Definition
Incidence
Risk Factors
Causes

• Psychological
  
• Vascular
  
• Hormonal
  
• Neurological
• Miscellaneous
• Drug Related

Causes of Erectile Dysfunction

Why does erectile dysfunction occur?
Until 10 years ago, it was believed that most sexual problems were psychological. We now know that physical abnormalities can be documented in 70% of cases. There are five areas in which problems can occur.

As you can see, there are many factors which can contribute to erectile dysfunction. The more factors you affected by, the higher the risk of erectile difficulty. Also keep in mind that erectile dysfunction is more related to health than to age.

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Psychological

Psychological aspects of erectile dysfunction include marital (relationship) problems, depression and stress. The resulting anxiety causes the release of adrenaline which cuts off blood flow to the penis causing the loss of an erection.

• performance anxiety (this is the most common psychological cause of erectile dysfunction);
• marital problems;
• depression;
• stress (job, family, financial);
• chronic pain;
• sexual abuse;
• Widower's syndrome (this involves performance anxiety);
• guilt; or fear (of catching a sexually-transmitted disease; of unwanted pregnancy; of failure).
• mental illness (eg. Manic Depression, Schizophrenia)

Vascular

The most common cause of erectile dysfunction is impaired blood flow either into or out of the penis. Hardening of the arteries, for example, reduces blood flow into the penis at the time of stimulation. Venous leak, which results in blood not being trapped in the penis, also can contribute to difficulty maintaining an erection. Factors that can impede blood flow include:

• smoking;
• diabetes;
• hardening of the arteries (athersclerosis);
• venous leak;
• abdominal aneurysm/aneurysm repair surgery;
• penile injury (fractured penis);
• pelvic steal syndrome (poor blood flow);
• injury to penile arteries (bicycle seat, motor vehicle accident)

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Hormonal

An imbalance of hormones such as testosterone, thyroid, or prolactin can alter your body's response to sexual stimuli, usually inhibiting a response.

• low testosterone;
• liver, kidney, thyroid problems;
• high levels of prolactin, a hormone produced by the pituitary gland.

Neurological

Nerve damage from neurological disorders such as diabetes and stroke affect the brain's ability to respond to sexual stimulation.

• diabetes;
• stroke;
• multiple sclerosis;
• Parkinson's;
• injury (head, back, groin);
• major surgery (bowel, prostate, bladder);
• alcohol abuse;

Radical Prostatectomy (removal of the prostate because of prostate cancer) can often cause erectile dysfunction. Although function may spontaneously improve, for the best result, we recommend starting some treatment as soon as the couple is ready for sexual activity after the operation.

Miscellaneous

Other causes of erectile dysfunction include:

• alcohol abuse;
• medication;
• high cholesterol;
• Peyronnie's disease; and
• prolonged, painful erection (priapism).

Hypertension medication, tranquilizers, anti-depressants, seizure medication and anti-inflammatory medication can all interfere with sexual function.

Peyronie's disease, an inflammatory condition which produces scarring within the shaft of the penis, causing it to curve or bend, can also contribute to erectile dysfunction. Priapism, or prolonged, painful erection, can permanently damage the spongy erectile tissue and result in erectile dysfunction.

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Drug Related

Medicine can also interfere with erectile activity. Here's just a few:

Drugs That May Affect Sexual Function
Alcohol Antihistimines Amphetamines Antiandrogens Antidepressants Atropine Barbiturates Chlordiazepoxide Chlorprothixene Cimetidine Clofibrate Clonidine Cocaine Decongestants Digitalis Diazepam Guanethidine	Heroin Imipramine Marijuana Methantheline bromide Methaqualone Methyldopa Monoamine oxidase inhibitor Morphine Nicotine Phenothiazines Psychadelics (LSD) Propranolol Reserpine Spironolacrone Thiazide diuretics Thioridazine

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