The causes of prostate disease and the inability to achieve sufficiently firm and healthy erection are indeed many. Previously, this was commonly called referred to as organic and/or psychogenic erectile dysfunction, while today we know that, in most cases, it is a combination of physical (prostate disease) and psychological factors. The most likely cause of erection dysfunction is the inflow of larger amounts of blood in the corpus and corpus spongiosum penis due to para sympathetically induced increased release of nitric oxide from the local endothelial blood vessel. Venous discharge of these structures is caused by compression of ergotated tissue, but also by the pressure of some pelvic muscles (such as m.Ischiocavernosus and m.bulbospongioso). With the loss of parasympathetic stimulation, there is a disorder of achieving a healthy and firm erection.

In addition to the mentioned neurogenic and vascular factors, psychological and hormonal as well as isoglucogenic factors are important for healthy and strong erections. Of the physical causes of ED, it should be noted that diabetes (which, with its complications on blood vessels and nerves, especially autonomic, can lead to vascular or neurogenic erectile dysfunction), spinal cord injury (it is extremely important to estimate the degree of the damage as this will determine the treatment options a doctor suggests. The treatment, specifically will be relating to how with one may achieve a firm erection with stimulation without visual stimuli or imagination) and endocrine disorders (eg hypogonadism, hyperprolactinemia).

We must not forget the effects of medication that a person is using at the time. Various antihypertensive drugs, endocrine remedies, analgesics, antipsychotics, antidepressants and many others may have a negative effect on achieving a healthy and firm erection.

Psychological factors may be causing (eg: depression and anxiety disorders, particularly panic disorders, significantly increase the incidence of weaker erections) factor in weaker erections. Performance-related stress and the fear of failure is the most important cause of unhealthy erection even when the body’s condition improves (post injury) .

Cultural factors may also have an impact on some men (eg: a misinterpretation that a man must have a strong erection as soon as he sees a beautiful woman, that the intensity of erection during the relationship does not change or takes into account physiological changes occurring at aging; slower erections, greater significance of physical stimulation) and mat also play a crucial role in establishing the diagnosis.

Three causes impacting on achieving a healthy and firm erection

Causes can be divided into three (3) groups:

  1. Organic – as a complication of a prostate disease
  1. Psychological – caused by mental health and emotional problems
  1. Mixed – a combination of organic and psychogenic causes


  • Gradually appearing, except in the case of injuries
  • Constant dysfunction and inability to achieve a healthy and strong erection
  • The absence of erection overnight or early in the morning
  • Being over the the age of 60
  • The ability to achieve an erection and orgasm

Read more about Causes of Organic Erectile Dysfunction >


  • Difficulty in achieving a firm erection (without injury)
  • Relative problems
  • Common night / morning erection
  • Men under 60 years without presence of risk factors
  • Possible disruption of orgasm or ejaculation

In 80% of cases, the causes of impossibility of achieving healthy and firm erections are mixed ethology with dominance of the organic component. Between 35 and 50% of men with diabetes suffer from erectile dysfunction, others with similar chronic illnesses (kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis and other circulatory diseases) have very similar results. The difference in the symptoms of ED depends on the cause of the appearance and prostate diseases that a person is encounters.