Physiological Causes Of Erectile Dysfunction

In this article we’ll be talking about the most common physiological causes of ED.Mind you that ED is usually a combination of underlying factors. For example, you not getting hard could be a mixture of: mental stress, slightly lower levels of testosterone and excessive porn consumption. It’s usually a mix though. Let’s go through the most common causes.

Are You Happy With Your Hardness?

I want to suggest to you to rate your EQ (hardness & ability to maintain erection) based on the following scale before we delve into the good stuff:

5- You have no problems getting hard and staying hard. Your erections are hard as steel consistently.

4-You generally don’t have problems getting hard and staying hard. Your erections are hard but you feel that they could be better.

3-You might have problems getting hard or staying hard at times, but usually don’t. You feel that your penis can be a bit ‘unreliable’ when it’s time to perform

2-You often have problems getting hard and staying hard. You’re definitely not satisfied with your erection quality which is consistently bad.

1-You pretty much always have trouble getting an erection and staying hard. You feel incapable and powerless at times.

Now that you got a better idea of where you at you know how badly you need to work on this. Just remember this: if you truly want to have super erections, you can make it happen as long as you’re willing to put in the effort and make some changes in your life.

Main Physiological causes of ED

Note that the endocrinological (hormonal) causes of ED will be covered extensively in another article soon. It’s just too much to write all in one go and I definitely don’t want to cause any type of information overload.

Erectile Dysfunction as a Health Indicator

Because our body is basically one huge biologically interconnected system, people that suffer from ED usually get an early warning signal that something is not quite right. At the other end of the spectrum, guys who never have problems getting hard will almost always be healthy. However, this is not always as black and white as one would think- there is a grey area.

As you know a lot of blood is needed to achieve a full erection which means that if your penis isn’t working as it should be your body might be ‘warning you’ that there is something wrong, and going limp is simply the physical expression of your (poor) physical health. In fact, there has been a study where 130 men between the age of 30 and 55 underwent heart surgery and almost 60% of them had been suffering from erectile dysfunction. So let this be a warning.

In general though, if you aren’t over 65 you shouldn’t worry about this. However, what we can learn from this is that erectile dysfunction (or lack thereof) is usually a good general health indicator- good or bad.

If you don’t have regular nocturnal penile tumescence (morning wood) it’s likely that something physical (likely hormonal in nature) is not quite right.

On the other hand, if you have regular morning erections, it’s likely that the cause is something else.


Vascular system 

When I talk about the vascular causes of ED I’m referring to the entire vascular system (blood vessels, arteries, smooth muscle tissues etc.). Because the corpora cavernosa need to fill with blood, it is no surprise that vascular problems, limiting blood flow, cause ED. There are four vascular causes that can result in ED namely[1]:

1. Atherosclerosis

2. Venous leakage

3. Hypertension

4. Pelvic deformations

We’ll talk about each of them obviously so you can decide for yourself if any of these causes might apply to your specific case.


1. Atherosclerosis

This medical condition is really just a fancy word of saying that the arteries are hardened.Usually due to a combination of cholesterol and triglycerides building up in the blood vessels the walls are thickened and plague builds up. Due to this thickening, less blood can flow through the vessels. If you are diabetic, this definitely applies to you.

More common causes for younger men are:

  • Hypertension.
  • Smoking.
  • Drug use.
  • Lack of regular physical exercise.
  • Poor nutrition.

2. Venous Leakage

When the structures within the corpora cavernosa fill with blood, the chambers push against the veins (e.g. dorsal vein) preventing blood from leaving the chambers. When someone has a venous leakage, this mechanism does not function properly hence, blood is slowly leaving the chambers- similar to having a flat tire.

If you have no problem getting an erection but have serious problems maintaining one, it could be that you have a minor venous leakage. If this is the case- you need to see a professional. Generally though, it is caused by deformations within the chambers which are extremely unlikely to happen.

3. Hypertension

Hypertension means you have high blood pressure. In 90% of the cases hypertension has no serious underlying medical condition[2]. It just means that the blood vessels are clogged or more narrow causing an increase in blood pressure because the same amount of blood needs to go through a smaller cylindrical tube.

Hypertension can be solved by improving the vascular system in itself.

We can do this by:

  • Getting regular physical exercise
  • Proper nutrition (healthy, balanced, natural foods).
  • Eating specific types of food like raw cacoa (lowers blood pressure).
  • Using supplements that improve bloodflow like Pycnogynol (more on this later).

4. Pelvic Deformations

I won’t go in detail about this. It comes down to this: if you had a serious accident of some sort causing severe disruption in the pelvic region blood flow will be blocked to some extent- resulting in ED. If this would be the case, I’m suspecting you would not be reading this article for you would need to consult a specialist. I just wanted to mention it however for peace of mind.

