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In general, the causes of erectile dysfunction (ED) may be grouped into the following two major categories:

• Psychogenic erectile dysfunction - the disorder is caused by or attributed to the person's thoughts and emotions.
• Organic erectile dysfunction - the disorder is caused by or can be attributed to a detectable physiological or structural abnormality or change in an organ.

Psychogenic Erectile Dysfunction

A variety of psychogenic factors can lead to the development of erectile dysfunction (ED) including:

• Depression
• Sexual performance anxiety
• Interpersonal relationship difficulties
• Psychological stress

Psychogenic erectile dysfunction is characterized by a sudden onset and results in a complete loss of sexual function. Psychological counseling plays a major role in the management of men who are diagnosed with psychogenic ED. Psychological interventions that may be used for the management of psychogenic ED include:

• Anxiety reduction and desensitization techniques
• Cognitive-behavioral therapy
• Guided sexual stimulation techniques
• Relationship (couples) counseling

Organic Erectile Dysfunction

The term organic erectile dysfunction refers to erectile dysfunction that is caused by an underlying physiologica disorder, anatomical abnormality, or direct trauma to the male genital area. In general, organic causes of ED include:

• Vascular disorders - account for about 40% of cases
• Diabetes - accounts for about 30% of cases
• Medications - account for about 20% of cases
• Pelvic injuries and surgery or radiation therapy to the pelvic area - account for about 6% of cases
• Endocrine (hormonal) disorders - account for about 3% of cases
• Injuries or diseases of the penis - account for about 1% of cases

Unlike psychogenic ED, the onset of organic ED is much more gradual and occurs over a much longer period of time. A major goal in the management of men with organic ED is to identify and treat the underlying organic cause that is responsible for the problem.