Erectile dysfunction (ED) is the inability to get or keep a firm erection sufficient for sexual intercourse.

In an erection, impulses from the brain and local nerves cause the muscles of the corpora cavernosa, two chambers in the penis, to relax and allow blood to flow in through the arteries and fill the spaces. The engorged chambers expand the penis and the tunica albuginea, a membrane covering the two chambers, helps to sustain the erection. The erection ends when muscles in the penis contract to stop the inflow of blood and open the veins for blood outflow.

Causes may be classified into several categories :

  • Psychological factors such as stress, anxiety, guilt, depression, low self esteem, and fear of sexual failure.
  • Chronic illnesses such as diabetes, high blood pressure, nerve disease or damage, multiple sclerosis, atherosclerosis and heart disease can damage the nerves and arteries to the penis, resulting in ED.
  • Poor lifestyle such as smoking, excessive alcohol intake, being overweight, and lack of exercise.
  • Pelvic surgery which can injure nerves and arteries near the penis.
  • Medications such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine, an ulcer drug.
  • Hormonal abnormalities such as low levels of testosterone.


Benign prostatic hyperplasia (also called BPH) is a condition that affects the prostate gland in men. The prostate is a gland found between the bladder (where urine is stored) and the urethra (the tube urine passes through).

As men age, the prostate gland slowly grows bigger (or enlarges). As the prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful.

Most symptoms of BPH start gradually.

Symptoms include:

  • the need to get up more often at night to urinate
  • the need to empty the bladder often during the day
  • difficulty in starting the urine flow and dribbling after urination ends
  • the size and strength of the urine stream may decrease

These symptoms can be caused by other things besides BPH. Tell your doctor if you have any of these symptoms, so he or she can decide on the tests to find the possible cause.