Erectile Dysfunction can be the result of physiological and/or psychological causes. Let’s examine the two.


The University of Maryland Medical Center (UMMC) reports that around 85 percent of ED cases are physically based.

First, we must understand that an erection works simultaneous with the nervous system. Impulses must occur in the brain, spinal column and penis; the nervous system must control these impulses. Healthy levels of nitric oxide must be present in the penile arteries and these arteries must be healthy.

Blocked Arteries

Accordingly, ED occurs more frequently in men who have Diabetes. Diabetes affects arteries by causing them to narrow, which causes insufficient blood flow to the penis. It also affects automatic and sensory nerves, which also cause an insufficient amount of blood to flow to the penis.

Cardiovascular disease causes arteries to harden and narrow. Not only could this lead to ED but it could lead to a stroke or heart attack. Cardiovascular disease is caused by high blood pressure (hypertension), smoking, high cholesterol, drug abuse and smoking.

Injured spinal cord or nerves

Trauma to the spinal cord or nerves could lead to ED because it interrupts communication between the brain, spinal column and penis.

Low Testosterone

Testosterone is a male sex hormone produced primarily in the testes and affects male libido. When a man suffers from low testosterone, his sex life may suffer. A man may experience a condition called ‘testosterone deficiency’ also known by scientists as ‘male menopause’.

Testosterone deficiency may be contributed to…

  • Chemotherapy
  • Injury to the testicles
  • Pituitary gland abnormality
  • Medication (certain antidepressants)
  • Alcoholism
  • Any chronic illness
  • Stress

For men 40 and older, levels of testosterone in the blood stream declines about 1 percent each year and it is believed that as many as one-third of the men in the US have low levels by the age of 60.

Talk to your physician about Testosterone Replacement Therapy.

High Blood Pressure Medicine

High blood pressure medicines are prescribed when diet and exercise fail to get high blood pressure under control. Among high blood pressure medicines, thiazide diuretics and beta-blockers are common causes of erectile dysfunction.

Thiazide diuretics

These are water pills (pills that treat water retention) that decrease blood volume by diuresis (increased production of urine).


Beta-blockers cause the heart to beat slower, which reduces blood pressure.

Below is a chart with common thiazide diuretics and beta-blockers…



Believe it or not, too much anxiety could cause erectile dysfunction. Anxiety can cause fatigue, rapid heartbeat and it can raise your blood pressure. It is one of the most common psychological causes of erectile dysfunction.


Not only does stress raise cortisol levels, it could cause a man to experience erectile dysfunction. Also, too much cortisol could increase belly fat.


Depression is the result of a chemical imbalance in the brain. This imbalance could also affect sexual desire and libido (sex drive).

Once you find out the root cause of what’s causing your psychological issue, the sooner you can work towards fixing the issue. These issues may require therapy, patience and time.

According to a report from the University of Maryland, 15 percent of erectile dysfunction cases are psychologically related.


The postage stamp test will determine if your erectile dysfunction is psychological or physical. This is a test used while a man is asleep to determine his ability or inability to achieve an erection. A strip of four to six postage stamps (any kind) is used for each test. You should wrap the strip of stamps snugly around the shaft of the penis. The stamps need to overlap so the overlapped stamp can be moistened to seal the ring. In the morning, you should check to see if the stamp ring has been broken along the perforations. The test should be done over the course of three days.

Normal= If at least during one of the nights, the ring of stamps is broken between two stamps.

Psychological cause= If the stamp ring is broken, it means that erection problems while you are awake may be the result of a psychological cause.

Physical cause= If the stamp ring does not break on any of the 3 nights, it may be a sign that the erection problem is related to physical conditions or medications.