Erectile Dysfunction, Causative Factors and Complications

Erectile dysfunction (ED) is a condition that prevents men from getting or keeping a firm erection necessary for sexual activities. It is a very common sexual problem in men, affecting approximately 30 million men worldwide.

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Image Credit: Good Luck Photo / Shutterstock
Image Credit: Good Luck Photo / Shutterstock

What is erectile dysfunction?

Erectile dysfunction is a problem related to male sexual arousal, which is controlled by a variety of physiological processes including neurological, endocrine, emotional, muscular, and cardiovascular systems. Impairment in any of these systems can result in erectile dysfunction.

During sexual arousal, certain chemicals are released by nerve cells to increase blood flow into the penis, which subsequently increase the penile blood pressure, causing erection.

The most common reason of erectile dysfunction is lack of blood supply to the penis due to blockage in blood vessels or malfunctioning of the nervous system.

In addition, psychosomatic conditions (physical disorders aggravated by psychological conditions, such as stress or anxiety) are equally important causative factors for erectile dysfunction.

What are the common causative factors?

Having erectile dysfunction from time to time is not necessarily a matter of concern; however, a medical assistance is essential if the erection problems worsen gradually with time or happen frequently during sexual activity.

Premature ejaculation, which is the inability to maintain prolonged erection, is a major form of erectile dysfunction. It mostly occurs due to stress or performance anxiety. If your partner is affected by depression, his erection can also be severely affected.

Certain diseases, such as cardiovascular disorders, obesity, Parkinson’s disease, multiple sclerosis, and Peyronie's disease, affect erection in men. A person with injuries/surgeries in the pelvic area or spinal cord can also suffer from erectile dysfunction. Other important causative factors are smoking, alcohol consumption, and lack of physical activity.

Men with diabetes often suffer from erectile dysfunction. The main reason is diabetes-induced hardening of the arteries or impairment of the nervous system that regulates erection. Certain medications that are used to treat blood pressure, anxiety, depression, sleep disorders, glaucoma, and cancer also increase the risk of developing erectile dysfunction.

Hormones play an important role in controlling erection. Any abnormality in the endocrine system, such as increased or decreased secretion of prolactin or thyroid hormones, can lead to erectile dysfunction.

In addition, hormonal therapies for enlarged prostate/prostate cancer or excessive steroid use by bodybuilders can cause erectile dysfunction. Sometimes, low testosterone level is also responsible for the situation.      

What are the common complications?

Erectile dysfunction can cause sexual dissatisfaction, which brings relationship problems and puts a man under stress, anxiety, embarrassment, and low self-esteem. These emotional conditions can in turn worsen erectile dysfunction.

If your partner suffers from erectile dysfunction and related emotional burdens, it is important to make him understand that the condition can be treated. Since many factors are involvement in the development of erectile dysfunction, doctors initially try to find out the underlying cause. Depending on the cause and severity of the condition, doctors then decide which treatment strategy to follow.

Most importantly, risk factors must be identified and eliminated (smoking, alcohol use) or properly treated (diabetes). Additionally, oral medicines are available that work by increasing nitric oxide release from the penile blood vessels in response to sexual stimulations.

Nitric oxide helps relax the penile muscles, increase blood flow, and facilitate erection. However, these medicines have some side-effects, including nasal congestion, headache, vision problems, stomach upset, backache, etc.

In some cases, a doctor may also prescribe your partner with medicines that expand blood vessels and increase blood flow to the penis. These medicines can be self-injected into the base or side of the penis through a fine needle. Each injection produces an erection that lasts for about an hour. These medicines can also be injected into the penis using urethral suppository. A small suppository is placed in the penile urethra with the help of an applicator. Possible side-effects include mild bleeding, prolonged erection, or fibrous tissue formation. Because of the risk of minor bleeding with injections, barrier protection (condoms) should be used during sex to prevent transmission of HIV and other bloodborne infections.

If medicines fail to induce erection, your partner may be treated with penis pump, which is a hollow tube attached to a pump. This device is used to create vacuum that pulls blood into the penis.

In case all the treatment strategies fail to work, a doctor may recommend surgical placement of penile implants (inflatable or bendable rods) into both sides of the penis. Although these implants come with high-degree of satisfaction, there is a risk of surgery-related infections.

Daily exercise, maintaining a healthy weight, refraining from smoking, and reducing alcohol consumption  should be priorities for all persons, but especially those with erectile dysfunction.

Further Reading

Last Updated: May 14, 2019

Dr. Sanchari Sinha Dutta

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.

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