Causes of Erectile Dysfunction
Psychological Reasons for Erectile Dysfunction
Psychogenic erectile dysfunction is caused by various psychological disorders. Psychological disorders can be both the main cause of the ailment, and secondary. They are treated by methods of psychotherapy under the guidance of psychotherapists.
Organic Causes of Erectile Dysfunction
- Endocrine disorders (violation of the level of sex hormones (hypogonadism), diabetes mellitus, thyroid dysfunction, etc.).
Vascular system damage. Vascular erectile dysfunction can be based on factors such as arterial insufficiency of penis and disorder of venous outflow of the penis. Arterial insufficiency of the penis consists of insufficient arterial blood flow to cavernous tissue of the penis. Causes of arterial insufficiency of the penis are manifold:
- congenital defects of arteries of the penis;
- atherosclerotic lesion of the aorta;
- defeat blood vessels of the penis on the background of diabetes;
- elevated blood cholesterol (hypercholesterolemia);
- hypertonic disease;
- injuries of the perineum, posttraumatic disorders of patency of arteries of the small pelvis.
Disorders of venous outflow of penis occur in about a third of patients with impaired erectile function. Venous insufficiency includes venous leakage and venous-occlusive dysfunction.
The problem of venous insufficiency consists of the premature discharge of blood through venous systems of the penis, as a result of which prolonged maintenance of erection becomes impossible.
With venous occlusive dysfunction, as a rule, it is difficult to achieve an erection and it is even more difficult to keep it for a sufficient amount of time.
Organic changes in the penis (“cavernous” erectile dysfunction). Main reasons:
- Peyronie’s disease;
- the consequence of intracavernous injection – the introduction of drugs in the cavernous body of the penis.
- Neurological disorders. Causes of the disease may be diseases of the neurological sphere (for example, diabetes), as well as consequences of previous surgeries on rectum, prostate, bladder.
- The consequence of taking medications. Common medications that negatively affect sexual function include: antidepressants, psychotropic tranquilizers, antihypertensive drugs.
Mixed Causes of Erectile Dysfunction
They have both psychogenic and organic nature. In most cases, erectile dysfunction has a mixed nature, because organic problems tend to provoke psychogenic disorders, and on the contrary, psychological pathologies tend to cause various changes in physiological aspect (for example, depression provokes the development of androgen deficiency).
Proved risk factors for the development of erectile dysfunction:
|Disorder||Risk of ED|
|Ischemic heart disease||39%|
|Heart diseases and smoking||56%|
Diagnostic Minimum for Erectile Dysfunction
- total testosterone;
- blood sugar;
- lipid spectrum.
Anatomy and Physiology of Penis
The penis consists of a spongy body and 2 cavernous ones. Cavernous bodies are located at the top and along the entire length of the penis, the spongy body is directly below them. The blood supply to each of the bodies is autonomous – they are completely isolated from each other. Both cavernous and spongy bodies consist of lacunae and resemble a sponge.
In case of sexual excitement, the brain sends an appropriate signal to nerve cells of penis vessels. This leads to rapid and prolonged expansion of arteries, narrowing of veins and filling the lacuna with blood. Thus, the increase of penis size and its erection appear due to the accumulation and stagnation of blood in cavernous and spongy bodies.
Treatment of Erectile Dysfunction
If problems in the intimate sphere arise due to organic disturbances, then only elimination of the cause can help. In the case of the development of chronic diseases, the patient is recommended to undergo the course of preventive therapy of underlying disease at least twice a year.
When the cause of erectile dysfunction is vascular disorders in the penis, one of the methods of therapy is surgery on vessels of this organ. The purpose of intervention is to increase flow of blood and reduce outflow. According to Express Pharmacy data, the effectiveness of the method is 20 – 80%.
In absence of effect of therapy of pathology that caused erectile dysfunction, and surgery on vessels, it is possible to carry out endoprosthesis replacement of male’s genital organ. Unfortunately, there are serious disadvantages to this method of treatment:
- irreversibility: cavernous and spongy bodies are removed and without a prosthesis, a man can not live sexually;
- development of inflammatory processes or rejection of implants;
- damage of prosthesis;
- the high cost of surgery.