Sexual Dysfunction – Causes

What are the causes of sexual & erectile dysfunction?

Organic causes of sexual dysfunction

  • CP/CPPS inflammatory issues (the impact in SD/ED is 65-85%)

Physical causes of sexual dysfunction

  • Low testosterone levels
  • Prescription drugs (antidepressants, high blood pressure meds)
  • Blood vessel disorders such as atherosclerosis (hardening of the arteries) and high blood pressure
  • Nerve damage from diabetes or prostate surgery
  • Smoking
  • Alcoholism and drug abuse
  • Obesity

Psychological causes of sexual dysfunction

  • Concern about sexual performance
  • Marital or relationship problems
  • Depression, feelings of guilt
  • Effects of past sexual trauma
  • Work-related stress and anxiety

What causes erectile dysfunction (ED) in males?

A. Chronic Prostatitis

Chronic prostatitis is the main and most common cause for erectile dysfunction, as we have described in the dedicated section. The mechanisms by which prostatitis affect erections, blood flow in the penis etc. are complex, and therefore we have made a dedicated post about them.

B. Chronic Diseases

The link between chronic disease and erectile dysfunction is most striking for diabetes. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Yet evidence shows that good blood sugar control can minimize this risk.

Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis. All these aforementioned chronic diseases have serious impact on penile endothelial vasculopathy decreasing the blood flow and thus creating sclerotic lesions in cavernosal tissue and erection nerve damaging which impairs nerve impulses throughout the penile shaft.

C. Lifestyle                                                             

Lifestyle choices that impair blood circulation can contribute to ED. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis particularly vulnerable to ED. Being overweight and getting too little exercise also contribute to ED.  Studies indicate that men who exercise regularly have a lower risk of ED.

Erectile Dysfunction - Georgiadis Urology

Figure 1: Smoking can be a major contributor to erectile or sexual dysfunction.

D. Surgery

Surgery, including treatments for prostate cancer, bladder cancer, or BPH can sometimes damage nerves and blood vessels near the penis. In some cases, the nerve damage is permanent, and the patient will require treatment (mostly intracavernosal injections with vasoactive agents) to achieve an erection in the time of sexual intercourse.

In others, surgery causes incomplete or temporary damages, resulting in ED/SD that may be gradually improved by long standing therapy after 12 to 18 months but sometimes more than two years.

E. Medication

ED may be a side effect of medication, including certain blood pressure drugs, antidepressants, and tranquilizers. Men should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems.

F. Psychological

ED usually has something physical behind it, particularly in older men. But psychological factors can be a factor in many cases of ED. Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.

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