Testosterone controls much of a man's physical and sexual characteristics.  Low levels of testosterone can cause erectile dysfunction.

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Many prescription drugs that influence hormones, nerves or blood circulation can have an adverse effect on erections.

Eating a diet of high cholesterol and fat can raise blood cholesterol levels.  High levels of cholesterol can lead to clogged arteries which can hinder 

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Recreational drugs or alcohol abuse can decrease blood flow to the penis and.or decrease sex drive.  Long term abuse can lead to ED and other sexual problems.

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Damage to the nerves controlling erection can occur in men with diabetes.

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The chemicals in cigarettes can damage the lining of blood vessels, limiting the movement of blood to your penis.

Certain cancer treatments, such as treatment for prostate cancer, can result in ED as a side effect.  Normal functions can return after one or two years following the cancer treatment without medical interventions.

Depression, anxiety, stress or other mental health conditions can prevent enjoyment of things or activities that bring pleasure.  There is a correlation between a man's state of mind and his ability to perform sexually.

Erections are all about blood flow.  There are a number of causes for clogged arteries including diabetes, high blood pressure and obesity.  If left untreated, clogged arteries can lead to life threatening illnesses.

Several studies have suggested that ED may be a good indicator that a man may likely develop heart disease symptoms within five years.

Long term ED can occur after an injury if the nerves or blood supply is interrupted.  This can include spinal cord injury or major trauma to the pelvis, hips or penis itself.

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Excessive exposure to pornography can exhaust a man's sexual capacity and drive.  The period of time between erections is called the refractory period and that time can increase with age.