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• Anatomical conditions that result in changes to the physical structure of your penis, for example as a result of Peyronie’s disease, which affects the tissue of the penis, can cause erectile difficulties.

Erectile dysfunction can also be the result of psychological causes like depression and anxiety. Emotional issues can also affect whether you feel physically able to get and keep an erection. If you are having relationship problems or starting a new relationship, if you feel like you don’t know what you’re doing when it comes to sex, if you have had sexual issues in the past or have experienced sexual abuse, then you may find that you are experiencing erectile dysfunction. Counselling can help to resolve these issues.

It is possible to get erectile dysfunction that is caused by both physical and psychological factors. An example might be, if you have multiple sclerosis and find it difficult to get an erection, you may then be worried about this. The two factors together can lead to an episode of ED. 

If you drink alcohol heavily, take illegal drugs like heroin, cocaine or cannabis, or if you are very tired, this can result in erectile dysfunction, too.