(A) age Current research suggests that age is the strongest independent factor among ED-related risk factors. ed is an age-related disease, with prevalence rates ranging from 0,1% at age 20 to 75% at age 80. 1994 U.S. MMAS results showed that the prevalence of ED in the 40-49, 50-59, 60-69 and 70+ age groups was 38%, 48%, 57% and 67%, respectively. 67%. A random survey of 1582 urban men over 40 years old in Shanghai found that the prevalence of ED was 32,8% for 40-49 years old, 36,4% for 50-59 years old, 74,2% for 60-69 years old, and 86,3% for over 70 years old. Studies have also shown that the association between age and ED not only shows an increase in prevalence, but also a change in severity, with moderate ED more common in older men over the age of 60. It is generally believed that a significant decrease in serum androgen levels with increasing age may be the direct cause. However, there have been no findings demonstrating a significant relationship between decreased serum free testosterone and ED. In addition, as age increases, the structure of the penile white membrane and cavernous body changes, which may lead to a decrease in the ability to block venous blood return; the increased prevalence of cardiovascular diseases, hypertension and diabetes, as well as the treatment of these diseases, all impair the erectile function of the penis to varying degrees, and this trend also increases with age. (B) Somatic diseases 1, cardiovascular diseases Cardiovascular diseases are the main somatic diseases associated with ED, including atherosclerosis, peripheral vascular disease, hypertension and myocardial infarction. Cardiovascular disease by affecting the arterial blood supply to the cavernous body and lead to arterial ED. some studies have found that ED may be the first manifestation of cardiovascular disease or “early warning signs”. 2, diabetes can affect erectile function by affecting the autonomic nervous system, peripheral vascular system and the mental nervous system. The severity and prevalence of ED is significantly related to the age and duration of diabetes, the type of diabetes, blood sugar control, diabetic neuropathy, diabetic nephropathy and hypertension. 3, abnormal lipid metabolism The role of hypercholesterolemia in sexual dysfunction is controversial. A study showed that men with high total cholesterol (TC) had a high risk of ED, and high-density lipoprotein (HDL) was negatively correlated with ED patients. 4, chronic prostatitis Some patients with chronic prostatitis are accompanied by premature ejaculation, decreased libido, erectile dysfunction and painful ejaculation. The mechanism of chronic prostatitis leading to sexual dysfunction is unknown, most scholars believe that anxiety, depression, low self-esteem, low energy, fatigue, paranoia and insomnia are the main causes. The recurrence and non-healing of long-term testicular distension, perineal and penile discomfort, and lower urinary tract symptoms also add to the psychological burden of patients. The majority of the chronic prostatitis patients’ sexual dysfunction is due to psychological factors, in addition to medication, but also need more psychological counseling and treatment. 5, chronic liver and kidney insufficiency The prevalence of ED in patients with alcoholic cirrhosis is 70%, while in patients with non-alcoholic cirrhosis is 25%, suggesting that the prevalence of ED is related to liver insufficiency. The prevalence of ED in patients with chronic renal insufficiency is as high as 45%, but the pathophysiological mechanism is unknown. In addition, for kidney transplant recipients, if the transplanted kidney function is normal, most patients can regain the level of sexual function before the disease. (C) drugs Some anti-hypertensive drugs play an important role in the development of ED, MMAS, and the treatment of cardiac drug-related ED accounted for about 28% of the reported; other drugs, such as hypoglycemic drugs and tricyclic antidepressants can also lead to ED. Cardiac active drugs: long-term use of cardiac glycosides can lead to ED, along with gynecomastia and hypoactive libido, the mechanism is unknown, but the serum estrogen Elevated serum levels of estrogen and decreased levels of luteinizing hormone (LH) and testosterone may play a role. In recent years, digoxin has been found to cause ED by inhibiting the action of sodium/potassium ATPase. Hormones: Estrogens and luteinizing hormone releasing hormone (LHRH) analogs used to treat prostate cancer often cause ED. exogenous estrogens can inhibit gonadotropin releasing hormone secretion and decrease testosterone levels in the blood. The application of LHRH analogues can also reduce libido in 92% of patients and ED in 86% of patients. Psychotropic drugs: Most drugs that can produce central nervous system sedation or depression can lead to ED. causes may include elevated serum prolactin, sedative effects, anticholinergic effects, reduced activity of the dopamine system and the central effects on the limbic system. (D) habits and ED-related habits include: long-term smoking, alcohol and drug use, etc. 1, smoking Epidemiological investigation that smoking can lead to ED, some people believe that smoking can increase the likelihood of ED. But it is certain that smoking can increase the prevalence of cardiovascular disease associated with ED. Smoking may also aggravate the impact of drugs on ED. 2, alcohol abuse ED in alcoholics with a prevalence of more than 50%, mainly manifested as erectile and libido disorders. (E) living conditions Divorced, living alone, the prevalence of ED is higher than those who have a spouse. The prevalence of ED is lower in those with a college degree or higher than in those with a high school degree or lower. High-income people have a lower prevalence of ED than low-income people. It may be that low education and low income people are often accompanied by a lack of attention to health, as well as poor living conditions, while smoking and alcohol abuse tend to be more. (f) Trauma and medical factors ED is associated with pelvic surgery, especially radical prostatectomy, cystectomy, and rectal surgery. In radical prostatectomy, the use of a nerve-preserving procedure can significantly improve postoperative erectile function, but more than 50% of patients still need to seek other forms of postoperative treatment to improve their erectile function; patients with symptoms of lower urinary tract obstruction are also associated with a higher prevalence of ED; genital, pelvic, and spinal cord injuries can destroy the nerves and blood vessels distributed in the penis, which is also a risk factor for ED; spinal cord The severity of ED due to spinal cord injury is determined by the segment of the injury, the presence or absence of spinal shock and the degree of trauma. The incidence of ED is higher in patients with prostate cancer treated with radiation therapy than in patients undergoing radical prostatectomy with preservation of nerves.