseases/15029-heart-disease--erectile-dysfunction |website=www.clevelandclinic.org |location=[[Cleveland, Ohio]] |publisher=[[Cleveland Clinic]] |access-date=4 January 2022 |archive-date=4 January 2022 |archive-url=https://web.archive.org/web/20220104083110/https://my.clevelandclinic.org/health/diseases/15029-heart-disease--erectile-dysfunction |url-status=dead }}</ref> By contrast, [[plant-based diet]]s show a lower risk for ED.<ref>{{cite journal |last1=Bauer |first1=SR |last2=Breyer |first2=BN |last3=Stampfer |first3=MJ |last4=Rimm |first4=EB |last5=Giovannucci |first5=EL |last6=Kenfield |first6=SA |date=November 2020 |title=Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study |editor-last=Rivara |editor-first=FP |editor-link=Fred Rivara |journal=[[JAMA Network Open]] |publisher=[[American Medical Association]] |volume=3 |issue=11 |pages=e2021701 |doi=10.1001/jamanetworkopen.2020.21701 |issn=2574-3805 |pmc=7666422 |pmid=33185675 |s2cid=226850997}}</ref><ref>{{cite journal |last1=Lu |first1=Y |last2=Kang |first2=J |last3=Li |first3=Z |last4=Wang |first4=X |last5=Liu |first5=K |last6=Zhou |first6=K |last7=Wang |first7=W |last8=Shen |first8=C |date=May 2021 |title=The association between plant-based diet and erectile dysfunction in Chinese men |journal=Basic and Clinical Andrology |publisher=[[BioMed Central]] |volume=31 |issue=1 |pages=11 |doi=10.1186/s12610-021-00129-5 |doi-access=free |issn=2051-4190 |pmc=8117588 |pmid=33980148 |s2cid=234476038}}</ref><ref>{{cite journal |last1=Russo |first1=GI |last2=Broggi |first2=G |last3=Cocci |first3=A |last4=Capogrosso |first4=P |last5=Falcone |first5=M |last6=Sokolakis |first6=I |last7=Gül |first7=M |last8=Caltabiano |first8=R |last9=Di Mauro |first9=M |date=November 2021 |title=Relationship between Dietary Patterns with Benign Prostatic Hyperplasia and Erectile Dysfunction: A Collaborative Review |journal=[[Nutrients (journal)|Nutrients]] |publisher=[[MDPI]] on behalf of the EAU-YAU Sexual and Reproductive Health Group |volume=13 |issue=11 |pages=4148 |doi=10.3390/nu13114148 |doi-access=free |issn=2072-6643 |pmc=8618879 |pmid=34836403 |s2cid=244453931}}</ref>
*[[Prescription drugs]] (e.g., [[SSRI]]s,<ref>{{cite journal |vauthors=Delgado PL, Brannan SK, Mallinckrodt CH, Tran PV, McNamara RK, Wang F, Watkin JG, Detke MJ |date=June 2005 |title=Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder |editor-last=Freeman |editor-first=MP |journal=[[The Journal of Clinical Psychiatry]] |publisher=Physicians Postgraduate Press |volume=66 |issue=6 |pages=686–92 |doi=10.4088/JCP.v66n0603 |issn=1555-2101 |pmid=15960560 |s2cid=39581439}}</ref> [[beta blockers]], [[antihistamines]],<ref>{{cite journal | url=https://pubmed.ncbi.nlm.nih.gov/7850330/ | pmid=7850330 | year=1995 | last1=Cará | first1=A. M. | last2=Lopes-Martins | first2=R. A. | last3=Antunes | first3=E. | last4=Nahoum | first4=C. R. | last5=De Nucci | first5=G. | title=The role of histamine in human penile erection | journal=British Journal of Urology | volume=75 | issue=2 | pages=220–224 | doi=10.1111/j.1464-410x.1995.tb07315.x | access-date=2022-12-09 | archive-date=2022-12-09 | archive-url=https://web.archive.org/web/20221209211555/https://pubmed.ncbi.nlm.nih.gov/7850330/ | url-status=live }}</ref><ref>{{cite web | url=https://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction | title=Drugs That Can Cause Erectile Dysfunction }}</ref><ref>{{cite web | url=https://www.yahoo.com/lifestyle/8-substances-that-may-be-killing-your-erection-127187355828.html | title=8 Substances That May be Killing Your Erection | date=26 August 2015 | access-date=9 December 2022 | archive-date=9 December 2022 | archive-url=https://web.archive.org/web/20221209211146/https://www.yahoo.com/lifestyle/8-substances-that-may-be-killing-your-erection-127187355828.html | url-status=live }}</ref> alpha-2 adrenergic receptor agonists, [[thiazides]], hormone modulators, and [[5α-reductase inhibitors]])<ref name="uptodate">Cunningham GR, Rosen RC. Overview of male sexual dysfunction. In: UpToDate, Martin KA (Ed), UpToDate, Waltham, MA, 2018.</ref><ref name="LMCC" />
