Diabetes. Diabetes may contribute to as many as 40% of impotence cases . Between one third and one half of all diabetic men report some form of sexual difficulty. Atherosclerosis and nerve damage are both common complications of diabetes; when the blood vessels or nerves of the penis are involved, erectile dysfunction can result.

High Blood Pressure. Erectile dysfunction is more common and more severe in men with hypertension than it is in the general population. Many of the drugs used to treat hypertension are thought to cause impotence as a side effect; in these cases, it is reversible when the drugs are stopped.

More recent evidence is suggesting, however, that the disease process that causes hypertension itself is the major cause of erectile dysfunction in these men. Newer anti-hypertensive agents, including angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) are less associated with erectile dysfunction. In fact, ARBs may be particularly effective in restoring erectile function in men with high blood pressure who suffer from impotence.

Parkinson’s Disease. As a risk factor for impotence, Parkinson’s disease (PD) is an under-appreciated problem. It is estimated that about one-third of men with PD experience impotence. The physical cause of PD-related impotence is most likely an impaired nervous system. Depression and lowered self-esteem also contribute to erectile dysfunction in these patients.

Other Medical Conditions. Multiple sclerosis (MS), which affects the central nervous system, also precipitates sexual dysfunction in as many as 78% of male patients. Corticosteroids, which are common treatments for MS, may improve sexual function. Other medical conditions that contribute to erectile dysfunctions include spina bifida, a history of polio, and chronic kidney failure.

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American Urological Association