It may be a taboo subject, but impotence is a very real and very upsetting condition that affects as many as 30 million American men.

Many men are taken off-guard by this sexual decline and sudden inability to get an erection. Impotence, or erectile dysfunction, could be caused by a whole host of physical and emotional conditions.

Whether you’re concerned about impotence right now or want to learn what to avoid, these five common causes of impotence give you a place to start.

1. Weight-Related Complications

Perhaps the biggest cause of impotence is directly related to weight. If you’re overweight or obese, your likelihood of suffering from erectile dysfunction is higher.

That’s because weight-related complications seriously affect blood circulation. Buildup in arteries restricts blood flow, and without proper blood circulation, there won’t be enough blood to produce an adequate erection. This is more or less the sexual equivalent of a dam blocking a river. Still more weight-related complications damage the blood vessels and nerves that control erection.

The biggest offenders when it comes to weight-related complications are diabetes and atherosclerosis. In fact, some estimates suggest that up to half of men with diabetes also suffer from impotence. Diabetics also experience erectile dysfunction sooner than other men. According to WebMD, men with diabetes develop ED 10 to 15 years earlier than men without diabetes. For diabetics over the age of 70, there’s a 95% likelihood you’ll struggle with erectile dysfunction.

Any way you slice it, that extra weight you’re carrying around is doing serious damage to your love life.

2. Poor Lifestyle Choices

Besides behaviors that lead to weight gain, there are other lifestyle choices that may be hurting your sex life.

Heavy drinking, for example, leads to the condition known as “brewer’s droop” in which men have difficulty attaining an erection. Men with brewer’s droop also experience lower sexual pleasure.

Don’t let yourself think that exchanging temporary impotency for a night of good times is worth it. According to a study in the Journal of Sexual Medicine, men can suffer brewer’s droop for more than a year after giving up heavy drinking.

“It does not seem to be just a temporary problem, because erectile ability was still affected after a year and, according to the results, did not seem likely to improve just with [alcohol] abstinence,” wrote the study authors.

Cigarette smoking also exacerbates existing vascular problems like high blood pressure, worsening circulation and decreasing your ability to achieve an erection.

3. Low Testosterone Levels

As the male sex hormone, testosterone is the driving factor behind a man’s sex drive and performance. Not producing enough testosterone, however, can sap your sex drive in an instant.

These effects were proven in a large study of men in Massachusetts. Of these men, 11% reported a low sex drive. Researchers then tested T-levels in each subject and found that 28% of men with low testosterone levels also had low libido. With an average age of 47, these men were relatively young. You can imagine how the effect worsens with age.

However, low-T levels are rarely the sole cause of impotence. More often than not, there are multiple factors at play. Coupled with conditions like metabolic syndrome, diabetes, endothelial dysfunction, and obesity, low testosterone production can take a sobering toll on romance.

4. Psychological Problems

Of course, not all problems are physical. Sometimes the real reason behind your sexual frustration is knocking around inside your head.

Psychological factors like depression, anxiety, and stress rob you of your sex drive and leave you unable to perform up to expectations. That’s because the process of achieving an erection is controlled by the brain; your dominant mood dictates what impulses are sent from the brain to the penis. If negative impulses are received instead of positive impulses, it will result in poor erection quality or no erection at all.

Even non-diagnosed conditions can affect your sex life. If you’re paralyzed by fear that you’ll fail in bed, it becomes a self-fulfilling prophecy. And of course, failure in bed once is likely to increase your fears and depression. In this way, psychological problems present a vicious cycle that can be difficult to break out of.

5. Prescription Medication

The sobering truth of psychologically-induced impotence is that treating it via prescription medication may actually worsen impotence. This is also true for beta-blockers and diuretics meant to treat high blood pressure.

Because these drugs alter your hormones, nerves, and blood circulation, they can have a profound effect on sexual health and performance. Paired with substances like alcohol, nicotine, and marijuana, effects of these medications may become worse.

Sexual side effects are not often listed on prescription medication labels, which leaves many men at a loss to explain their sudden difficulties in the bedroom.

References

[1] Adams, Stephen. 2013. “Brewer’s droop can hang around for months.” The Telegraph.

[2] Travison et al. “The relationship between libido and testosterone levels in aging men.” The Journal of Clinical Endocrinology and Metabolism.(2006): Vol. 91, Issue 7.