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Vascular Disease is the leading cause. Vascular disorders including arteriosclerosis (hardening of the arteries), hypertension, hypercholestremia and other conditions which interfere with the blood flow to the penis. Additionally, "venous leakage" also contributes to poor erections. This condition occurs when the penile veins are unable to constrict efficiently during an erection. When these veins "leak" blood escapes to the periphery resulting in a poor penile erection

Diabetes is another common cause. Approximately fifty percent of men with diabetes (insulin dependent) experience some degree of sexual dysfunction after the age of fifty-five. Diabetes results in poor circulation and/or peripheral neuropathy. When the nerves are involved sexual stimuli are not transmitted appropriately to or from the brain and erectile dysfunction develops.

Substance Abuse can also negatively effect male potency. The chronic use of cocaine, marijuana, alcohol, steroids etc. often results in impotence, as well as a decrease in desire. Excessive tobacco use can also attribute to sexual dysfunction by accentuating the effects of other risk factor such as vascular disease or hypertension.

Radical Pelvic Surgery. Surgical procedures involving the prostate gland, bladder or colon may interfere with the nerves involved in the erectile response. Radiation therapy for cancer may also effect the erectile process.

Neurological diseases health problems such as multiple sclerosis, Parkinson's disease, spinal cord injuries, long term effects of diabetes can also result in the disruption of the normal sequence of events necessary for an erection to occur.

Deficiencies in the Endocrine System health problem are another source. Low levels of testosterone or thyroid hormone can interfere with the stimulation process necessary in the erection sequence. Excessive production of prolactin by the pituitary gland may contribute to decreased levels of testosterone resulting in a lack of desire. Diabetes once again enters the scenario as it is classified as an endocrine disorder.

Psychological health issue is usually diagnosed when no physical causes can be defined. Pure psychological sexual dysfunction usually occurs suddenly without warning as opposed to physical sexual dysfunction that may gradually develop over years. Some common causes of psychological male sexual dysfunction are as follows:

• Performance anxiety is one of the most common causes. When a man feels pressured to achieve or maintain an erection, he will commonly become anxious and nervous when in a sexually demanding situation. Stress increases the body's production of catecholamines such as adrenaline and nor-adrenaline, which act as erection inhibitors. The release of these inhibitors further contributes to failure resulting in more anxiety. Therefore, the cycle begins, increased stress resulting in increased catecholomines that further inhibits the erectile process.
• Depression health problem is another cause of psychogenic sexual dysfunction. Unfortunately, many of the popular antidepressant medications (for a list see prescription medications in the next section) have side effects which include erectile failure.

Anatomical Deviation of the Penis, Peyronies Disease, may also cause sexual dysfunction. This condition usually develops from an inflammatory process and results in fibrous scaring of the penis. (The cause of this process is not yet understood) However, when an erection does occur, there is a bending of the penis secondary to the scar tissue. This curvature may interfere with erectile capacity and/or ejaculation.

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