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Common physical causes of erectile dysfunction Atherosclerosis (clogged blood vessels) High blood pressure High cholesterol Low levels of testosterone Metabolic syndrome (a condition with increased blood pressure, body fat around the waist, high cholesterol, and high insulin levels) Obesity Peyronies disease (a condition where scar tissue develops inside the penis) Sleep disorders Smoking tobacco Some medications Surgeries or injuries that affect the spinal cord or pelvic area