These are the four main vascular causes of ED.

Let’s go to the habitual causes of ED. Note that I’m using the term habitual in the broad sense- any cause that we can immediately fix.



Based on my experience & research, there are 8 main habitual causes that will fuck up your erection quality namely:

1. Lack of Erections

2. Underdeveloped PC muscles

3. Choke Gripping

4. Being Tired

5. Physical Stress

6. Lack of Physical exercise

7. Poor nutrition

8. Smoking


1. Lack of Erections

When we don’t get erections on a regular basis whether self induced or when having sex the tissues within the corpora cavernosa will weaken. Erections are not only for pro-creation and entertainment: they are a vitally important way to maintain the internal structures and tissues healthy by increasing oxygenation. This means that by getting erections, more oxygen will enter the tissues of the penis resulting in increased nitric oxide levels. In fact, a study published in 2007 actually stated the following:

It is believed that a chronic state of corporal oxygen desaturation or hypoxemia secondary to the loss of nocturnal is a fundamental pathophysiological cause of erectile dysfunction(ED).” (Padmanabhan & McCullough, 2007 p.223)[3]

For a lot of you reading this, simply getting more erections again will have an amazingly positive impact on your ability to get and stay hard. Give the guy some breathing space if you know what I mean-preferably with a hot girl


2. Underdeveloped PC Muscles

Because the PC muscles are responsible for deliberately pumping the blood to the corpora cavernosum underdeveloped PC muscles might prevent you from achieving your desired level of hardness. This will be the problem for a lot of younger guys out there reading this.

So how do you know whether you have underdeveloped PC muscles? It’s hard to tell, though I’d say a good indicator is whether someone actually trains these muscles deliberately, similar to working out your biceps in the gym. If you don’t do any sort of exercises for your PC muscles, chances are you have underdeveloped PC muscles similar to people that don’t go to the gym will likely have underdeveloped muscle groups.

People with very strong PC muscles will always be able to get harder erections because strong PC muscles make it easier for your body to pump blood to the chambers within the shaft of the penis which is why developing a strong set of these ‘sex muscles’ is a must for anyone who wants to have ultimate erection hardness.

Take it from me; its really important to develop good PC muscles for your penile strength. I know there was a hype some years ago and all the media could talk about was doing kegels (developing good PC muscles) and I don’t care if it was a hype, it’s legit and improving them works- simple as that.

 3. Choke-Gripping

Here’s the thing: we tend to choke-grip (CG) (using a very tight grip) when we masturbate (combined with some porn). Now I personally prefer to not masturbate and just get jiggy with a girl but when I still fapped and had problems with getting hard it was probably closely related to the fact that I choke gripped my dick to death and just pumped away like crazy. Whether we’re in a relationship, a fling, or are single, masturbating is the consistent factor here for most guys.

Though I don’t have solid empirical evidence on this one, most of us use the choke-grip pretty much always when we’re masturbating. It’s basically how we conditioned ourselves to masturbate because it’s the most satisfying for our low level of sensational awareness and the easiest and quickest way to reach orgasm which is what it’s all about (until you came across this website I hope).

Ultimately, if you get used to the CG (without having sex for an extended period of time but not necessarily) you’ll likely end up having trouble getting hard at some point. A CG will provide more stimulation than a girls vagina- even if she is super tight.

Since we’re not sure anymore on how to arouse ourselves based solely on our imagination we rely solely on touch as the stimulus for getting aroused and because we’re used to the CG, stimulation during sex often isn’t enough. The touch input we need to get aroused isn’t there which results in various forms of erectile dysfunction. The solution here is simple though: whenever you masturbate, use a light grip. This is really important when you start edging. Don’t choke grip your cock-seriously.

4. Being Tired

It might come as no surprise but simply exhausted whether it’s because you worked all day and had a lot of things on your ‘to do list’ or because you’ve just had a busy week mentally speaking (always fretting, worrying etc.) is not really beneficial for your hardness. Also for guys out there reading this who do any form of penis enlargement: keep in mind that you can sometimes just fatigue your dick so it just needs some time off to recover- don’t worry about it.

Nonetheless it can be quite frustrating when you’re penis isn’t working when you get together with that gorgeous girl.

If you’re reading this you obviously want to find your inner sex god and thus prevent situations like this from happening again. I’m not here to guarantee you that they will never happen again because we all react differently (physiologically speaking) to busy days or weeks. Still, if you make sure you take some time to relax every day and work on improving your PC muscle strength you will see dramatic changes.

