Historically, when an individual
consulted his physician concerning ED he was usually informed there were
no known physiological answers concerning his condition. Today, a
generation of research has resulted in significant advances in both the
diagnosis and treatment of ED. Physicians now understand that
approximately eighty-five percent of ED is attributable to
physical/organic conditions while only fifteen percent is due to
psychological or mixed origin (both psychological and organic). Some
important causes of physiological ED are as follows:
Vascular Disease is the leading cause of ED. Vascular
disorders including arteriosclerosis (hardening of the arteries),
hypertension, hypercholestremia and other conditions which interfere
with the blood flow to the penis. Additionally, "venous leakage"
also contributes to poor erections. This condition occurs when the
penile veins are unable to constrict efficiently during an erection.
When these veins "leak" blood escapes to the periphery
resulting in a poor erection
Diabetes is another common cause of ED. Approximately
fifty percent of men with diabetes (insulin dependent) experience some
degree of ED after the age of fifty-five. Diabetes results in poor
circulation and/or peripheral neuropathy. When the nerves are involved
sexual stimuli are not transmitted appropriately to or from the brain
and ED develops.
Prescription medications often cause ED as a side
effect. Some two hundred known medications fall into this category
including :-
- Antihypertensives medications significantly
- Beta-blockers e.g. Atenolol, Propanolol and Tenorium.
- Diuretics medications e.g. HydroDiuril and Lasix.
- Ace Inhibitors/Calcium Channel Blockers medications e.g.
Vasotec, Lotension, Cardizem, Norvasc periodically cause ED,
however, they are generally represent an excellent alternative
medication for individuals with drug induced ED.
- Antidepressant/Antipsychotic medications of almost any label can
also result in ED e.g. Prozac, Elavil, Zoloft, Thorazine, Haldol.
Note: Many other medications in a variety of classes can
periodically cause ED. If you are taking a prescription medication
or over-the-counter medication, regularly, please consult with your
physician. However, never alter a dosage or discontinue a medication
without the advice of your physician.
- LH-RH Analogs/Antiandrogen medications e.g. Lupron Depot®,
Eulexin, Nilandron®, Casodex®, etc. These medications are
used in the treatment of prostate cancer. They function by
decreasing the production of testosterone in the testes and adrennal
glands. The decrease in testosterone often results in ED.
- Chemotherapy/Radiation therapy are also significant contributors
to ED. These drugs/treatments are used in the treatment of cancer.
Substance Abuse can also negatively effect male
potency. The chronic use of cocaine, marijuana, alcohol, steroids etc.
often results in ED, as well as a decrease in desire. Excessive tobacco
use can also attribute to ED by accentuating the effects of other risk
factor such as vascular disease or hypertension.
Radical Pelvic Surgery also result in ED. Surgical
procedures involving the prostate gland, bladder or colon may interfere
with the nerves involved in the erectile response. Radiation therapy for
cancer may also effect the erectile process.
Neurological Diseases such as multiple sclerosis,
Parkinson's disease, spinal cord injuries, long term effects of diabetes
can also result in the disruption of the normal sequence of events
necessary for an erection to occur.
Deficiencies in the Endocrine System are another
source of ED. Low levels of testosterone or thyroid hormone can
interfere with the stimulation process necessary in the erection
sequence. Excessive production of prolactin by the pituitary gland may
contribute to decreased levels of testosterone resulting in a lack of
desire. Diabetes once again enters the scenario as it is classified as
an endocrine disorder.
Psychological ED is usually diagnosed when no physical
causes can be defined. Pure psychological ED usually occurs suddenly
without warning as opposed to physical ED that may gradually develop
over years. Some common causes of psychological ED are as follows :-
- Performance anxiety is one of the most common causes of
psychological ED. When a man feels pressured to achieve or maintain
an erection, he will commonly become anxious and nervous when in a
sexually demanding situation. Stress increases the body's production
of catecholamines such as adrenaline and nor- adrenaline, which act
as erection inhibitors. The release of these inhibitors further
contributes to failure resulting in more anxiety. Therefore, the
cycle begins, increased stress resulting in increased catecholomines
that further inhibits the erectile process.
- · Depression is another cause of psychogenic ED.
Unfortunately, many of the popular antidepressant medications (for a
list see prescription medications in the next section) have side
effects which include erectile failure.
Anatomical Deviation of the Penis, Peyronies
Disease, may also cause ED. This condition usually develops from an
inflammatory process and results in fibrous scaring of the penis. (The
cause of this process is not yet understood) However, when an erection
does occur, there is a bending of the penis secondary to the scar
tissue. This curvature may interfere with erectile capacity and/or
ejaculation.
