Erectile dysfunction (ED) is a condition where a man is unable to get or maintain an erection firm enough for sexual intercourse. Neurological ED is a type of erectile dysfunction where the inability to maintain or sustain an erection is due to a neurological (nerve-related) disorder.

Erection is a complex process that involves your mind, nerves, hormones, and blood vessels. Abnormality of either system can result in ED. The prevalence of neurogenic erectile dysfunction is estimated to be between 10% and 19% of all ED cases.

But the good news is that various treatment options are available to manage ED. So, if you feel you may have a problem with erection, talk to your doctor and they will help you manage it.

You can read more about erectile dysfunction here.

The Process of Erection

Before we move ahead to the causes, let us first understand the process of erection. The shaft of the penis is surrounded by two chambers and contains the urethra in the center.  The surrounding tissues of the chambers include smooth muscle fiber, small blood vessels, and empty spaces. 

Erection is a complex process. When sexually aroused, signals from the nerve endings in the penis or brain prompt the blood vessels to dilate and smooth muscles of the chambers to relax. This causes the empty spaces to fill with blood.

The pressure of blood flow causes the sheath to press on veins, which drain blood out of the penis. The pressure thus traps the blood inside the penis. With more flow of blood, the penis stiffens and expands, resulting in an erection.

When arousal ends, smooth muscles contract, relieving pressure off the veins, and the penis returns to the original flaccid state.

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Neurological Disorders and Erectile Dysfunction

Nerve disorders may alter the processing of sexual stimuli, which may increase or decrease desire, impede arousal, or curb genital engorgement. This is because the alteration of stimuli between the nerves and brain interferes with a climax, genital engorgement, and ejaculation.

Neurological disorders may also make it difficult for you to stimulate, embrace, maintain bowel and urinary continence during sex, or engage in intercourse.


Multiple neurological disorders can increase the risk of ED. As mentioned earlier, nerve diseases alter the brain’s ability to communicate normally with your reproductive system. This can prevent you from getting or sustaining an erection.

Common nerve disorders that are associated with ED are:

  • Parkinson’s disease
  • Multiple sclerosis (MS)
  • Stroke
  • Alzheimer’s disease
  • Brain or spinal tumors
  • Epilepsy
  • Spinal cord injury

Besides, if you have had prostate surgery and experienced nerve damage during surgery, it may result in ED. It is also seen that long-distance bicycle riders can have temporary problems in getting an erection. This is because of the repeated pressure on the genitals and buttocks that alters the functioning of the nerves.


Symptoms of the neurological condition depend on the type of disease. Some common symptoms include:

  • A headache that is different or changes
  • Sudden onset or persistent headache
  • Numbness or tingling sensation
  • Memory loss
  • Double vision or loss of sight
  • Muscle rigidity
  • Impaired mental ability
  • Lack of coordination
  • Seizures
  • Slurred speech
  • Muscle wasting
  • Back pain that radiates to toes, feet, or other parts of the body

Some common symptoms of ED are:

  • Difficulty in getting an erection
  • Difficulty in maintaining the erection
  • Loss of sexual desire


If your doctor feels that you may have a nerve-related disorder, they will check your hearing, vision, and balance. They may also advise imaging tools such as MRI, CT, and PET scans to confirm the diagnosis.

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If you have a neurological disorder and notice a change in the duration or frequency of erections, it is best to consult your doctor. Many men may find talking about this problem embarrassing, but not consulting will only keep you away from a treatment that may reverse your problem.

To confirm the diagnosis, your physician will ask your questions and run a physical check. They may also advise urine and blood tests to ensure the cause of ED, such as low testosterone levels and diabetes.

Once the diagnosis of erectile dysfunction is confirmed, they may refer you to a sexual health expert or prescribe medicines to manage the same. If they feel that pills are not suitable, other treatment options may be recommended (more on this below).

Also, even if you do not have any symptoms of erectile dysfunction or are diagnosed with a neurological disorder, you can discuss the probability of getting it in the future with your physician.

They can help you with lifestyle changes and other precautions you can take to prevent ED.

Treatment and Care

Treatment for your neurological disorders depends on the severity of the type of problem. Managing erectile dysfunction includes oral prescription medicines, lifestyle changes, and preventive measures.


Usually, the doctor’s first choice is oral pills called PDE5 inhibitors. All these medicines do not increase your sexual desire but increase blood flow to the penis and help get an erection when you are sexually aroused.

Prescription medicines for ED include:

  • Sildenafil
  • Vardenafil
  • Avanafil
  • Tadalafil

You should also avoid these medicines if you:

  • Take nitrate drugs
  • Have liver or kidney diseases
  • Have an eye disorder known as retinitis pigmentosa
  • Had a stroke or heart attack in the past six months

However, do not worry, even if pills are not an option for you. There are other ED treatment options as well.

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Other Treatment Options

Some other common treatment options include:

  • Penis suppository
  • Injections
  • Vacuum pump
  • Testosterone replacement
  • Penile implants
  • Vascular surgery

Lifestyle Changes

Whether ED has an emotional or a physical cause, some lifestyle modifications can help manage ED.

Some lifestyle modifications that may help are:

  • Limiting the intake of alcohol 
  • Stop smoking
  • Eating healthy
  • Being active
  • Reducing anxiety


While ED has various causes, certain measures may help you prevent it, especially when you have a neurological disorder. Impotence has a variety of causes. However, there are still measures you can take to help prevent it.

Some possible options include:

  • Avoiding drugs, smoking, or alcohol abuse
  • Following a healthy diet
  • Exercising regularly
  • Getting enough sleep
  • Managing anxiety, stress, and depression

Read more about stress, depression and ED here.

Final Thoughts

Most nerve disorders are long-term diseases, and if left unattended, it may hamper the functioning of various body parts, including the penis, increasing the risk of ED. 

Various treatment options are available to manage ED and help you get back your healthy sex life. Besides, if you have a neurological condition, making certain lifestyle modifications, such as being active and managing stress, may help prevent or manage ED

You can work with your physician and dietitian to manage your neurological condition and prevent ED.

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