When a man has erectile dysfunction (ED), he cannot achieve or maintain a firm erection. ED is also called "impotence." About one in ten men has erectile dysfunction or some degree of impotence.

Most ED has a physical cause. Diseases such as diabetes or prostate cancer and its treatment, injury, and the side effects of drugs can reduce or prevent blood flow and nerve impulses to the penis. Only about 10% of impotence has a psychological cause. Another physical cause of impotence can be lifestyle. Stress on your body or mind can affect your erectile function.

Key lifestyle changes can reduce your chance of ED Clinical studies have found that changing or managing a variety of lifestyle factors can help decrease the chances of developing impotence.
Quit Smoking
ED. Achieving an erection is a complex process. It involves the nervous (brain, spine, nerves), vascular (blood flow), and endocrine (hormones) systems. When these systems work perfectly, smooth muscles relax and penile tissues fill with blood.

Smoking can harm all of these systems. The Massachusetts Male Aging Study (MMAS) found that smoking worsens cardiovascular problems that lead to impotence. It was found that smokers with heart disease and high blood pressure were impotent more often than non-smokers with the disease.

Quitting smoking can help some men partly or fully restore erectile function. The MMAS results underscored this point, especially in men under 60.
Control diabetes
Diabetes is a major risk factor for erectile dysfunction. Diabetes can harm arteries or nerve endings in the penis. Men with diabetes are 2-5 times more likely to experience impotence. By age 70, more than 50% of men with diabetes have some ED. Diet, exercise, and insulin therapy can help avoid diabetes-related ED.
Reduce cholesterol
can destroy the walls of your veins. It can harden, narrow, or block the arteries leading to your penis. This can result in ED. So check your cholesterol level often. If your cholesterol is high, see a doctor. Reduce and lower cholesterol through diet, exercise, and medication if necessary.
Avoid substance abuse
Abusing alcohol, tobacco, marijuana, cocaine, and other substances is a major cause of impotence. For example, more than 80% of chronic alcoholics have chronic impotence.
Lose weight
The American Urological Association has found that overweight men are more likely to have ED. For example, a man with a waistline of 42 inches was nearly twice as likely to have ED as a man with a 32-inch waistline. Losing weight can help protect your health and your erectile ability.
Exercise
Regular exercise can reduce the chances of getting ED, according to the same American Urological Association study that correlated erectile dysfunction with being overweight.
Reduce stress and anxiety
Stress and anxiety are leading causes of temporary ED. Reducing stress can mean better erections when you want them.

How does an erection occur?
The penis contains two chambers called the corpora cavernosa, which run the length of the organ. A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea.

The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum. Erection begins with sensory or mental stimulation, or both.

Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.

Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.
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