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1 Achalasia. 2  Achalasia is a condition that affects the smooth muscle portion of the esophagus, that is, the lower esophagus and the lower esophageal sphincter. 3  Specifically, the peristaltic wave disappears, and the lower sphincter does not relax.
Vascular problems that cause ED may be related to high cholesterol, diabetes, smoking, surgery or medication. Mayo Clinic researchers interested in ED have focused in several areas. The following are summaries of recent and current areas of research in ED. 1  The physiologic mechanisms and chemical processes that medicate smooth muscle relaxation, and penile erection as the end result of smooth muscle relaxation. 2  The association between smoking and erectile dysfunction.