* Neurogenic disorders (e.g., [[diabetic neuropathy]], [[temporal lobe epilepsy]], [[multiple sclerosis]], [[Parkinson's disease]], [[multiple system atrophy]])<ref name="uptodate"/><ref name="LMCC"/><ref name="booksexualdisfunction">{{cite book |last1=Azadzoi |first1=Kazem M. |last2=Siroky |first2=Mike B. |title=Male Sexual Function |year=2006 |chapter=Neurogenic Sexual Dysfunction in and |location=[[Cham, Switzerland]] |publisher=[[Springer Nature]] |series=Current Clinical Urology |doi=10.1007/978-1-59745-155-0_9 |isbn=978-1-59745-155-0 |pages=195–226 |s2cid=67897138}}</ref>
* Cavernosal disorders (e.g., [[Peyronie's disease]])<ref name="uptodate"/><ref name=AMN>{{cite web |author=<!--Staff writer(s); no by-line.--> |year=2006 |title=Male Sexual Dysfunction Epidemiology |url=http://www.health.am/sex/more/male_sexual_dysfunction_epid/ |work=Erectile dysfunction |publisher=Armenian Health Network, Health.am |access-date=2007-10-07 |archive-date=2021-02-22 |archive-url=https://web.archive.org/web/20210222234413/http://www.health.am/sex/more/male_sexual_dysfunction_epid/ |url-status=live }}</ref>
* [[Hyperprolactinemia]] (e.g., due to a [[prolactinoma]])<ref name="uptodate"/>
* Psychological causes: [[Stage fright|performance anxiety]], [[stress (biology)|stress]], and [[mental disorders]]<ref name=health.am>{{cite web |vauthors=Lue TF |year=2006 |title=Causes of Erectile Dysfunction |url=http://www.health.am/sex/more/causes_of_erectile_dysfunction/ |work=Erectile dysfunction |publisher=Armenian Health Network, Health.am |access-date=2007-10-07 |archive-date=2021-02-22 |archive-url=https://web.archive.org/web/20210222234416/http://www.health.am/sex/more/causes_of_erectile_dysfunction/ |url-status=live }}</ref>
* Surgery (e.g., radical [[prostatectomy]])<ref name=healthcommunities>{{cite web | title =Erectile Dysfunction Causes | publisher =Healthcommunities.com | work =Erectile Dysfunction | url =http://www.urologychannel.com/erectiledysfunction/causes.shtml | year =1998 | access-date =2007-10-07 | archive-date =2007-10-09 | archive-url =https://web.archive.org/web/20071009220836/http://www.urologychannel.com/erectiledysfunction/causes.shtml | url-status =dead }}</ref>
* [[Ageing]]: after age 40 years, ageing itself is a [[Risk factor (epidemiology)|risk factor]] for ED, although numerous other pathologies that may occur  with ageing, such as [[testosterone deficiency]], [[cardiovascular diseases]], or [[diabetes]], among others, appear to have interacting effects<ref name="Gokce">{{cite journal | vauthors = Gökçe Mİ, Yaman Ö | title = Erectile dysfunction in the elderly male | journal = Turkish Journal of Urology | volume = 43 | issue = 3 | pages = 247–251 | date = September 2017 | pmid = 28861293 | pmc = 5562240 | doi = 10.5152/tud.2017.70482 | doi-broken-date = 20 March 2025 }}</ref><ref name="Meldrum">{{cite journal | vauthors = Meldrum DR, Morris MA, Gambone JC, Esposito K | title = Aging and erectile function | journal = The Aging Male | volume = 23 | issue = 5 | pages = 1115–1124 | date = December 2020 | pmid = 31724458 | doi = 10.1080/13685538.2019.1686756 | s2cid = 208018226 }}</ref>
* [[Kidney disease]]: ED and chronic kidney disease have pathological mechanisms in common, including vascular and hormonal dysfunction, and may share other comorbidities, such as hypertension and diabetes mellitus that can contribute to ED<ref name="Papa">{{cite journal | vauthors = Papadopoulou E, Varouktsi A, Lazaridis A, Boutari C, Doumas M | title = Erectile dysfunction in chronic kidney disease: From pathophysiology to management | journal = World Journal of Nephrology | volume = 4 | issue = 3 | pages = 379–387 | date = July 2015 | pmid = 26167462 | pmc = 4491929 | doi = 10.5527/wjn.v4.i3.379 | doi-access = free }}</ref>