5. Physical Stress

Physical stress might seem identical to feeling tired but this is not the case. When you are tired as a result of something that happened or a long day at work, you usually feel drained, you have no energy left. If you are experiencing physical stress however, your body just needs to rest. It’s usually muscle related. It could be anything; maybe you ran a marathon, had an insanely hard work out or were out working on the house the entire day. Whatever it is, sometimes we just need to rest. Unfortunately in these chaotic times we hardly, if ever, take time to actually do so and as a result our hardness suffers.

6. Lack of Physical Exercise

It probably comes as no surprise to you that a lack of regular physical exercise will impact your erection quality (EQ) negatively. Maybe the most important effect of regular physical exercise will be the effect it has on your heart and blood vessels (your cardiovascular system). In order to effectively pump blood through your body and to your genitals you simply need healthy blood vessels and a strong, healthy heart.

In addition to the cardiovascular effect of regularly exercising it will be easier for you to stay in shape. Being in shape is extremely important because people with excess body fat or suffering from obesity will not only be more prone to a lot of medical illnesses but they will also suffer from weak erections due to the cluttering of the arteries (which can result in hypertension or atherosclerosis).

Lastly, exercising regularly will help you get out of a (slight) depression or prevent you from falling in to one. Numerous studies have shown time and time again that people who exercise on a regular basis are generally healthier, happier, and more successful in life.

7. Poor Nutrition

Unfortunately a lot of us in today’s modern consumption society give in to our Caveman brain too frequently and overindulge in excessively fatty, salty, chemically enhanced or sweetened types of food- all being detrimental to our health. Apart from the obvious effect of eating poorly (getting fat) people that don’t receive all the right nutrients will either have high cholesterol levels or feel fatigued at some point. They might not notice this until they actually improve their physical health and realize, in retrospect, how they have a lot more energy as they go through their day but it will definitely be luring, detrimental to your erectile health.

8. Smoking

Obviously one if not the most damaging thing you can do for your penis is smoking whether it would be cigarettes or some form of drugs that you inhale by smoking it. It would be pointless to quote new studies showing how damaging this habit is for your general health, in particular your heart, blood vessels and lungs.

It also damages the endothelium which is the cell lining inside your blood vessels.

There is no pack-a-day 10years+ smoker that will consistently have titanium- like erections without some medical assistance (e.g. using Viagra). In fact, I’d bet my fucking life on it.

This is simply because smoking is suicide in terms of the effects it will have on your blood vessels. If you want ultimate hardness, stop smoking right now. You wanted a reason? Here it is. The more you smoke, the more damage you will inflict upon your arteries thus the harder it will be for your penis to pump blood to the chambers effectively.

Similar to smoking, excessive drinking won’t be beneficial to your erections (as you probably know). There is a reason we call it ‘whiskey dick’. Excessive drinking will result in hardening of the arteries and decrease your cardiovascular system which will in turn affect your blood flow. This is similar to drug use though drugs have the nasty habit if not only messing with your body but also with your mind and your hormones.

Note: because I feel that whiskey dick really needs to be discussed more in depth I’ll go over this in a future article. In the mean time- limit your alcohol consumption

A Word Serious Medical Conditions

Despite the fact that there are a lot of things we can do that could cause ED there are without a doubt some serious medical conditions that can also be the cause of ED that should be mentioned. The most common ones are below:

  • Prostate cancer.
  • Diabetes.
  • Neurological damage.
  • Prescription drugs.
  • Dorsal/superficial trombosed vein.
  • Specific hormonal imbalances.

If you suspect (or know) that you have trouble getting hard because one of the conditions mentioned above I highly recommend you speak to a medical professional as soon as possible.

That said, it’s very very unlikely that you fall in this category but it is good to be aware of serious potential causes. What you could always do is schedule an appointment with your doctor and/or urologist and see whether there might be something that you overlooked which is something I would recommend anyways if you really have problems with it.

Try to pinpoint what you believe are likely physiological causes for your ED. Note that it could be just a mental thing or hormonal thing but as I said before, it’s usually a mixture of causes that is causing you to have erectile dysfunction.



[1] Bonnard, M. (1999) The Viagra Alternative: The Complete Guide to Overcoming Erectile Dysfunction Naturally. Rochester. Healing Arts Press

[2] Carretero, O.A., & Oparil, S. (2000). Essential Hypertension- Part I: Definition and Etiology. Clinical Cardiology: New Frontiers. 101. 329-335

[3] Padmanabhan, P., & McCullough, A.R. (2007). Penile Oxygen Saturation in the Flaccid and Erect Penis in Men With and Without Erectile Dysfunction. Journal of Andrology. 28: 2.

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