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Another 2021 study found that smoking is a Several other health conditions can cause a person to have ED, type 2 diabetes heart, kidney, or blood vessel disease high blood pressure atherosclerosis the buildup of fats, cholesterol, and other substances in or on a persons artery walls multiple sclerosis a chronic condition that affects a persons nervous system injury from treatments for prostate cancer injuries to a persons: penis spinal cord prostate bladder pelvis surgery for bladder cancer Certain psychological factors may cause a person to develop ED, such as: stress anxiety depression low self-esteem guilt or worry about sexual performance or failure Other factors that may contribute to ED include: excessive alcohol intake some illegal drugs having obesity or being overweight not being physically active ED can also be a side effect of several common medications