* Lifestyle habits, particularly [[smoking]], which is a key risk factor for ED as it promotes [[Atherosclerosis|arterial narrowing]].<ref>{{cite journal | vauthors = Peate I | title = The effects of smoking on the reproductive health of men | journal = Br J Nurs | volume = 14 | issue = 7 | pages = 362–66 | year = 2005 | pmid = 15924009 | doi=10.12968/bjon.2005.14.7.17939}}</ref><ref>{{cite journal | vauthors = Korenman SG | title = Epidemiology of erectile dysfunction | journal = Endocrine | volume = 23 | issue = 2–3 | pages = 87–91 | year = 2004 | pmid = 15146084 | doi = 10.1385/ENDO:23:2-3:087 | s2cid = 29133230 }}</ref><ref>{{cite journal |vauthors=Kendirci M, Nowfar S, Hellstrom WJ | title = The impact of vascular risk factors on erectile function | journal = Drugs of Today | volume = 41 | issue = 1 | pages = 65–74 | year = 2005 | pmid = 15753970 | doi = 10.1358/dot.2005.41.1.875779 }}</ref> Due to its propensity for causing [[detumescence]] and erectile dysfunction, some studies have described [[tobacco]] as an anaphrodisiacal substance.<ref>{{cite journal |pmid=28723353 |year=2015 |last1=Verze |first1=P. |title=The Link Between Cigarette Smoking and Erectile Dysfunction: A Systematic Review |journal=European Urology Focus |volume=1 |issue=1 |pages=39–46 |last2=Margreiter |first2=M. |last3=Esposito |first3=K. |last4=Montorsi |first4=P. |last5=Mulhall |first5=J. |doi=10.1016/j.euf.2015.01.003}}</ref>
*[[COVID-19]]: preliminary research indicates that COVID-19 viral infection may affect sexual and reproductive health.<ref name="Sansone">{{cite journal | vauthors = Sansone A, Mollaioli D, Ciocca G, Limoncin E, Colonnello E, Vena W, Jannini EA |author7-link=Emmanuele A. Jannini| title = Addressing male sexual and reproductive health in the wake of COVID-19 outbreak | journal = Journal of Endocrinological Investigation | volume = 44 | issue = 2 | pages = 223–231 | date = February 2021 | pmid = 32661947 | pmc = 7355084 | doi = 10.1007/s40618-020-01350-1 }}</ref><ref name="Tian">{{cite journal | vauthors = Tian Y, Zhou LQ | title = Evaluating the impact of COVID-19 on male reproduction | journal = Reproduction | volume = 161 | issue = 2 | pages = R37–R44 | date = February 2021 | pmid = 33434886 | doi = 10.1530/rep-20-0523 | s2cid = 229455124 | doi-access = free }}</ref>
Surgical intervention for a number of conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply.<ref name=healthcommunities/> ED is a common complication of treatments for prostate cancer, including [[prostatectomy]] and destruction of the [[prostate]] by [[external beam radiation]], although the prostate gland itself is not necessary to achieve an erection. As far as inguinal hernia surgery is concerned, in most cases, and in the absence of postoperative complications, the operative repair can lead to a recovery of the sexual life of people with preoperative sexual dysfunction, while, in most cases, it does not affect people with a preoperative normal sexual life.<ref name=groin-cause>{{cite journal |vauthors=Zieren J, Menenakos C, Paul M, Müller JM | title = Sexual function before and after mesh repair of inguinal hernia | journal = Journal of Pharmaceutical and Biomedical Analysis | volume = 12 | issue = 1 | pages = 35–38 | year = 2005 | pmid = 15661052 | doi = 10.1111/j.1442-2042.2004.00983.x | s2cid = 30209465 }}</ref>

ED can also be associated with bicycling due to both neurological and vascular problems due to compression.<ref>{{cite journal |vauthors=Sommer F, Goldstein I, Korda JB | s2cid = 34409059 | title = Bicycle riding and erectile dysfunction: a review. | journal = The Journal of Sexual Medicine | volume = 7 | issue = 7 | pages = 2346–58 | date = July 2010 | pmid = 20102446 | doi = 10.1111/j.1743-6109.2009.01664.x }}</ref> The increased risk appears to be about 1.7-fold.<ref>{{cite journal |vauthors=Huang V, Munarriz R, Goldstein I | title = Bicycle riding and erectile dysfunction: an increase in interest (and concern). | journal = The Journal of Sexual Medicine | volume = 2 | issue = 5 | pages = 596–604 | date = September 2005 | pmid = 16422816 | doi = 10.1111/j.1743-6109.2005.00099.x }}</ref>

