Erectile Dysfunction: Causes
The other day we began a series on erectile dysfunction (EF); a condition which affects millions of men in the US alone, and I tried to give the topic a personal perspective by sharing my own experiences with ED. Today I would like to take a closer look at the major causes of ED.
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health problems can cause or worsen erectile dysfunction. Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical problem that slows your sexual response may cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
The major physical causes of ED are:
- Diabetes: This chronic disease can damage the nerves and blood vessels that aid in getting an erection. When the disease has not been well controlled over time, it can double a man’s risk of erection problems.
- Kidney disease: Kidney disease can affect many of the things you need for a healthy erection, including your hormones, blood flow to your penis, and parts of your nervous system. It can also sap your energy level and rob you of your sex drive. Drugs for kidney disease can also cause ED.
- Neurological (nerve and brain) disorders: You can’t get an erection without help from your nervous system, and diseases that disrupt signals between your brain and your penis can lead to ED
- Blood vessel diseases: Vascular diseases can block the blood vessels. That slows the flow of blood to the penis, making an erection difficult to get. Atherosclerosis (hardening of the arteries), high blood pressure, and high cholesterol are among the most common causes of ED.
- Prostate cancer: Prostate cancer doesn’t cause ED, but treatments can lead to temporary or permanent erectile dysfunction.
The physical causes of ED are not only disease-related. There are many other potential causes, including:
- Surgery: Surgery for both prostate cancer and bladder cancer can damage nerves and tissues necessary for an erection. Sometimes the problem clears up, usually within 6 to 18 months. But the damage can also be permanent. If that happens, treatments exist to help restore your ability to have an erection.
- Injury: Injuries to the pelvis, bladder, spinal cord, and penis that require surgery also can cause ED.
- Hormone problems: Testosterone and other hormones fuel a man’s sex drive, and an imbalance can throw off his interest in sex. Causes include pituitary gland tumors, kidney and liver disease, depression, and hormone treatment of prostate cancer.
- Venous leak: To keep an erection, the blood that flows into your penis must stay in your penis. If it flows back out too quickly — a condition called venous leak, in which the veins in your penis don’t constrict properly — you will lose your erection. Both injuries and disease can cause venous leak.
- Tobacco, alcohol, or drug use: All three can damage your blood vessels. That makes it difficult for blood to reach the penis, which is essential for an erection. If you have hardened arteries (arteriosclerosis), smoking will dramatically raise your risk of ED.
- Prescription drugs: There are more than 200 prescription drugs that can cause ED.
- Prostate enlargement: Prostate enlargement, a normal part of aging for many men, may also play a role in ED.
In addition to physical/medical causes of ED, psychological issues can also contribute to ED. It is widely said that the brain is the body’s largest erogenous zone, so it stands to reason that how we think can play a big role in ED. Following are some psychological factors that can contribute to ED:
- Stress: Stress can be job-related, money-related, or the result of marital problems, among other factors.
- Anxiety: Once a man experiences ED, he may become overly worried that the problem will happen again. This can lead to “performance anxiety,” or a fear of sexual failure, and consistently lead to ED.
- Guilt: A man may feel guilty that he is not satisfying his partner.
- Depression: A common cause of ED, depression affects a person physically and psychologically. Depression can cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED
- Low self-esteem: This can be due to prior episodes of ED (thus a feeling of inadequacy) or can be the result of other issues unrelated to sexual performance.
- Indifference: This may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple’s relationship.
The good news is that there are a wide and growing variety of treatments for ED (including Clinical Hypnotherapy which has been shown to be extremely effective in treating ED; but I’m getting ahead of myself). Please come back tomorrow when we look at the most common treatments for ED.In the meantime, I hope you have an intentionally great and stimulating day.