Erection problems are often caused by a combination of physical and psychological factors. The following causes are possible:
Physical:
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When older, it takes longer before the penis gets stiff and the man needs to be sexually stimulated for longer.
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Anomalies in the vessels, for example due to heart and vascular diseases like arteriosclerosis and high blood pressure.
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Surgery of the prostate.
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Diseases and medication for heart and vascular diseases, diabetes
mellitus, multiple sclerosis and Parkinson's disease can be a cause.
Medicines for depression and high blood pressure may cause erection
problems (see also other question).
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Smoking, drugs and alcohol dependence.
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Anomalies of the penis.
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Hormonal anomalies.
It is important to know whether the body functions well. When an erection is possible: in the morning, while sleeping or when masturbating then physical problems can be excluded.
Erection problems are often a symptom of some other illness. Thus, if a man starts having erection problems, he should always get a general medical examination.