Table 3.

Causes of erectile dysfunction

Predisposing	Precipitating	Maintaining
Lack of sexual knowledge	New relationship	Relationship problems
Poor past sexual experience	Acute relationship problems	Poor communication between partners
Relationship problems	Family/social pressures	Lack of knowledge about treatment options
Religious/cultural beliefs	Pregnancy/childbirth	Ongoing physical or mental health problems
Restrictive upbringing	Other major life events	Other sexual problems in the man or his partner
Unclear sex/gender preference	Partner’s menopause	Drugs (see also Table 1)
Previous sexual abuse	Acute physical or mental health problems
Physical/mental health problems	Lack of knowledge about normal changes of ageing
Other sexual problems in the man or his partner	Other sexual problems in the man or his partner
Drugs (see also Table 1)	Drugs (see also Table 1)

Adapted with permission from Hackett et al. (30). Adapted with permission of Blackwell Publishing Ltd., Hackett G. Kell P, Ralph D et al, British Society for Sexual Medicine guidelines on the management of erectile dysfunction. J Sex Med 2008; 5: 1841–65.