• Diabetes. Between 35 and 50% of men with diabetes have erection problems. About half of men with diabetes develop erection problems within five years of being diagnosed with diabetes.

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  High blood pressure, blood vessel disease, stroke
• High cholesterol and low HDL (high density lipoproteins) cholesterol (a "good" form of cholesterol that protects you against heart disease)
• Low levels of the hormones needed for the normal development and function of the sex organs (hypogonadism). This leads to low levels of testosterone, the hormone necessary for erections, but does not affect the nerves or blood vessels. Thyroid problems may also increase the risk of erection problems.
• Multiple sclerosis
• Injury to the penis or pelvic region
• Pelvic surgery or radiation treatment
• Use of drugs to treat high blood pressure or depression, diuretics, or tranquillisers
• Chronic alcohol or recreational drug abuse, cigarette smoking

The following factors increase the risk of a psychological cause of erection problems:

• Depression
• Anxiety or stress
• Relationship problems
• Recent major life change (birth of a child, retirement, job change, loss or death of a partner, divorce, marriage)

Reviewed by Dr Werner Botha Specialist Urologist, Cape Town Medi-clinic.

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