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Erectile dysfunction (impotence) - Causes

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Last reviewed: 04.07.2025
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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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