What factors increase the risk of problems?

A number of risk factors can affect penis health. Some can be changed and some cannot. For example:

• Heart disease, diabetes and related conditions. Heart disease, diabetes, high blood pressure, high cholesterol and obesity can increase the risk of erectile dysfunction.
• Certain medicines. Erectile dysfunction is a possible side effect of some common medicines. These include blood pressure medicines, antidepressants, prescription sleep medicine, medicines that decrease hunger, ulcer medicines and prostate cancer medicines.
• Prostate cancer treatment. Surgical removal of the prostate gland, called radical prostatectomy, and surrounding tissue as treatment for prostate cancer might cause urine leaks and erectile dysfunction.
• Smoking. Along with other health risks, smoking raises the chances of having erectile dysfunction.
• Excessive drinking. Drinking too much alcohol can lead to lower sexual desire, erectile dysfunction and poor choices in sexual behaviors.
• Hormone levels. Hormone imbalances, especially not having enough testosterone, have been linked to erectile dysfunction.
• Psychological factors. Depression, severe stress or other mental health problems, as well as medicines for these conditions, may raise the risk of erectile dysfunction. In turn, erectile dysfunction may contribute to anxiety, depression, low self-esteem or stress about sexual performance.
• Neurological conditions. Stroke, spinal cord and back injuries, multiple sclerosis and dementia can affect the movement of nerve impulses from the brain to the penis. This can cause erectile dysfunction.
• Getting older. Aging generally results in lower testosterone levels. These lower levels can lead to a higher risk of erectile dysfunction, less intense orgasms, lowered force of ejaculation and less sensitivity of the penis to touch.
• Sex that is not safe. Sex without using protection, sex with multiple partners and other risky sexual behaviors raise the risk of sexually transmitted infections.
• Piercings. A penis piercing can cause a skin infection and interrupt the flow of urine. Depending where the piercing is placed, it also might lower the ability to achieve an erection or orgasm.