What factors increase the risk of problems?

Various risk factors can affect penis health — some modifiable and some not. 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 medications. Erectile dysfunction is a possible side effect of a number of common medications, including blood pressure drugs, antidepressants, prescription sleep medicine, ulcer drugs and drugs for prostate cancer.
• Prostate cancer treatment. Surgical removal of the prostate gland (radical prostatectomy) and surrounding tissue as treatment for prostate cancer might cause urinary incontinence and erectile dysfunction.
• Smoking. Along with other health risks, smoking increases your chances of having erectile dysfunction.
• Excessive drinking. Excessive drinking can contribute to reduced libido, erectile dysfunction and poor choices in sexual behaviors.
• Hormone levels. Hormone imbalances, especially testosterone deficiency, have been linked to erectile dysfunction.
• Psychological factors. Depression, severe stress or other mental health impairments, as well as medications for these conditions, may increase 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 transfer of nerve impulses from the brain to the penis, causing erectile dysfunction.
• Getting older. Aging generally results in a decline in testosterone levels and is associated with an increased risk of erectile dysfunction, decreased intensity of orgasms, decreased force of ejaculation and less penile sensitivity to touch.
• Unsafe sex. Unprotected sex, sex with multiple partners and other risky sexual behaviors increase the risk of sexually transmitted infections.
• Piercings. A penis piercing can cause a skin infection and disrupt urinary flow. Depending where the piercing is placed, it might also worsen your ability to achieve an erection or orgasm.