Urology-Online

Causes of Erectile Dysfunction

Synonyms

Erectile dysfunction, impotence,
medical: Erectile dysfunction (ED)

The causes of the Erectile dysfunction lie in the various systems that contribute to a man's ability to have erections. So there is a psychological, vascular-related (vascular), the Nervous system concerned (neurogenic), hormonal or even the small ones Muscles concerned (myogenicErectile dysfunction. For many men, however, the condition is made up of several of these factors. Also Medication can cause erectile dysfunction.

1. Psychogenic erectile dysfunction:

Just as a suitable stimulation of the psyche, for example through images or thoughts, can cause an erection, another mental stimulus can also block or interrupt it.

causes: Especially feelings like fearBe it before the failure towards the woman, or triggered by early childhood experiences, upbringing or trauma, can severely limit or completely prevent a man's erectile function.

Epidemiology: About 40% of erectile dysfunction are psychological.

Symptoms: The more or less subconscious fears described here lead to a so-called primary disorder that lasts for a long time, while problems within the respective situation or partnership trigger a mostly acute, secondary disorder that only relates to the current situation. This is often caused by other sexual disorders, such as Loss of libido (Loss of sexual pleasure) or an ejaculation disorder (Ejaculation disorder), accompanied.

Thus, the psychogenic erectile dysfunction is to be regarded as a symptom of a deeper, psychological problem. Therapy must therefore also start here.

2. Vascular erectile dysfunction:

This is where the blood vessels of the penis are affected. If they can no longer fulfill their function more or less well, erectile dysfunction occurs.

causes: A basic distinction is made between arterial (affecting blood flow) and venous (affecting blood flow) Disorder. An arterial disorder can be caused by the following factors: lipid metabolism disorders, smoking, high blood pressure or Diabetes mellitus. This gives rise to the classic risk factors for hardening of the arteries (arteriosclerosis), which can also affect the fine vessels of the penis and its erectile tissue. If these are calcified, less blood can flow through them into the erectile tissue. Their diameter is also less easy to expand, resulting in erectile dysfunction.
Other causes of impaired function of the arteries can also be injuries to the arteries caused by operations or accidents. Venous outflow disorders can also have several underlying causes.
One of them is the innate existence of additional (ectopic) Veins in the erectile tissue. If there are more veins, more blood will drain off and there will no longer be enough build-up in the erectile tissue to enable an erection. Is the Musculature The structure of the erectile tissue changes, for example through the accumulation of connective tissue, so it loses its ability to relax, which is an essential prerequisite for filling the erectile tissue and compressing the veins. This is usually caused by a previous arterial disorder, as this means that the muscle cells are no longer adequately nourished and are converted into connective tissue.
The erectile tissue muscles can not only bemorphologically), but also functionally changed. Here the process of signal transmission is disturbed, which leads to relaxation. However, the consequences are the same as just described.
Another factor that leads to a venous outflow disorder is a pathological connection of the cavernous veins with those of the surrounding penile tissue or the glans. If this is the case, an excessive amount of blood flows out of the erectile tissue in this way, which leads to erectile dysfunction.
If the connective tissue covering (fascia) that surrounds the erectile tissue, the so-called tunica albuginea, is damaged, this also leads to a venous erectile dysfunction, since the erectile tissue cannot fill up enough to prevent drainage via the veins.

Epidemiology: Arterial vascular restrictions make about 50 – 80% all organically caused erectile dysfunction. It is worth noting here that studies have shown that there is a large correlation between the incidence of erectile dysfunction and the number of sclerosed coronary arteries. With regard to multivascular diseases of the Cardiovascular system were here 2/3 of patients affected by erectile dysfunction; at 70% from them the erectile dysfunction even went the symptoms of the Coronary heart disease ahead.

Symptoms: Typical of vascular-related erectile dysfunction that affects the arteries is a delayed and / or slowed erection, which can be weak or even complete. This erectile dysfunction is of course independent of the partner. Furthermore, the disorder does not start suddenly, but rather develops slowly and increases in severity.

A venous erectile dysfunction is shown by the symptoms of an erection that occurs quickly, which, however, subsides after a few minutes, i.e. cannot be maintained. If there are additional veins in the penis, this is usually since birth the case. This erectile dysfunction does not develop slowly, but is present from the beginning and is usually discovered by men during puberty.
If the problem is mixed, i.e. if both arteries and veins are affected in some way, then in moderate cases a slowed erection occurs, which only lasts for a short time and / or does not develop completely.

3. Endocrine (hormonal) erectile dysfunction

causes: The influence of male hormones (Androgens) on the erection mechanism is not yet fully understood. The male sex hormone testosterone apparently plays a role here. It has been found that erectile dysfunction can occur in men with low testosterone levels. This can happen with the so-called Hypogonadism (Underactive gonads) may be the case, but testosterone levels also decrease with age. Also become rarer with one Thyroid hyperfunction or underactive erectile dysfunction observed.

Symptoms: If there is a testosterone deficiency, there are mainly decreased nocturnal erections. However, it can still be triggered by visual stimulation with images. However, the erection is not sufficient for sexual intercourse.

Often times, the endocrine-disrupted erectile dysfunction is also associated with one Loss of libido (Loss of sexual desire) and a reduced semen production.

4. Neurogenic (by the nervous system) caused erectile dysfunction

Both for the recording of stimuli, be it via the eyes in the form of pictures or via the skin Our nervous system is responsible for touching it, as well as for its processing, interconnection and transmission. To trigger an erection, functioning nerve fibers are therefore essential.

causes: One cause of neurogenic erectile dysfunction can be damage to the Backmarks be. This is where the nerve tracts run between the brain and communicate with the genital organs. A Paraplegia, a tumor or vascular damage can be responsible for it.
A common cause of neurogenic erectile dysfunction is damage to the Pudendal nervewho are at a radical prostate Removal is difficult to avoid in prostate cancer.
In addition to bleeding, impotence is the greatest risk with such an operation.
There are also numerous diseases that damage the central or peripheral nervous system. Example would be the Polyneuropathy, of the Parkinson's disease, the multiple sclerosis or the Alzheimer's disease. A tumor or hemorrhage in the brain can also paralyze the areas that must be intact for erectile function.

Symptoms: They differ depending on the location of the nerve damage. If a man is paralyzed from the thoracic or lumbar vertebrae downwards, the psychogenic erection no longer works, but the reflexively triggerable erectile function is retained.
Exactly the opposite is the case if the lesion is in the spinal cord below the second sacral vertebra (S2) is located. Then the potency that can be triggered by thoughts is retained, but the reflex path for the reflex erection is interrupted and thus it is paralyzed.
In the case of neurodegenerative diseases as well as tumors or bleeding, the symptoms depend on the location and degree of nerve damage.

5. Drug-related erectile dysfunction:

The use of various medications can cause impotence as a side effect. The most important are listed below:

Cardiovascular drugs: Antihypertensive drugs (Antihypertensive drugs), Diuretics (Dehydration drugs)

Hormone therapeutics: Antiandrogens (Drugs that lower testosterone levels)

Psychotropic drugs: Antidepressants, Neuroleptics (Drugs for psychosis), Sedatives (tranquilizers), hypnotics (Sleeping pills), Anti-epileptic drugs