Disease conditions that are associated with ED are diabetes, atherosclerosis, high blood pressure, neurological diseases and a variety of operations. Operations that are associated include prostate cancer surgery, some rectal surgery, and some neuro surgery or lower spine operations. Radiation treatment for prostate cancer is also a factor. Medications may cause erectile dysfunctions. Frequent problems occur with medications used for high blood pressure, also with antidepressant medications and other psychoactive medications. Trauma may also cause erectile dysfunction. Fractured pelvis or other injuries in the vicinity of the genitalia may be associated. Smoking is a major associated cause of erectile dysfunction. It certainly can make worse the vascular disease caused by diabetes, atherosclerosis or high blood pressure. Large alcohol intake can be associated with sexual problems. This is due to hormonal changes that may be brought about by liver disease. Mild alcohol intake is not associated with any sexual difficulties.