There are many causes of erectile dysfunction – it's a multifactorial disease that often arises due to the action of several circumstances. The patient himself can't always determine the specific moment with which he could associate the onset of the disorder, which significantly complicates differential diagnosis. The doctor needs to conduct a sufficiently large number of laboratory and instrumental examinations to exclude various pathologies.
What Causes Erectile Dysfunction in Men
The etiology of the disease can be briefly divided into several types:
- Organic – related to the pathology of any organ or system (cardiovascular, nervous, endocrine, etc.);
- Psychogenic – the disorder forms due to various mental disorders, frequent stressful situations, and other specific circumstances that affect the patient's personality;
- Mixed – includes both the impact of some somatic (organ) pathology and mental disorders that arose in the background of the disease.
The most common cause of erectile dysfunction is mixed, associated with some chronic process. This is due to the fact that any health disorder directly affects our moral well-being.
Risk Factors
Additionally, patients should be aware of risk factors that may evolve into conditions causing erectile dysfunction. Most often, these aspects are modifiable – if timely eliminated, the chance of developing the disease in the future can be greatly reduced.
1. Excessive body weight
Increased fat tissue affects the state of erection in several ways.
Firstly, it is a source of estrogens (female sex hormones) – that's why its percentage is naturally higher in women than in men. However, while estrogen is a normal hormone for women, its excessive amount in men suppresses testosterone synthesis and leads to visual "feminization": the appearance of gynecomastia (enlargement of the mammary glands), reduced hair growth, and decreased erectile function.
Secondly, an increase in lipids in the subcutaneous fat tissue also leads to their increase in the blood. Over time, they begin to deposit in the vascular wall, forming atherosclerotic plaques. These, in turn, block the lumen of the arteries and lead to ischemia of the underlying parts (specifically – the muscles of the penis). Also, blocked vessels increase blood pressure, requiring the heart to contract more strongly to supply blood through the artery occluded by the plaque. As a result – the formation of arterial hypertension, also a cause of erectile dysfunction.
Thirdly, excess weight exerts increased pressure on the lower part of the body, making it more difficult for a person to move, leading to a preference for sitting more to relieve leg fatigue. This leads to a sedentary lifestyle with all its ensuing complications.
2. Sedentary lifestyle
Hypodynamia (low mobility) can occur due to obesity, as well as without it, due to a person's reluctance to engage in physical activity or high fatigue at work. However, predominantly sedentary or standing work leads to the development of unpleasant diseases.
Firstly, to varicose veins enlargement. Veins begin to pathologically change, stretch, and their lumen expands. As a result, the valve apparatus stops working – venous walls have insufficient muscle fibers to maintain tone, and blood in them moves due to tight closure of the valves. If the valves start to let blood back, it begins to accumulate in the lower parts of the body. While the disease only affects the legs, it does not affect erection, but in the future, it can potentially lead to venous leakage from the erected penis – resulting in lost erection.
Secondly, to hemorrhoids. Hemorrhoids are the same varicose vein enlargement, but of the rectum. It is located close to the veins of the genital organs, so in this case, the pathology can spread faster than from the lower limbs.
Thirdly, without sufficient physical activity, excess body weight quickly accumulates, forming a pathological vicious circle.
3. Smoking
The entry of nicotine into the body leads to a multitude of various changes. Due to chronic poisoning, testosterone levels decrease, vascular walls are damaged (arterial elasticity decreases, venous lumen increases), and the risk of malignant tumors increases. The inability to fill the cavernous bodies of the penis with blood and retain it there is a frequent cause of erectile dysfunction.
Given the widespread prevalence of this harmful habit, it is one of the most important modern problems leading to reproductive disorders and worsening the quality of sexual activity.
4. Alcohol abuse
Alcohol and erectile dysfunction are two interconnected aspects. In the first half-hour after consumption, ethyl alcohol indeed dilates blood vessels, facilitating the occurrence of an erection, and a slight euphoric effect increases arousal. However, this effect only lasts about half an hour – then there is the opposite constriction, even more forcefully than usual.
Moreover, due to long-term consumption of alcoholic beverages, the sensitivity of the genital organs decreases, the amount of testosterone decreases, and cerebral circulation is disturbed. Men who abuse ethanol are apathetic, prone to depressive states, and find it difficult to concentrate on pleasure. Some drinks additionally contain estrogens – which also lead to gynecomastia (enlargement of the mammary glands) and reduced sexual function.
5. Use of medicinal or narcotic substances
Medicinal and narcotic substances are chemical compounds that affect many complex physiological processes occurring in the human body. Often changes in, seemingly, an area unrelated to erection can lead to the development of temporary dysfunction. Among the drugs that cause erectile dysfunction:
- Antibacterial agents;
- Antidepressants;
- Psychotropic substances;
- Antihypertensive agents (for lowering pressure);
- Hormonal drugs – glucocorticosteroids, anabolics, hypoglycemic drugs.
Thus, the same diabetes mellitus is a cause of erectile dysfunction not only because of psychological aspects (shame due to an insulin pump, for example) or its action on blood vessels and nerves, but also because of taking hypoglycemic drugs. Its example clearly shows the mixed effect of various factors and causes on erection quality.
6. Disruption of the sleep-wake cycle
Can a lack of sleep cause erectile dysfunction? Definitely, yes – insufficient sleep and rest negatively affect the entire body, a person cannot concentrate, their attention is scattered, it is difficult to perform any work (both mental and physical). Due to fatigue, muscle weakness, and apathy, an adequate erection and completion of sexual intercourse become impossible.
Moreover, recent studies have determined that lack of sleep leads to a decrease in testosterone.
7. Age
Aging is a frequent cause of erectile dysfunction, which, unfortunately, cannot be avoided. One can quit smoking, using alcohol or drugs, but it's impossible to stop aging. It is a complex physiological process, during which there is a natural decrease in hormonal activity, muscle strength, and an increase in the frequency of chronic diseases of the genitourinary system (for example, prostatitis), depressive, neurological, cardiovascular, and other disorders.
Treatment of Erectile Dysfunction
If any risk factor has already affected the quality or duration of an erection, the patient, on the recommendation of a treating doctor, may use supporting medications, prostate stimulators, injections, or undergo penile prosthesis implantation.
One such stimulator is Erectonus. This is a special device that works by using electrical impulses. It is not a vibrator or massager in the direct sense of these words, more resembling a device for physiotherapeutic electrotherapy or electrophoresis. The waves it emits not only maintain the prostate and surrounding muscles in tone but also help cope with chronic inflammatory processes, as does any other physiotherapy.