Most cases of erectile dysfunction of physical origin, occur in older men and are due to vasculogenic insufficiency that prevents wide opening of the arteries. Known risk factors are linked to both genetics and to lifestyle. Erectile dysfunction is one of the typical symptoms of metabolic syndrome. However, also drug abuse, smoking, obesity, advanced age, renal insufficiency, diabetes and cardiovascular disorders are strongly associated with the development of erectile dysfunction. On the other hand, psychological factors are related to performance anxiety and stress.