Erectile Dysfunction 101 – Facts, Causes, and Management Options

Nelson Vergel

Founder, ExcelMale.com
Erectile dysfunction (also known more commonly as impotence or sexual dysfunction) is the inability to maintain a sufficiently rigid erection for a satisfying sexual experience.

According to the Global Survey of Sexual Attitudes and Behaviors, erectile dysfunction affects approximately 5-28% of men aged 40-80 years. The study was done on adults from 29 different countries.

This health issue has been clearly defined back in 1992, but it has been observed and recorded for thousands of years. The ancient Egyptians had papyrus drawings of sexual positions as well as remedies and cures for afflictions known as “weakness of the male member”.

Sexual dysfunction can be diagnosed by questionnaires or lab testing and there are numerous ways of managing and improving its symptoms.

Erectile dysfunction causes
This type of health problem can have multiple causes and the most common ones are:

  • Pharmacologic – caused by different types of medications such as antidepressants, analgesic narcotics, antiulcers, antihypertensives, etc. There are more than 200 medications which have been associated with sexual dysfunction and some of them decrease the testosterone levels which in turn lower erection rigidity, sex drive, etc.
  • Endocrinologic – this refers to testosterone deficiency and hypogonadism. Testosterone replacement therapy might help in this case. Diabetes is a disease which might be linked to ED because it causes damage to the microvasculature of the body as well as the nervous system.
  • Neurogenic – caused by aging or neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease. Neurogenic causes refer to damages to the nervous system and can include strokes, injuries to spinal cord, etc. These health problems can severely affect erection quality regardless of age.
  • Vasculogenic – affections such as arteriosclerosis, high blood pressure, high triglyceride levels can also cause erectile dysfunction. Men with blood pressure higher than 130/85, a body mass index over 30 as well as triglycerides over 150 mg/dL are at risk of developing ED at some point in the future.
  • Psychogenic – this refers to improper stress management, feelings of guilt, shame, depression, anxiety, lack of self-confidence, internal sexual conflict, etc. Men who have very stressful lives are more likely to have weak erections as well as poor libido.
It is worth mentioning that unhealthy habits such as smoking, excessive alcohol consumption, and lack of exercise can drastically increase the likelihood of developing impotence for men of all ages.

Before treating ED, doctors first assess the health of the cardiovascular system (heart, veins, and arteries) to determine if it is healthy enough for proper sexual activity. A high cardiac risk might indicate that the patient needs treatment for a heart condition first, before receiving treatment for erectile dysfunction.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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