Erectile Dysfunction (ED) is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.
Causes of ED can be either physical or psychological, or a combination of both. Certain medications, prescribed to treat other conditions can, in some cases, cause ED.
Physical problems leading to ED can be categorised in four ways: -
- Vasculogenic (vascular caused by reduced blood flow))
- Neurogenic (nerve related)
- Hormonal (eg) lack of tesosterone
- Anatomical (eg) due to shape of penis
- Vasculogenic (ie) reduced blood flow
Conditions of this type affect the blood flow to the penis (70% of physical related causes). Causes include:
Cardiovascular Disease (CVD) –As the blood vessels in the penis are a lot smaller than the blood vessels elsewhere in the body, they are often affected first. Having ED is often considered an early warning sign for cardiovascular disease.
Diabetes – Over 50% of men with diabetes will suffer from erection problems. This is due to circulation problems caused by diabetes thus reducing blood flow in the penis and nerve damage from prolonged incontrolled high blood glucose which disrupts nerve signals between the brain and penis.
High blood pressure – both treated and untreated high blood pressure can be a cause of ED
- Neurogenic (nerve related)
Conditions of this type relate to the brain and nervous system.
Multiple Sclerosis (MS) – a condition of the central nervous system that affects movement. ED is an often an overlooked common complication for MS sufferers.
Parkinson’s disease –like MS, sexual and erectile dysfunction is common in men with Parkinson’s. It is a symptom which may appear long before more recognised symptoms of the disease appear (eg.) Tremor, slowdown in movement.
Stroke – Whilst stroke in itself is rarely a cause of ED, stress and worry about resuming an active sex life post stroke is more likely to be the cause.
The primary hormone related to ED is Testosterone. As men get older, typically, testosterone levels drop. Reduced levels can reduce libido (sex drive), which in turn can have a direct effect on a man’s ability to achieve an erection.
Additionally, too much Cortisol produced by stress will also have a diminishing affect of Testosterone levels. Other related examples include thyroid hormone where either too much (hyperthyroidism) or too little (hypothyroidism) is produced. Other ED related hormone imbalances can come from Liver or Kidney disease. Simple blood tests by your GP can diagnose any of these hormone deficientcies and excesses and once diagnosed are easily treated.
Referring to the structure and function of the penis itself there are several conditions which can result in ED, two of which include Hypospadias (relates to the abnormal development of the male urethra which is duct where urine and semen is transferred) and Peyronie’s disease (a hard lump develops within the penile tissue due to injury leading to scarring. For more information on these two conditions check out my full ED article at www.whelehans.ie
To be continued....next week I discuss diagnosis and treatment
Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended