Erectile dysfunction

Updated 03 August 2018

Risk factors for erectile dysfunction

There are many risk factors for erectile dysfunction that may interfere with the blood vessels or nerves needed to have normal erections.


The following factors increase the risk of having a problem with the blood vessels or nerves that are needed to have normal erections:

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

It’s important to ensure that diabetes is well controlled from the start as established neuronal and vascular changes are permanent.

• High blood pressure, blood vessel disease and 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 especially applies to the male hormone testosterone. Thyroid problems may also increase the risk of erection problems.

• Multiple sclerosis, Parkinson’s disease, spinal cord injury and other neurological diseases.

• Injury to the penis or pelvic region.

• Pelvic surgery or radiation treatment.

• Use of drugs to treat high blood pressure or depression, diuretics or tranquilisers.

• Chronic alcohol or recreational drug abuse and 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 or marriage)

• Restless legs syndrome. Recent studies show higher incidence of ED in men with this condition.

Read more:

Causes of ED  

Treatment of ED 

Symptoms of ED

Reviewed by Dr Dave Bowden MBBCh (Wits), FCS (SA) Urol. Specialist Urologist in private practice, Christiaan Barnard Memorial Hospital, Cape Town. (February 2015)


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Erectile Dysfunction Expert

Dr Kenny du Toit is a urologist practicing in Rondebosch, Cape Town. He is also consultant at Tygerberg hospital, where he is a senior lecturer at Stellenbosch University. He is a member of the South African Urological Association, Colleges of Medicine South Africa and Société Internationale d’Urologie. Board registered with both the HPCSA (Health professions council of South Africa) and GMC (General medical council UK). He has a keen interest in oncology, kidney stones and erectile dysfunction.

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