Alcohol, tobacco and prescription drugs are a few well-known causes of erectile dysfunction. But plenty of guys who don’t touch the stuff experience erectile dysfunction, too—and for many different reasons. Below, you’ll find five lesser-known causes of erectile dysfunction, explained by Dr. Seth Cohen, assistant professor of urology at the NYU Langone Medical Center.
Are you assaulted by a fear of not performing well in the sack? That can cause erectile dysfunction—and for a scientific reason. Performance anxiety launches the body into a fight-or-flight response, which increases the production of a hormone called cortisol. As Cohen explains, cortisol increases blood flow to the brain and the muscles, which in an actual fight-or-flight situation, would benefit you: The extra blood flow would provide your muscles with the strength necessary to fight or… well, flight. When you’re about to do the deed, however, cortisol is your erection’s worst enemy: “You’ll experience a racing heart and blood flow to the muscles, but we’re not designed to have an erection while running away from a gorilla or a tiger,” Cohen explains. Now that’s an interesting image.
The treatment for sexual performance anxiety (more specifically, psychogenic erectile dysfunction) is typically psychological in nature. “Psychiatry, psychology, sex therapy—you have to work on the issue preventing you from relaxing and having an enjoyable intimate moment,” Cohen adds. This sex guide might also help you relax before hopping between the sheets.
Any kind of damage to the penis can cause erectile dysfunction, for obvious reasons. Here are a few more common causes of penile trauma, according to Cohen:
- Rough Sex: “Penile fracture, or breaking one’s penis, usually happens during rough sexual intercourse,” Cohen explains. “The penis has a thick inner layer that holds the erectile tubes, and if you put too much pressure onto these tubes, your penis will snap.” To clarify, this isn’t a broken bone—in fact, the penis contains zero bones. But the erectile tubes are essential to stiffness, so if they snap, you won’t be able to get it up.
- Prone Masturbation: “Prone masturbation is the act of rubbing the penis against a bed to achieve erection and to ejaculate,” Cohen explains. “The penis was not designed to be rubbed in a strenuous manner against a flat object.” As such, prone masturbation can traumatize the arteries and nerves within the penis—and if you traumatize them enough, boom: Erectile dysfunction.
If you’re running on fumes, your body automatically starts pumping out cortisol, which as we mentioned early on, won’t do your erection any favors: “Cortisol doesn’t care about your erections—it just wants to keep your heart pumping,” Cohen explains, adding that sleep deprivation also messes with testosterone levels.
Metabolic syndrome is a cluster of conditions—including increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol—that increase your risk of heart disease, stroke and diabetes. Having any one of these conditions will also increase your risk of erectile dysfunction. “What diabetes and high blood pressure do is deposit plaque within the arteries throughout the body,” Cohen explains. “The small arteries throughout the body—like those in the penis—are very susceptible to damage and injury as a result.” That’s a real downer, so to speak.
Hypogonadism (Aka, Low Testosterone)
As Cohen explains, the testicles have two main functions: Producing sperm and testosterone. If, however, they become lethargic about producing testosterone—which can happen as a result of hormonal disorders, diabetes or even being kicked in the balls—you’re sure to experience a lower sex drive and erectile dysfunction, since testosterone is the primary male sex hormone.
While it’s possible to supplement testosterone, it comes at a price. “When you take testosterone, you basically tell the brain there’s no purpose for your testicles anymore,” Cohen explains. “Your testicles stop making testosterone and sperm while you’re supplementing, which will make you infertile for the time being.” Numerous studies found that supplementing testosterone resulted in low sperm concentration (oligozoospermia) or even complete absence of sperm in semen (azoospermia) within just 10 weeks.
It’s also extremely important to visit a specialist if you’re experiencing erectile dysfunction, rather than snagging off-label testosterone pills from your buddy at the gym. According to Cohen, those pills can do permanent damage to your baby makers, since adding testosterone to the body through supplementation (especially in inappropriate doses) impedes sperm production.
Treating & Preventing Erectile Dysfunction
So, what can you do to prevent erectile dysfunction? For starters, take care of yourself: Get plenty of sleep and eat well. Second, visit a sex therapist if just the thought of sex causes your palms to sweat. Lastly, protect your penis with all your might. Following this advice, erectile dysfunction will be a thing of the past, and you (and your penis) will be up and running in no time.