Temporary or permanent damage to your body that directly or indirectly affects the vascular, neurological, hormonal, or muscular systems can cause ED. For example, ED results from spinal cord injuries, trauma to the perineum (“biker’s ED,” where intense, prolonged bike riding may cause harm to the perineal vascular or neurological system), or damage caused by penile priapism (erections lasting more than four hours). Common causes of ED are surgeries (such as cardiac surgery, radical prostatectomy, spinal cord surgery, or cystecomy) and pelvic area radiation and chemotherapy for cancer treatment.