What Causes Erectile Dysfunction?

What can be done to help?

Erectile dysfunction can be described as the inability to achieve or maintain an erection long enough to have fulfilling sexual intercourse.

An erection is achieved when there is sexual arousal and the brain sends nerve signals to the penis which in turn increases its blood flow,  which results in the tissue expanding and hardening.  On the basis that three factors are involved, that is, arousal, nerve stimulation and blood flow, if there is any disruption to any of these contributory factors then erectile dysfunction will ensue.

The cause of erectile dysfunction can be split into two areas, the psychological causes and the physical causes.

 

Psychological causes

  • Depression
  • Anxiety
  • Fear of sexual failure
  • Guilt (the belief that sexual intercourse is wrong)
  • Low self-esteem
  • Stress
  • Post-traumatic stress disorder

 

Physical causes

  • Diabetes - whilst the cause of ED in men suffering from diabetes is quite complex, generally speaking, diabetes can result in disruption of blood flow to the penis as well as damage to the nerves responsible for the erection process.
  • Heart and blood vessel disease - the same process which creates heart disease may also contribute to ED but sooner and can often be an early indicator of heart disease.  In developing heart disease there is a process of hardening of the arteries (atherosclerosis) and constriction of blood vessels in the cardiovascular system which subsequently can contribute to ED as this process will interfere with the  blood flow to the penis which in turn is a major factor responsible for achieving an erection
  • High blood pressure - again, this is experienced in developing heart disease as the blood pressure rises in response to its forcing its way around the constricted vessels
  • Chronic kidney disease
  • Multiple sclerosis - ED in MS is related to the nerve damage in the central nervous system associated with Multiple Sclerosis
  • Parkinson’s disease -  ED is the most common sexual issue for men with Parkinson’s Disease.  The effects of the progressing disease, the side effects of Parkinson’s medication as well as the anxiety and depression often associated with Parkinson’s can reduce libido as well as affecting erections and orgasm.

Treating the depression may help with the ED but bear in mind that some antidepressant drugs can actually cause ED.

  • Peyronie's disease - in Peyronie's disease there is scar tissue which may cause pain during an erection and this, in turn, may lead to psychological issues leading to erectile dysfunction
  • Injury from treatments for prostate cancer - this includes radiation therapy as well as surgery
  • Injury to the spinal cord, penis, prostate gland, bladder or pelvis
  • Surgery for bladder cancer
  • Low levels of testosterone

There are a variety of medicines prescribed which can contribute to erectile dysfunction, some related to the other factors already contributing to the ED!

These include hypertension medication (treatment for high blood pressure), antidepressants and tranquillisers among others.  If you are suffering from ED it is advisable to consult with your GP regarding any prescription medication you may be taking

 

Other factors

There are several other lifestyles and behavioural factors that may contribute to the erectile dysfunction:-

  • Smoking - this can contribute to the narrowing of blood vessels and so will interfere with the blood supply to the penis
  • Drinking too much alcohol - they call it ‘brewer’s droop’ for a reason!
  • Using illegal drugs
  • Being overweight
  • Not taking regular exercise

 

Treatment for erectile dysfunction

For the psychological problems which may be causing the erectile dysfunction, we can consider individual counselling or counselling with your partner.

It may be that your doctor would advise sex counselling.

For physical problems that may be associated with the ED, the initial approach would be to treat any underlying conditions that may be causing the ED, for instance, hypertension, high levels of cholesterol or diabetes.

Aside from this, there are medications specifically designed to manage the symptoms of ED.  There are several types around and it may be that you need to try different types and different doses before you find one that suits you.

These oral medications encourage better blood flow into the penis to aid erection;  they are known as PDE inhibitors and brands such as Stendra (avanafil), Viagra (sildenafil). Cialis (tadalafil and Levitra (vardenafil) are amongst them.

 

Sources

Erectile Dysfunction (Impotence) https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/

Everything you need to know about erectile dysfunction (ED) https://www.healthline.com/health/erectile-dysfunction

What is erectile dysfunction https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction(ed)

Symptoms and Causes of Erectile Dysfunction https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes

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