Concerns that use of pornography can cause ED<ref>{{cite journal | vauthors = Robinson M, Wilson G | title=Porn-Induced Sexual Dysfunction: A Growing Problem | journal=Psychology Today | date = July 11, 2011}}</ref> have little support<ref>{{cite journal |last1=Whelan |first1=Georgina |last2=Brown |first2=Jac |title=Pornography Addiction: An Exploration of the Association Between Use, Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years |journal=The Journal of Sexual Medicine |date=September 2021 |volume=18 |issue=9 |pages=1582–1591 |doi=10.1016/j.jsxm.2021.06.014 |pmid=34400111 |issn=1743-6109 |quote=There was no evidence for an association between internet pornography use with erectile dysfunction, premature ejaculation, or sexual satisfaction. However, there were small to moderate positive correlations between self-perceived internet pornography addiction and erectile dysfunction, premature ejaculation or sexual dissatisfaction.|doi-access=free }}</ref><ref>{{cite journal |last1=Grubbs |first1=Joshua B. |last2=Gola |first2=Mateusz |title=Is Pornography Use Related to Erectile Functioning? Results From Cross-Sectional and Latent Growth Curve Analyses |journal=The Journal of Sexual Medicine |date=January 2019 |volume=16 |issue=1 |pages=111–125 |doi=10.1016/j.jsxm.2018.11.004 |pmid=30621919 |s2cid=58592884 |issn=1743-6109 |quote=there was evidence of a positive, cross-sectional association between self-reported problematic use and ED, but no consistent association between mere use itself and ED.|doi-access=free }}</ref> in epidemiological studies, according to a 2015 literature review.<ref>{{cite journal | vauthors = Landripet I, Štulhofer A | title = Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men? | journal = The Journal of Sexual Medicine | volume = 12 | issue = 5 | pages = 1136–1139 | date = May 2015 | pmid = 25816904 | doi = 10.1111/jsm.12853 | doi-access = free }}</ref> According to [[Gunter de Win]], a Belgian professor and sex researcher, "Put simply, respondents who watch 60 minutes a week and think they're addicted were more likely to report sexual dysfunction than those who watch a care-free 160 minutes weekly."<ref name="Boom 2020">{{cite web | vauthors=Van Boom D | title=Porn addiction is ruining lives, but scientists aren't convinced it's real | website=CNET | date=1 December 2020 | url=https://www.cnet.com/features/porn-addiction-is-ruining-lives-but-scientists-arent-convinced-its-real/ | access-date=2 October 2021 | archive-date=3 November 2021 | archive-url=https://web.archive.org/web/20211103032850/https://www.cnet.com/features/porn-addiction-is-ruining-lives-but-scientists-arent-convinced-its-real/ | url-status=live }}</ref><ref name="Jacobs Geysemans Van Hal Glazemakers p. ">{{cite journal | vauthors = Jacobs T, Geysemans B, Van Hal G, Glazemakers I, Fog-Poulsen K, Vermandel A, De Wachter S, De Win G | title = Is online pornography consumption linked to offline sexual dysfunction in young men? A multivariate analysis based on an international web-based survey | journal = JMIR Public Health and Surveillance | date = September 2021 | volume = 7 | issue = 10 | pages = e32542 | pmid = 34534092 | doi = 10.2196/32542 | publisher = JMIR Publications Inc. | pmc = 8569536 | quote = '''Conclusions:''' This prevalence of ED in young men is alarmingly high and the results of presented study suggest a significant association with PPC. | doi-access = free }}</ref>

In seemingly rare cases, medications such as SSRIs, [[isotretinoin]] (Accutane) and [[finasteride]] (Propecia) are reported to induce long-lasting [[Iatrogenesis|iatrogenic]] disorders characterized by sexual dysfunction symptoms, including erectile dysfunction in males; these disorders are known as [[Selective serotonin reuptake inhibitor#Sexual dysfunction|post-SSRI sexual dysfunction]] (PSSD), post-retinoid sexual dysfunction/post-Accutane syndrome (PRSD/PAS), and [[Finasteride|post-finasteride syndrome (PFS)]]. These conditions remain poorly understood and lack effective treatments, although they have been suggested to share a common etiology.<ref>{{Cite journal |last1=Giatti |first1=Silvia |last2=Diviccaro |first2=Silv.ia |last3=Panzica |first3=Giancarlo |last4=Melcangi |first4=Roberto Cosimo |date=August 2018 |title=Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin? |url=https://pubmed.ncbi.nlm.nih.gov/29675596/ |journal=Endocrine |volume=61 |issue=2 |pages=180–193 |doi=10.1007/s12020-018-1593-5 |issn=1559-0100 |pmid=29675596 |s2cid=4974636 |access-date=2022-12-27 |archive-date=2022-12-27 |archive-url=https://web.archive.org/web/20221227060439/https://pubmed.ncbi.nlm.nih.gov/29675596/ |url-status=live }}</ref>
* Rarely impotence can be caused by [[aromatase]] being active. See [[Androgen replacement therapy]].