Drugs, alcohol, and erections
Alcohol does the exact opposite of erectile dysfunction medication. It reduces how much blood flows to your penis, so getting hard is more difficult. Some illegal drugs do almost the same thing.
To see if this is causing your erectile dysfunction, try an experiment – try getting an erection without drinking first and compare it to times where you have been drinking first and see if there’s a difference.
Drinking heavily and taking drugs long-term can make your erection problems last longer, even when you’re sober.
Stress, fatigue, and erections
Anxiety and stress can affect the blood flow to your penis, and the chemical signals your brain is putting out to get erections going. And, fatigue and tiredness can stop you feeling aroused altogether.
Making sure you’re well-rested and relaxed before sex, and comfortable during, can improve your chances of getting and staying hard. Chronic stress can be managed with relaxation techniques, exercise, and counselling. Fatigue should go away with rest. If it doesn’t, then you might want to talk to a doctor and consider chronic fatigue or depression as possible causes.

Performance anxiety
Performance anxiety, sometimes called ‘stage fright’, is when you can’t do what you’re trying to do because the experience of being watched is too overwhelming for you to focus.
When it comes to sex, the same thing can happen. The pressure to perform can make you feel less aroused, and also cause erectile dysfunction.
Other reasons for performance anxiety can include worrying about ejaculating too quickly, fear of STIs, and even fear of erectile dysfunction itself.
When you’re feeling anxious, your blood is pumped away from places like your penis, and into the heart and lungs to try and help you get ready for ‘fight or flight’. It can also get in the way of you releasing the chemical from your brain that causes erections.
Other mental health causes
Depression and anxiety can both affect erections. Anxiety can increase your stress levels and distract you, making it difficult to feel aroused. Depression can also limit arousal and interest in sex.
The main treatments for both depression and anxiety – selective serotonin reuptake inhibitors (SSRIs, antidepressants) – can also cause erectile dysfunction as a side effect. They can also make it difficult to orgasm, too.
Relationship problems
It’s never good to jump to conclusions about your relationship because you’re having erection problems. There are lots of causes of erectile dysfunction that have absolutely nothing to do with your partner(s). On the other hand, the stresses and pressures of being in a relationship, or certain relationship dynamics, can sometimes be a cause of erectile dysfunction.
If you find that you often lose erections with one person then it could be your feelings towards them are getting in the way. It doesn’t necessarily mean you aren’t still attracted to them (but this is a possibility).

Health conditions
There’s a lot of different health conditions that can cause erectile dysfunction. It is important to have a check-up with your GP if you are having problems with your erections as there may be an underlying health condition causing them.
Common conditions that can cause erectile dysfunction, and how they cause it:
Conditions |
How they cause erectile dysfunction |
- Heart conditions
- High blood pressure
- High cholesterol
- Diabetes
- Metabolic syndrome
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These conditions can all affect blood flow to the penis, making erections more difficult. Scientists think that smooth muscle damage could also link heart conditions with erectile dysfunction.
Diabetes can also cause nerve damage, which can affect the nerves that control your ability to get erections.
Metabolic syndrome is a term used to describe a combination of high blood pressure, diabetes, and obesity. This makes it far more likely that you will get ED than have just one of these conditions.
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Certain sleep disorders such as sleep apnea can cause erection problems. This is because sleep apnea can affect your testosterone levels making it harder for you to get an erection. |
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Prostate infections and treatments for other prostate problems can cause erectile dysfunction. This happens in a number of different ways, including nerve damage during prostate surgery, side effects from medications, or as a direct result of infection. |
If you think you might have one of these conditions, you can check out our sections below on symptoms related to erectile dysfunction and getting tested for erectile dysfunction.
Other medications
Erectile dysfunction can be a side effect of a number of different medications. Below is a list of some medications that are known to cause erectile dysfunction in some men:
- Diuretics – used to treat high blood pressure and some other conditions
- Antihypertensives – used to treat high blood pressure
- Fibrates – used to lower cholesterol (but not the same as statins)
- Antipsychotics – used for some mental health conditions, like schizophrenia
- Antidepressants – used for anxiety, depression, premenstrual syndrome and other conditions
- Corticosteroids – a type of steroid used for asthma and other conditions
- H2-antagonists – used for stomach ulcers
- Anticonvulsants – used to treat epilepsy
- Antihistamines – used for allergies like hay fever
- Anti-androgens – used to treat a number of conditions related to male hormones, like testosterone
- Cytotoxics – used in cancer treatment
If you suspect that your erectile dysfunction is caused by a medication that you are taking, speak to your GP as soon as possible. Your GP may be able to suggest an alternative treatment or advise you on how to lessen this side effect.
Cycling
Definitely one of the more surprising causes, but it’s true – spending a lot of time on a bike can throw a bit of a spanner in your works.
Regular cycling puts a lot of pressure on the area below your penis – the perineum, or ‘gooch’. This can affect the blood flow to the area around your penis, which can make erections less reliable.